Cost after Insurance? Anthem BC/BS

Hey everybody could you tell me how much you were responsible after insurance? I have Anthem Acess ppo and was told it pays 100% of allowable amount. Mine is 70/30. I'm trying to figure about how much I will be responsible for and if Georgetown will accept payments? Have been approved and just waiting on pre-op to call Thanks Tammy

Hi Tammy!

I have Anthem as well, Federal Employee Plan.  I really don't remember at this point how much I had to pay out of pocket though it really wasn't much.  However, when I had surgery with Dr. Tom it was at a different facility and I'm sure the prices have changed since back then.  I'd say your best bet to try to figure what your cost will be after insurance pays their cut will be to call the office at Georgetown and see what the final costs will be and then go from there.  If nothing else, they should at least be able to give you a ballpark figure of what the surgery cost will be.

Tammy,
I have Anthem.  I didn't have surgery at Georgetown, I had mine at Norton's.  But, I though I'd share my costs with you to just give you an idea of what to expect.  I just had Lap Band surgery on 3/25.  The surgery cost $26,000.  I had to pay $773.00.  I was pleasantly shocked!  Especially since the orignal bill from Norton's was for the $26,000 (pending insurance).  Since it was so large, I had met my deductable (thanks to the pre test and the 6 months of meeting with my doctor as well.)  When I got that bill, I was so afraid that I was going to have to pay 30% of that, which would have been $7,800.  But, after insurance rates/discounts and such, I only owe $773.  Most places will work a payment plan with you.  As long as you pay something, I think it's okay.  Best of luck to you!

Tammy you benefit can be found online on the Anthem website and if you are having surgery as a inpatient then you just need to find those benefits.   What do you mean 100% of the allowable and then you say 70/30 that would not be 100% of the allowable.   I worked for Anthem for 25 years and each contract is basically different.   So you need to find out if you have a yearly deductible, any co insurance and your max out of pocket.  That in itself will tell you the most you could be liable for the max out of pocket. 

 I have Anthem at the time of my surgery I had to pay the $600 fee to the Center (not covered by insurance) then any co-pays for Dr. visit.  I was an inpatient stay overnight.  The insurance covered the rest.  If I did it this year I would have to pay $450 out of pocket, then its 80/20.  Check with your insurance.  The plan depends on your employer and what they have worked out with the insurance company.

Thanks everyone .I'm going to check with ins. co. and GT.I'm just waiting for a call from Pre-op I've already been approved. again thanks Tammy