I currently own a Blue Shield of California PPO. It has a deductible of $1000 which I still haven’t met. Should I be the one to pay for the doctor visits I’ve made or is a part of it going to be covered by my insurance policy?
Blue Shield of California will not usually pay for any part of the treatment until the deductible amount has been exceeded. You will have to pay for the entire amount of bills related to the treatment until the deductible amount is reached. There are some policies that provide for co-payments for the doctor visits, which mean that the insurance pays for part of the doctor visits. Lots of PPO plans, like Blue Shield of California PPO, provide for copayments on regular medical visits. However, some services that may be part of the visit, such as laboratories and radiology, are subject to the deductible amount and are not covered by the co-payment amount. If this is so, these services will be billed to Blue Shield of CA and will be subject to the deductible limit. See to it that in the final bill, the deductible is not more than it should be and that payments are made according to the EOB (Explanation of Benefits) in your Blue Shield of CA PPO policy. Answer by General Public - June 16, 2009 3:50pm 1 CommentLeave a comment |
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How Blue Shield of California will pay for treatment of illnesses and related doctor visits depends entirely on the terms of the policy which can vary from policy to policy. You should look for the section called EOB, Explanation of Benefits, of your Blue Shield of California policy to determine how they will pay.
What plan are you on with Blue Shield of California? There are a few plans that will give you your offices visits with just a flat $30 before you have even met your $1000 deductible. If you would like to discuss, please give me a call 877-707-9898.
Comment by Lesley — June 18, 2009 @ 10:36 am