Question:
Total Out of Pocket Expenses

What is the amount I will pay for surgery covered by Carefirst, with Dr. Anez ? My insurance is Carefirst BCBS, Select Providers, and my surgeon is Dr. Anez. Dr. Anez is NOT in this particular network, though he does participate in other Carefirst panels (e.g., Carefirst Choice). The hospital is in network. BCBS pays 80% of the doctor's fees, up to $2110. What should I expect to pay for the surgery?    — Beth S. (posted on December 2, 2002)

December 2, 2002
Your plan will pay 80% to an out of network doctor? That sounds like a high percentage for oon benefits. However, since most surgeons charge substantially more than the 2110. they are willing to pay, (mine charged 4000.) I would say your out of pocket will be anything the surgeon charges over the 2110. Since you are using an out of network surgeon, they are not required to take the insurance contract adjustment. If this is the surgeon you really want, I would try and strike a deal with him, Its worth a shot. You didnt say what your in network benefits are for the hospital. So I cant give you any idea there. Also, even though your surgeon has the choice panels....you have the select product, he is still out of network for YOU.
   — RebeccaP