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Highmark BCBS out-of-pocket costs

Hey guys, i'm about 2 months before surgery and i'm nearly done with all my insurance and surgeon requirements: as per insurance i have had to complete 6 monthly PCP visits, 1 psych visit, structured nutrition plan as overseen by my PCP/surgeon. As per my surgeon i have had to have, 2 chest x-rays, bloodwork, EGD, sleep study (was then diagnosed with sleep apnea), 1 psych visit, EKG. My question and what i've been worried about is payment after all is said and done, i have a balance of $600 after my sleep study i am to pay (after insurance) :( which i'm signing up for an FSA through my employer to pay for these costs, i'm just not sure how much to put on my FSA or credit card they give me, at the first of the new year (2017). Anyone have any idea how much i should estimate for total surgery, one co-pays are made? Just the hospital stay and surgery itself (plus the sleep study cost). I checked out the cost estimator on Highmark's website and it was no help to me at all. Help please!?

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The HSA can't be used retroactively, FYI. You must incur the costs in 2017 in order to use 2017 funds. My plan has a carryover of $500, so in theory, I could use $500 of 2016 money in 2017, but not vice versa. The max contribution for someone with just themself on the insurance plan is 2,550. It's what I contributed in 2016, and it was all used up by June, sadly.

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I'll be honest, i don't know a lot about the HSA/FSA my plan also has a carryover of $500. Any advice you can offer on it would be helpful. I'm applying or getting the account for the next year, as in 2017 which will be the same year as my surgery so nothing will be in 2016.

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@girlhasnofluff i sent you a pm

  • 5 months later...

I have Highmark of Delaware and I'm having a similar question. My coinsurance max out of pocket is $500. But there's also a "total max out of pocket" that's like $7k. According to the Highmark glossary, the coinsurance counts towards meeting the total out of pocket costs of $7k. What ridiculous terminology! Did you guys pay anything near $7k?

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