Care Cost Estimator disclaimer

This information, provided for informational purposes only, is applicable only to Independence Blue Cross (Independence) members whose information and costs are searchable in the Care Cost Estimator tool as the information is specific to each member’s benefit plan. The information does not constitute (a) medical advice, (b) a prior authorization or approval that any particular services are eligible for coverage under the terms of your benefit contract, and (c) an adjudicated claim for benefit coverage. Do not avoid getting health care or make health care decisions based on the cost estimates displayed on this website. Use this information to talk to your physicians when asking for help with medical decisions. Only you and your doctor can decide which medical decision is best for you.

The information does not guarantee coverage of any service or of any particular payment amount. Your benefit coverage will be determined by the terms of your health plan benefit contract. Factors that affect your coverage include the actual services provided to you; your eligibility; applicable deductibles, copayment and coinsurance amounts; and any applicable benefit contract restrictions such as authorization or pre-certification requirements, exclusions or limitations. In addition, this website presents information relating to a broad number of providers, which may not participate in the network applicable to your benefit plan. Please check the appropriate online provider directory to determine whether a particular provider is considered a participating provider for your benefit plan.

The cost information provided by this tool is intended to help estimate typical member out-of-pocket costs for certain services generally performed in connection with certain procedures or diagnostics. Your actual out-of-pocket cost obligations (deductible, coinsurance, copay) may differ from these estimates depending on, but not limited to, such things as whether: (a) you have other claims processed before you receive the requested services, (b) you receive fewer, more or different services, (c) the services are performed by fewer or more providers, (d) you have or will reach your health plan's out-of-pocket maximum or (e) your medical spending account balance (if applicable) has changed. Such cost may also vary based on the complexity of the services rendered, the type of your benefit plan, Independence’s contractual arrangements with the providers which render services to you, and other factors. Always review the most current version of your health plan documents to determine your actual coverage, benefits and out-of-pocket expense obligations. Also, certain services may require an authorization as described in your health plan documents.

Independence has used provider claims information which includes contracted reimbursement rates and/or fee schedules in place during the defined time period to develop the displayed estimates using the assigned methodology. Such data may be updated periodically by Independence, potentially resulting in different estimates for the same services and/or procedures. Provider participation in Independence provider networks changes periodically and participation by your particular provider must be verified prior to receiving services. The information on this site is only applicable to the listed health care providers, and is not applicable for Independence Medicare Advantage members, or in situations where Independence is not the primary payer.

Fees for a procedure may include other services related to the specific procedure, such as anesthesia, imaging guidance, and tests. Each cost range includes the typical cost for each procedure’s grouping of related services, including facility, physician and other ancillary services. Whether your actual cost falls within the range depends on which related services your doctor recommends, requires or prescribes for your treatment, as well as your own condition.

Your use of this information is subject to the terms and conditions of www.ibx.com Terms of Use, Privacy Statement and HIPAA information. You should consult with your own physician about your particular medical condition. This information is not a recommendation or endorsement by Independence of any particular health care provider or its services. Independence does not guarantee that services will be available or will be of any particular quality or cost. In addition to cost, quality is as an important factor in determining where you or your family should seek care. Please refer Pennsylvania Health Care Quality Alliance, Hospital Quality Search Tool, and/or other provider quality information available through the Care Cost Estimator tool in order to make a balanced decision related to your healthcare options.

The Care Cost Estimator is provided through Independence Blue Cross, but the listed providers as well as the National Consumer Cost Tool data is maintained by the Blue Cross Blue Shield Association with information compiled from Blue Cross and Blue Shield Licensees. The Blue Cross and Blue Shield Licensees have made reasonable efforts to ensure that the list of providers displayed is up to date and accurate. Please note that only providers that have cost data submitted to the Blue Cross Blue Shield Association will be included in this tool. Please call the listed provider before making an appointment to verify that the provider continues to participate in your Health Plan’s network. Members should refer to their benefit contract or contact their Health Plan’s Customer Service department to determine if the provider type and treatment or services requested are covered. Neither the Blue Cross and Blue Shield Association nor any of its Licensees shall be liable for any losses, damages, or uncovered charges as a result of using this Care Cost Estimator tool or receiving care from a provider listed in this third-party website.