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Originally Posted by retiredguy123
If you use the Blue Cross preferred providers for medical care, the provider cannot charge you more than the amount allowed by Blue Cross. And, when your out of pocket costs, such as copays and coinsurance, exceed the catastrophic annual limit, Blue Cross will cover everything else at 100 percent. That is the way the insurance plan works. In general, Medicare is not going to cover things that Blue Cross doesn't. It will only reduce your copays and coinsurance payments, but you need to weigh that benefit against the cost of the Medicare premiums.
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When you are in a situation where you are in a hospital for a surgery or procedure there are times when you will be treated by an anesthesiologist or doctor in the emergency room or in the outpatient center whereas the hospital or facility is in your plan but the doctors are out of network doctors. They do not tell you this when you are being treated. The way you find out is when you get the bill. You can't stop each doctor who is treating you and say "are you in my plan?". There are so many people who are involved in your care that it would be impossible and just would not work. My husband has our insurance BC/BS federal and Medicare for the last five years. He has had many kinds of procedures and has had to pay $0 for anything. This includes tests and labs. I am hoping and praying that this will be in my future. When you sign up for Medicare IT becomes your primary and BC/BS is secondary.