BCBS FED

[Nikki44 5]

How much did you pay for surgery? I've met my deductible but can't figure out exactly what I'm going to owe and when (I know the 85/15% but am still confused). Thanks!

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[thprice79 20]

I have bcbs fed, and the insurance specialist at the surgeons office told me that it will be covered 100%, and I will just have to pay copays, which amount to 500. But it also depends on how much overweight you were going in, and if you had pre existing conditions. A lot of variables come into play. I would call the insurance specialist at your docs office and inquire about it.

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[Nikki44 5]

Thanks a bunch. Was it covered at 100% bc you've met your deductible? I called the program insurance coordinator and they referred me to BCBS, which referred me back to the office, lol. It's a huge hospital system, so I'll just have to spend some time drilling down this week and figure it out.

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[thprice79 20]

Sorry to hear of the frustrations! Mine was covered because I fit into the morbidly obese category. I'm 5'6 and was 275. I'm down to 239 at 4 weeks out . I had high blood pressure and on meds, have sleep apnea and on CPAP, I had a hernia, and was borderline diabetic. I can't wait to be healthier and hopefully not need the meds or CPAP after awhile.

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[Nikki44 5]

That's fantastic!!! So happy for you. I fall into that category as well (5'1, 240) and have all of those same things except the hernia. Thx for the info and keep up the great work. Imagine how amazing you'll feel (and me too) in three months...six months...a year. Woo hoo!!!!

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[jwinters19 124]

I don't have bcbs but I do have a federal plan. I suggest going to the website and reading your plans booklet. Mine gave bariatric surgery its own section. I also had to use it several times to correct the hospital insurance specialists, as they were given wrong information by my insurance several times.

I would assume, if it's covered, you might pay the 15%. My plan is 5/95 once I meet my deductible and so I paid 5% of hospital and surgeons fees.

Biggest take away: research on your own instead of relying on info from reps! Doing that saved me the hassle of paying (and presumably getting a refund of) 3,000 extra!

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[vamping 183]

Do you have Basic or Standard?

[kwatasia 3]

I would love to know also I have BCBS FED BASIC

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[vamping 183]

@@kwatasia Basic should just be the surgeon and hospital (or surgical center) copays. Anestheisa is 100% covered on Basic so no extra there. I have a secondary payer so I had to look it up. I am not sure if it's 100% paid if it is a center of excellence or not.

From the FEP Blue site for Basic:

Hospital Care

Inpatient: $175 per day; up to $875 per admission
Outpatient: $1001 per day per facility

Surgical care

$1501 in an office setting
$2001 in a non-office setting

https://www.fepblue.org/en/benefit-plans/compare-plans/

[kwatasia 3]

Thank you @@vamping the surgeon and hospital same fee?

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[vamping 183]

@@kwatasia I believe so but you'd have to check the site. Sorry about the 1 at the end of a few of those numbers. It should be a small "1" as it is a reference within the brochure. I now have a secondary payer that picks up my co-pays so I'm not sure what the exact fee was for mine, but I know with past surgeries the co-pay to the facility and the surgeon was the same price for me. I've had Basic for almost 20 years.