BCBSTX TRS Active Care Questions...cross-posted

Hoping there are some fellow TX educators in the house with BCBSTX TRS Active Care that can answer these questions for me....so here goes:

1.  Does BCBS require a nutritionist visit? 

2.  If so, was it covered by insurance?

3.  What did your surgery end up costing you in the end?  I've met my deductible for the year already (yay!) so I'm hoping the total cost will be low.  I know that my surgeon's copay is separate from my hospital copay.

I meet with my surgeon for the first time next week and I am excited and nervous and scared all at once.  I also have my psych evaluation next week too.

I'd rather get the answers from someone who's been here, done this than sit on the phone with the insurance people. :)  Thanks in advance...all the help I've gotten from you all has been invaluable so far!

Lee

 

I'm not sure if it pays & requires the same as when I had mine done 7 years ago. If it does, it does require a nutritionist visit and I believe it paid for it. If not it was less $100. I also had to have a psychological which I paid for, then I think it reimbursed art of it. I ended up paying $3000 out of pocket between surgeon and hospital, but I may not have met deductible that year. I remember it was after Hurricane Rita and I got a new plain roof rather than a metal one like I wanted and used the extra money it would have cost me to pay my part of surgery.


Good luck. No matter what it costs, you will be glad you did it.

Karla

I am 6 days post op and work for Univ Texas Southwestern Medical Center which has their insurance through BCBS.  I not sure if this is helpful as even though I am parts of TRS I don't know if the insurance part is.

1.  My nutritionist and psych visits were covered under the regular physician copay.

2.  Not sure about your agency by this past Sept they started a plan that if you used UTSW physicians and hospital then your deductible was $2500 if you used and outside physician or hospital it was $5000 and then 100% paid for everything else. 

3.  My surgery will only cost me a total of $2540 which is the deductible and the $40 for other visits.  Now everything is 100%.

I hope that this helped and if I can answer anything else please let me know.

This is helpful!  Thank you.  I know that for TRS, there is a $5000 copay that does not count toward our deductible or out of pocket maximum.  My surgeon has teachers pay $2000 of this copay.  My deductible ($1200) has been met for the year, so everything from here on out is covered at 80% until I meet my out of pocket maximum ($2000), and then it's 100%.  I'm just trying to gauge how much into my savings I need to dig! :)

Thanks for your help.  May I friend you here?

I would think that you would only have to pay up to the $5000 and then it is 100% coverage just like mine then.  From what you are saying it appears that our coverage is the same.  For bariatric after the $5000 it is completely covered at 100%.  I understand about the digging into the savings. 

I would be happy to friend you here.  There is a new journey and to share and help is truly a blessing.