hello i was wondering if anyone has had surgury with them as your insurer. I was wondering what the co-pay is for it. Some places i have seen says $250...others i don't know. Anyone know?

Hi,

Unless you're self insured rather than through an employer, it's a misconception that a particular insurance company sets the payments and co-pays; those decisions are made by the employer when they enter into a contract with the insurance companies, so that co-pay could be different for most people. My particular copay with REgence Blue Cross Blue Shield is 15% - but only up to a maximum of $1000 per year - again this was a decision made by the employer. If your insurance is through your employer, they should have a benefits book which would explain your particular insurance plan.

yeah...my husband put me on his insurence...he has had this ins. for 9 years. So i don't know. Although if i call could they tell me? i mean on my ins. card it says office visit 25 er 100 and medical health 25 that is it.

Yes they should be able to answer your questions - they may even have the insurance information on-line. Ask for the benefits department - is it a large company he works for ?

um...i think that there are 30-40 people who work there...maybe a little more.

i can call them tommorow...perhaps i will call the dr. first, to see if any news. How long does it take for the insu. to get back to see if you are approved?

This is my wifes account but I have questions and answers... not many answers yet. hehe About the insurance I have the same insurance, 'Blue Cross Blue Sheild', I also thought that it would be no problem getting approved. I work for Autozone, I thought that my wife would get approved... that was a big NO! What it really deals with is your husbands employer. They made a contract with the insurance company, so their are a whole lot of things that are missing in the benifits the that the company provide. Blue Cross may offer more options and better plans that would be better suited for each situation. I hope that this helps out. This would be our first post. :crying:

I did talk to my dr. and we have been..well ...i have been waiting for a year to have bcbs approve my hospital to do LBS. (which has been approved, in june although the dr. had been doing it for years at his other office) (oh that is funny...lap band surgury....pounds (LBS)...sorry it is late) So you are saying that it depends on the company he works for? I know that we pay up the wazoo for my insurence. The company pays for his. We pay 100 a week for mine..well ok 85 a week for mine (feels like 100). So if we pay all that...then that means it is justified right? lol...jk. Ok...should i talk to the people at his work then? or what?

Hi:

You should call the phone number on your blue cross card and ask them. Each employer designs their plan with bcbs. It's kind of like a car - comes with many different options to chose from. Each employer negotiates with bcbs to get the best benefits for their dollar. So, give the number on your card a call.

My bcbs copayment for the surgery was $500 because it was an overnight hospital stay. However, when I had day surgery it was only $250. If the money is a big problem, ask your doctor if day surgery is a possibility as long as you have good support at home.

Best wishes to you with your lap band journey. I love my band and how it's helped me to become a better me.

Take care.

Sue

I had surgery with Bc/BS as my insurance co and I didn't have to pay a penny!! Good luck to you!

My co-pay was $1200 for the hospital, $100 for the surgeon.

Hi,

Unless you're self insured rather than through an employer, it's a misconception that a particular insurance company sets the payments and co-pays; those decisions are made by the employer when they enter into a contract with the insurance companies, so that co-pay could be different for most people. My particular copay with REgence Blue Cross Blue Shield is 15% - but only up to a maximum of $1000 per year - again this was a decision made by the employer. If your insurance is through your employer, they should have a benefits book which would explain your particular insurance plan.

Spoken like someone who works in insurance. :Banane37: No but seriously GLB is right. My wife used to be an agent and it varies from policy to policy on what the co-pays, deductables, and coverages are. For examply I have BCBS Florida Options. With my employer we have a $1500 total deducatable on all medical. Beyond the $1500 is 100% coverage in network. Now with that said it still has to be approved like everyone else who is lucky enough to be covered by insurance.