Inova Fairfax - BCBS PPO costs?

[Anonymous]

I am due this summer and will be having a planned C section delivery at Inova Fairfax. I'll have BCBS PPO. I'd like to get an idea of what costs I will be responsible for so that I can plan ahead/set funds aside/alleviate the stress of the oh-so-fun surprise bill. Anyone have experience with Inova and BCBS PPO? I plan on asking my doctor's office as well as the hospital, of course, but find that personal experiences of others help me ask the right questions/anticipate what might happen. Our first child was born when we had Kaiser and the non-Kaiser world is still very puzzling to me.

Thanks!

[Anonymous]

There are tons of different BCBS PPOs. You need to call your insurance company and ask them. In my case, my doctor's office calls the insurance company and then went over all the costs with us at our first or second prental appt, but th insurance company can tell you exaclty what you will pay for YOUR plan.

[Anonymous]

Agree with PP. Everybody's plan will have different levels of coverage. Your best bet is to call your insurance company directly and ask what they will cover.

FWIW, I had BCBS PPO and had an unplanned c/s at Georgetown - everything was covered 100%.

[Anonymous]

Anonymous wrote:Agree with PP. Everybody's plan will have different levels of coverage. Your best bet is to call your insurance company directly and ask what they will cover.

FWIW, I had BCBS PPO and had an unplanned c/s at Georgetown - everything was covered 100%.

Original PP here. This proves my point exactly. I, too, have a BCBS PPO and was quoted pretty high out-of-pocket costs. I am not even going to tell you how much because the finance person in my doctor's office said it is the highest she has seen for BCBS, but really, give them a call and they can easily give you the exact figures. And hope your plan is more like the second PP's than mine!

[Anonymous]

Thanks, OP here, I do realize that there are a million different types of plans... I guess I just want to be sure I ask the right questions and cover all my bases in order to avoid surprises. Thanks for your help!

[Anonymous]

Anonymous wrote:Thanks, OP here, I do realize that there are a million different types of plans... I guess I just want to be sure I ask the right questions and cover all my bases in order to avoid surprises. Thanks for your help!

I'm the PP who delivered at Gtown. I've called BCBS customer service many times, including during pregnancy, and in my experience they were always very helpful. Just tell them that you are having a c/s and ask what they will and will not cover. With a c/s, at a minimum you will be seeing bills from the hospital itself, the OB (that will be one bill for the prenatal services and delivery, they don't usually separate those), anesthesia, and pediatrician, possibly NICU too (but hopefully not!).

If you really want to cover your bases, find out what your annual out of pocket maximum is (per family, since you and the baby may have separate charges, especially if the baby ends up in NICU), and plan on paying that.

Also, I assume your c/s is medically necessary. If not, it might be worthwhile to ask how they handle that.

Good luck! And if you have further questions (once you have more info from insurance), I am sure people on this board would be able to help.