VanDweller Community Forums

Full Version: Who had the Blue Cross Blue Shield Ins? Have some questions
You're currently viewing a stripped down version of our content. View the full version with proper formatting.
Hey, i know someone here has it as it was mentioned in a post.

Need some answers regarding how the billing works and how the max limit works for pharm/doc/specialist.

Will be checking my messagebox daily for awhile...
I have had BCBS Federal Employee Plan since 1996. But BCBS has so many different plans that it is impossible to give more than very vague generalizations. If you go to a covered provider, they should take your insurance information, bill Blue Cross directly. Then BCBS pays the claim to their responsibility, and then, if you already haven't paid your copay, the provider should bill you. As far as how the max limit works for pharm/doc/specialist, the best bet is to call your BCBS member services number that is on your insurance card. They can be very helpful, I ask them stupid questions all the time because all the ins and outs are so complicated. And I'm an RN who has guided patients through health insurance and Social Security and Medicare morasses.

If you are going out of network, then all the rules pretty much change.

As far as pharmacy copay costs, they are generally counted towards your annual deductible.

That's about as far as I can take you. I wish I could help you more. If you have your insurance through your employer, don't even try to ask HR, because they almost never know more than those vague generalizations I mentioned above.
Ted
BCBS has all kinds of different plans. Mine is really good but costs $900/month. Their cheaper plans have less coverage.
BCBS administrates my insurance through my job, but the actual insurer is the company I work for
(01-26-2017, 04:06 PM)WalkaboutTed Wrote: [ -> ]I have had BCBS Federal Employee Plan since 1996.  But BCBS has so many different plans that it is impossible to give more than very vague generalizations.  If you go to a covered provider, they should take your insurance information, bill Blue Cross directly. Then BCBS pays the claim to their responsibility, and then, if you already haven't paid your copay, the provider should bill you. As far as how the max limit works for pharm/doc/specialist, the best bet is to call your BCBS member services number that is on your insurance card.  They can be very helpful, I ask them stupid questions all the time because all the ins and outs are so complicated. And I'm an RN who has guided patients through health insurance and Social Security and Medicare  morasses.  

If you are going out of network, then all the rules pretty much change.

As far as pharmacy copay costs, they are generally counted towards your annual deductible.

That's about as far as I can take you. I wish I could help you more.  If you have your insurance through your employer, don't even try to ask HR, because they almost never know more than those vague generalizations I mentioned above.
Ted

Oh no no! That was what I was wondering how they operated. Thank you so much! Now I can relax a bit more.