Question:
For anyone who had BCBS/Anthem Insurance-

How much of the total bill did insurance cover? I've heard of it covering 100%, and I've heard 80% (about $2,000 not paid). I really need to know a little more from anyone who has been through the whole insurance route! Thank you for any responses.    — [Anonymous] (posted on May 30, 2001)

May 30, 2001
It all depends on what your contract states, whether it's 80/20% or 90/10% or 100% after deductible has been met. You need to contact your customer service rep or look at your benefits booklet. It also depends on whether the healthcare providers are in network or out of network, because the ins co pays less usually if you go to a provider out of network. The amount the ins co will pay for a covered service is based on a predetermined allowable amount, which may be less than the amount charged by the provider. If you go in network you usually can't be balance billed by the healthcare provider, whereas out of network, you may be responsible for any amount not paid by the ins co. I have BCBS PPO which pays at 100% of the allowable amount after deductible has been met if I stay in network, but if I go out of network they'll pay only 80% of the allowable amount. I hope this helps, all the best to you.
   — dandjon