BCBS of Ma

I just received a phone call from the Barix Clinic that my company will only cover "50% Co- Insurance " First off WTH is that and secound I pay $400 a month for  insurance and your olny going to cover fifty percent of my bill!  I may have to cancel my surgery becuase peggie told me i was looking at a $7,000 bill i CAN'T afford that i have not stop crying since the phone call. I told her i would call her back. $300 Deductible is nothing , but 50%.

Don't give up. Se if they can take paymeny arrangements. Where there's a will there's a way. Stay strong.

Thanks DS thant actually what i have done! I ask if i give them 1/2 up front can i make payment arragments on the rest. I'm awaiting a phone call. I also going to see if i can get on my husbands insurance plan, but they may not cover pre exstisting conditions. Thanks for the reply! Keep me in prayer 

Did you personally a check with your insurance as to why they are paying only 50% is it possibly cause your going to a out of network provider, or is it because its weight loss surgery   I would check my benefits and to why so much of a co pay

Yes Vicki i did check My company has a clause in where they  will only cove 50% condeductible for weight loss surgery ,but they also have a clause where i can't pay over $3,000 per calander year out of pocket fee

Is the WLS excluded in the 3,000 out of pocket.  If its not then I would check with insurance as to why the Dr wants to charge over 7000.00

I was told that they charge $40,000 for ALL procedures which makes no since to me you CAN't charge $40,000 for lapband and $40,000 for RYN as well that makes no since But I will check with BCBS members services regarding is wls is excluded from that

I am on my wifes insurance, BCBS of MA. I have the same limitation on our policy.  I am trying to get the same answers. They say that WLS surgery has a lifetime max of 10K co-insurance after the deductable, but they also say that I have a max out of pocket of 3K ?. I am trying to get a lapband that should run me about  13-14K or more. If I understand this correctly, I pay my deductable, then they pay up to 10K, then I pay everything after that. If this is the case, I think I can afford this but I still don't understand the conflict between the max out of pocket vs teh 10K limitation. If anyone has any experiance with this situation that they would like to share I would really like to hear about it.

 

Thanks

I still don't under stand the whole max out of pocket and the limitation around that! When you find out some thing please let me know!