Question:
HOW MUCH DI D MEMBERS PAY OUT OF POCKET?

I HAVE BC/BS OF PENN. IF THEY SURGERY IS APPROVED AND COVERED, HOW MUCH DO I HAVE TO PAY OUT OF POCKET? I HAVE STARTED THE PROCESS OF GETTING APPROVED, AND WANT TO START SAVING MONEY IF I NEED TO. I DONT WANT ANYTHING TO STAND IN MY WAY OF SURGERY.HAS ANYONE HAD ANY EXP. WITH THIS COMPANY, MY SURGEON IS IN-NETWORK, AND ACCORDING TO THEIR CLAUSE THE SURGERY WILL BE APPROVED. I HAVE A 500.00 OUT-OF-POCKET MAXIMUM PER YEAR, I AM CURIOUS IF THIS IS ALL I WILL HAVE TO PAY ......THANKS ALOT    — LAURA J. (posted on March 14, 2002)

March 13, 2002
Well i dont have bc/bs but i know that most surgeons,anistgiologist and the hospital will want a deposit even if they are in network. Youll have to pay that before surgery. Maybe with luck you wont have to, but thats what happened to me and thats what alot of others have told me.. Hope this helps a little :-) Best of luck
   — Deanna B.

March 13, 2002
Yes, that is the most you would have to pay, if you haven't paid any other doctor's bills yet. If you have, then that would apply to the out-of-pocket maximum.
   — garw

March 13, 2002
I think that if the dr. etc. are in the network, they can not require you to pay a "deposit"--I know in Florida they can't---after you pay your out of pocket--insurance will pay at 100%
   — Linda L.

March 13, 2002
Check with your insurance company and ask the surgeon about the approval and charges. I have a BC/BS PA point of service and I was not only approved in 5 days, but only had to pay my co-pays for office visits, medication co-pays, and a emergency room co-pay for being re-admitted for a complication 2 days after being sent home. Getting your PCP's referral to the surgeon,and staying in network were key to my out-of-pocket costs being under $150. Give BC/BS of PA a call, they were very nice,helpful, and have always been great to work with---not just with my VBG, but my son as we needed help in diagnosing learning disabilities & ADHD, my father-in-law with critial issues and they even have my mother-in-law happy, & she is very hard to please! Quite honestly, I wouldn't have any other health insurance if I could be with these guys!
   — Sue F.

March 13, 2002
I had a $750 max out of pocket expense and that is all I paid...worth every penny. I would call you ins company and ask them for sure.
   — ZZ S.

March 14, 2002
I have a bcbs as well. You should call your customer service and asked them what you out of pocket max is. Mine is 1500.00 So that is the very most I will pay for covered health care the entire year. Just give them a call. Mindi
   — Mindi M.

March 14, 2002
You didn't state what type of plan you had (e.g., HMO, POS, PPO or traditional). Since you only mentioned ONE out of pocket of $500, I'm assuming you have an HMO plan. $500 will be the most you will pay out of your pocket for the year. However, you should check with your plan regarding copayments on office visits and prescription drugs since they typically don't apply to the out of pocket. If they don't apply to the out of pocket, you'll have to try and figure out how many times you'll go to the doctor for the remainder of the year and if you'll need any prescription drugs. If so, you out of pocket cost could go up to probably about $700. This is still a VERY low out of pocket expense. Most insurance plans have an out of pocket of about $2000.
   — Patty H.

March 14, 2002
First thing I would do (and I did) is call the insurance company. Give them the name of the hospital and doctor. Ask them what they'll cover. My hospital and doctor were not in our plan so I had to pay out-of-pocket expenses of $750.
   — dolphins94