Question:
Blue Cross CA copay questions

Hi everyone, I have Blue Cross of California POS. I will be using the PPO side of my plan for the surgery. I was wondering how copay works. My insurance said that 3k out of pocket is the maximum I will pay. Can anyone confirm this? Second of all, do I go through everything and then the bills come or are some copays needed up front (besides psych and nutrition). I know that some surgeons in CA require a deposit at the time of surgery or a week prior and mine does not so I was wondering how the copays/out of pocket expenses work. Also, if I am billed for this month's procedures in January, does what I pay in January count toward 2003 out of pocket expense? I've never had a procedure this major since I've had insurance and don't know how it works. Thanks.    — susanje (posted on December 8, 2002)

December 8, 2002
I have blue cross pers basic choice. My deductible had already been met. I only had to pay 3,000 for the surgery blue cross covered the rest. They did pre-authorize my surgery. I had no up front costs. I did have to pay for the nutritionist and psych, but they billed me. hope this helps.
   — kelly M.

December 8, 2002
You will have to pay upfront what the Doc and Hospital tell you to this will be your share of cost .. Do not let me repeat Do not pay any bills unitl you have heard from them a min 3 times or they are ready to turn you in... because you will be surprise how Insurance will pick these up start a file file them all away out of sight out of mind and Jan is the new fiscal year call Blue cross to make sure.. if you had Your surgery on Dec 31 and was in the hospital on Jan 1 you would owe a entire new share of cost do not pay any bills right away they are staggering amounts the insurance pays eventually after you have recieved 3 notices then pay the bills Kathy
   — Kathleen M.

December 9, 2002
I have BCBS ppo of Texas and mine works just about the same way yours does (I had a $2500.00 max. out of pocket) I guess I was lucky cause I didn't have to pay one red penny up front. My insurance ended up paying all but $89.00 of the Dr and $354.00 of the hosp.
   — Diana W.

December 10, 2002
$3000 is your max co-pay for the calendar year out-of pocket. My total hospital bill was $68,000 plus. I ended up paying the hospital only $700 - and the insurance paid the rest (my deductible was already satisfied from other medical bills, otherwise I would have had to pay my $500 deductible plus the $700). If you have any more questions, feel free to email me :)
   — Valerie H.

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