Question:
Hi. Does anyone have experience with Blue Shield of CA PPO?

I am new to Blue Shield, I've had Kaiser all my life, and I am wondering if they are pretty good about paying for WLS? I have to pay a large fee of $7850 up front to the surgeon when my deductible is only up to $5000, and I wonder if they are good in reimbursing the extra amounts?    — Lori P. (posted on October 27, 2002)

October 27, 2002
Hey girl, I had blue cross blue shield of california even though I reside in Las Vegas, nv and I also had surgery at the alvarado clinic by Dr Wittgrove...I had to put a sizable down payment prior to surgery too but after all was said and done I ended up getting half that refuned and then using half of the refund to pay deductables and co pays so I still felt i came out ahead because i manage to have all paid off insurance paid out well and did it in a timely mannor.....they didnt take long to approve the surgery either. Awesome insurance!! awesome Dr and good luck !!
   — Deanna Wise

October 27, 2002
Hi, I also have b/c of california ppo. So far, they have paid for all of my surgeon visits. I haven't gotten any indication from my surgeon that I will have to have a LUMP sum before surgery and I will go for my 3rd visit Nov. 5th. Hopefully, I won't get any surprises.
   — Leigh G.

October 27, 2002
I have BC of CA POS as of Sept 1, 2002. I used the ppo for my surgery on Oct.4, 2002. I went to Dr. Popoola and only had to pay a $250 deductible. That was all! Even though my insurance would only pay 70%. Email me directly if you have any questions and Good luck!
   — Kristi T.

October 27, 2002
I have BC/BS of CA PPO. I am waiting for approval as we speak...BUT I do know this-Depending on the plan you chose-that determines whether or not you have to pay anything other than your hospital co-pay out of pocket. I chose the High Option plan and only should have to pay my $300 hospital co-pay (standard). However, I do not have a $5000 deductible. I have no deductible. My ins pays 100% after my copay. Ask your HR person for a copy of the limitations and exclusions to your policy. It should clearly list there whether or not you have to pay a deductible, and whether your ins covers it. Another thing, if you have a $5000 deductible, is that for the year, or is it for this one specific surgery? You should not have to pay anything over and above the deductible. You might want to check this before you write the check. Do you really want to pay that doctor more money, when the ins co in going to pay for it too? Best Wishes!!!--Ann
   — Ann H.