I am a teacher, and the school where I was offered a job was enrolling its new employees in a plan with AETNA in an HRA as of 01/01/2017. I was used to having BCBS, but I was paying $347 a month in addition to a $50 co-pay to see a neurologist or any specialist. This was in addition to paying $15 for my medications monthly, which cost roughly $75 a month altogether. Keeping this plan was no longer a viable option.
I found the form for termination of coverage online. I filled it out, scanned it, and sent it in. I received an email stating the file was “completed and closed”, thinking that my coverage had been terminated. I then received a bill in the mail asking for two premium payments in the amount of $347 each, which is what I’d been paying for all of 2016. One for January and one for February. I decided to call these people and settle this.
After being hung up on, told I was wrong, and should have “followed directions” (the only directions stated I had to either fax or e-mail the form to them, which they denied having) I was told to “call the Marketplace and terminate your coverage.” I had the sent email AND form directly in front of me.
I called the Marketplace and dealing with them was much easier than dealing with these fools. You can barely understand them when you call for any type of assistance. All they know how to say is “I apologize”, “Would you like me to transfer you to an escalation specialist?, or “This issue is not for my department. I will transfer you to such and such department.” They are not receiving a premium payment for services I did not use in 2017.
Nothing but trouble even before any claim ever filed
I joined BCBS on 12-7-12 during the enrollment period and selected the check box election to have premiums deducted from SSA benefits and immediately began getting premium bills for the $28 monthly cost. I called and was told auto-deduct would begin in March, and was given a confirmation number for the call/incident, but the paper bills kept coming so I called again and got a 2nd ref. # after hanging on my prepay cell phone for close to half an hour. The representative promised all would be well beginning in June. I then sent a double payment for the 2 month period till June.
I then received another paper bill for a rate increase, completely unexplained, and another bill for a full month, plus the rate increase. It seems that explaining anything to customers is the worst form of torture for the reps at this company. I had already tried to register at the BC website in order to send a detailed msg of this incident, but after two hours of trying to jump through all the cyber hoops to complete the registration and trying this application at least 6 times and getting dead end msgs, I called the “problem with captcha” number on the button and learned from the representative that online registrations were not allow for Medicare recipients.
So, rather than posting this anywhere on their comprehensive website, they’ve decided to just let us folks dangle trying to do the impossible while pseudo errors are cited as appearing in their registration info & of course the members think it’s their error. This lengthy description is the definition of corporate disdain. Nowhere does it state on the site that Medicare members can’t register, so it seems BC has decided that they’re wasting a few hours trying to do the impossible is a good exercise to impart the lesson. At this point all that’s left, as intended by them, is to make another phone call – the only means of communication provided for us 2nd class members.
Completely Incompetent Customer Service
I tried numerous times to get my last name changed after I was married. Repeatedly they would tell me it was taken care of, and then they would proceed to send me new insurance cards with the wrong last name. When I would call regarding this, I would be put on hold for extremely long periods of time. Why is something so simple so complicated with them? My credit card companies had no trouble changing it in 5 minutes and mailing me new cards that week, but with BCBS NC, it takes an act of God to do anything.
Marketplace plans limitations
BUYER BEWARE! On the healthcare marketplace website they list plans for you to choose from. They are not outright fraudulent but there is vital information that they purposefully do not disclose regarding the BCBS Blue Choice PPO plans. That is the fact that very, very few doctors, many hospitals, clinics and other medical institutions do not accept this form of coverage. It makes the insurance close to useless and you end up paying $500 or so a month for insurance that you cannot use and still have to pay the majority of your medical bills.
If you have to go to a specialty doctor, it may almost be impossible to find one that accepts it. Their regular Blue PPO plans are accepted by a wide variety of medical professionals, however their BLUE CHOICE PLAN should only be taken with awareness of this caveat – it may be hard to find medical treaters who will accept that insurance.
Dishonest and Misleading About Coverage
Blue Cross Blue Shield claimed to cover the cost of my IUD Mirena, with only a $20 copay. However, they did not bother to tell me that the required STD test to get the IUD is NOT covered. It cost me almost $200 to get the test. Additionally, they did not pay for the ultrasound my doctor ordered after getting the IUD placed. An ultrasound is very important to get to make sure that the IUD is in place. Now I am charged $1200 for the ultrasound.
Lastly, I was charged $270 for the “office visit” to get the IUD place, and another $90 for the check-up visit, because my insurance only covers one office visit (that is not a medical diagnosis) per year. Why did they not tell me that I would be responsible for paying this? They are dishonest and misleading in their coverage. I am dropping BCBS after this month.
Claims Denial
I have a son with autism, he has the proper diagnosis by the University Psychiatry Dept. when he was 5. BCBS cannot deny our claims for speech therapy but they play with us denying claims for months up to one year in 2010 to later apologize and say it was a clerical error.
Now 2013 here we go again, they have lowered the allowed amount for a one hour session of speech therapy to $53.73 and they are breaking the bills in two and then paying 60% of the smaller amount, in the meantime my debt to the provider continues increasing every week and every time you ask for an explanation you get a different answer. It is the same m.o. as in 2010. It is exhausting and unnerving.
Terrible Blue Cross Blue Shield Representative
I have always had the worst experience with Blue Cross Blue Shield. I just talked to a man and he literally laughed in my face and was no help. I was trying to see if something was covered and he was no help. He just said, “I can’t do that for you, you have to talk to the doctor to see how much it will be. I can’t find that information out for you.” I don’t appreciate the lack of connection between the doctors and the insurance, it’s like they don’t even work together. It is so frustrating when trying to figure out if you can afford to pay for something when you aren’t given the price it will cost. This makes no sense at all. I just want to see how much it will cost and if it is covered. How hard can that be and why does it take forever.
Will. Not Cover Medications After Surgery
I had a total knee replacement three weeks ago. The insurance company would only cover 7 days of pain medication of one of my medications and they would not cover the other one at all. How do you recover from a surgery where they saw off parts of three bones and then hammer in an appliance onto two bones? This is cruel. I get the opioid epidemic, but please major surgery? I have taken ** and ** as much as possible, but I don’t want to damage my kidneys and Liver. No compassion only profits should be their motto.
Go Somewhere Else
I have been a customer for several years. I knew I was paying too much for poor coverage, but I didn’t want to bother with finding a new provider. After my oldest daughter secured her own insurance, I tried to remove her from my policy. Unfortunately, BCBS wanted me to pay to have her removed. I am done with BCBS. They have never helped me or my family. I can’t even afford to go to the doctor.
Prescription for Necessary Medical Equipment Denied
Over two years ago I started having severe headaches every time I went to bed. Multiple doctor visits resulted in MRI, neurologist visit, physical therapy, and several medications. Nothing made any difference. By the middle of 2017 the occurrences increased in intensity. By now, I’m not able to sleep except between the attacks that came about every 90 minutes.
Finally, in December 2017 I found a description on Mayo Clinic’s website that described in complete detail what I was experiencing. I immediately made an appointment with my doctor and he offered “an experiment.” He sent me home with an oxygen machine to use while I slept. Mayo Clinic’s website confirmed that the attacks I was experiencing were treatable with oxygen. After a three night trial, all my attacks stopped, I slept, I felt normal for the first time in over two years. I went back to tell my doctor and he told me to keep the machine until he could contact my insurance and order the machine for me.
What arrived was an oxygen tank that would only last 12-13 hours. I immediately knew that would not work. But because that was all that I was told my insurance would pay for, I tried it. Here is the result: I would go to sleep, and a cluster would wake me up. I would grab the oxygen line and turn on the machine. When it subsided, I would turn it off to save oxygen. Try to go to sleep, wake up again, turn it on, turn it off… Since the pain had already taken hold, I was never able to get complete relief because clusters will cause migraines. So for four days, I had migraines during the day, and the repeated cluster attacks at night.
I called BCBS to find out why I was rejected for a machine that would run all night. The woman on the phone told me she was “writing all this down.” The next day I went back to my doctor to discuss options. He told me he would “investigate, and contact BCBS and let me know.” The next day the oxygen company (Lincare) called and said they were bringing out another full machine to replace the empty one.
The very next day, LINCARE called and said, “BCBS has denied paying for a machine for you and an oxygen tank. We will be coming to take it back.” After the call, I called BCBS to make an appeal and gave a detailed history to Michael (who was very patient and sympathetic). He told me he would submit it as an expedited appeal and I would get an answer in 72 hours. When I hung up, I had a good cry from all the frustration and confusion and also quite a bit of hatred for an insurance person that will deny a request based on a form.
In about an hour, BCBS called me back. They said they were reviewing my appeal, but needed my doctor’s number. (WHAT?). So I gave it to her. Then, in a few minutes, she called me back and said, “Your expedited appeal has been changed to ‘regular processing’ because we could not reach your doctor.”
Every medical prescription I have tried to fill with BCBS has been denied and I’ve had to appeal to get it covered. Overall, I am a healthy person and I’ve resorted to natural medication to replace the prescriptions. This, however, has me over a barrel. If I can’t sleep, or rest, or function normally pretty soon the medical profession by the stupidity of BCBS will have me on multiple medications to get me what they will call “medically necessary.” May God do to them and more also as they have done to me.
Lost Premium Payments
Since Jan 1, 2018 I have been trying to get my family policy reinstated because of alleged non-payment. I provided proof of payment which was acknowledged several times. They received it, but “Unfortunately, we can’t find it, let alone show it has been cashed.” Until they do, they refuse to reinstate. WHY SHOULD I HAVE TO BE DENIED INSURANCE BECAUSE HIGHMARK CANT MANAGE THEIR ACCOUNTS?
At this point, I’d even pay the fee to stop payment on the original check, and FEDEX them another payment. This is unfair and irresponsible on the part of Highmark. I plan on calling our insurance commissioner, but what’s going to do for me while in need of medical coverage!
Worst Customer Service; They Will Rob You
Worst ever. I went from paying $70 a month to $595 a month with no warning or given reason, for someone who works minimum wage, full-time job that’s your whole paycheck biweekly. Then it was trying to receive my 1095-A form that was supposed to be sent to me the first of the year by law. I called the number on the back only to speak to a computer, finally when I somehow was able to speak to a real person I was transferred 20 times.
I called the Marketplace asking for help and spoke briefly to a gentleman named Michael who spoke over me and didn’t care to help me. He hung up on me 5 times. Finally I spoke to a woman named Ashton who also spoke over me and hung up on me 3 times. They don’t care about their customers. They only care about the money.
The Worst-- Without A Doubt.
When I got hired at my current job, I was pleased to find out that Blue Cross Blue Shield of Rhode Island allows girlfriends/boyfriends/common law spouses to receive healthcare coverage through someone else. My girlfriend has been without insurance for far too long, and this looked like the perfect opportunity to finally get her some. And she needs it, too– she’s got varying medical conditions that are far too expensive to be paid for without insurance. Nothing life threatening, mind you– but they’re conditions nonetheless.
When a year passes, that’s when you’re allowed to put a spouse/significant other on your insurance as a “domestic partner.” Great. BCBSRI mailed me a list of documents they’d need to prove that we weren’t trying to screw them over (as an aside, this took nearly a month to arrive in my mailbox, despite the fact that they’re about 4 miles from my house). The list had 6 or 8 items on it, only two of which were required for proof. No problem. I picked the “prove you’ve been living together for over a year” and “get a notarized relationship agreement” options.
I mailed them a copy of my lease (that she and I are both listed on) as well as a document I wrote up and had notarized, stating that we’ve been in relationship for the past 36 months. Everything is going fine, and my girlfriend will have insurance within a week or two. Or so I thought. Two weeks went by and I didn’t hear a peep from BCBSRI. I finally realized that something probably got messed up, so I called.
They informed me that her coverage was denied. When I asked why, I was told it was because I “didn’t supply the sufficient documentation,” which, as you know by reading this, is untrue. So I asked what I should do, and they told me to send it all again. So I did. I call them again, explaining my whole story. I’m now told that what I mailed them wasn’t enough. They need something like a joint checking account or joint ownership of a vehicle. I told them that was insane, because the paper I have says “Here’s 8 options, PICK TWO.” And that’s exactly what I did. They ask me to send the stuff again. So I did.
Another week goes by with no notice from them whatsoever, so I call again. This time, the story is different: They claimed that they never got the notarized agreement, but they did have the lease. This is false. They were mailed in the same envelope, so unless some employee lost the paper (which is my guess), they have both documents. The guy asks me if I can fax over the contract again. Once I do that, he’ll put in a request to get everything done quickly and he’ll be in touch. I faxed over the agreement and never heard from him again.
Yesterday, I called again after I got a letter saying that she was denied coverage. The reason for her denial was that (you guessed it) I provided insufficient documentation. Again, this is entirely untrue. I spoke with a customer service representative and explained the situation for the billionth time, and he said that he’d put a note on it marked “urgent” and he’d call me back in the morning (today). I never got that call. About an hour ago I called again and really gave the guy a hard time– I need this fixed not now, not yesterday, but THREE MONTHS AGO.
“Immediately” doesn’t begin to describe how quickly this needs to be done. He said he has no say in the matter, which is true, but he’d put another note on it to get it expedited. He informed me that since she was denied coverage (the reason doesn’t matter), I might have to file an appeals claim that could take up to a month to be resolved. I explained to him that an appeal was absolutely not even close to a viable option, and that this has to be fixed NOW. We don’t have another month to sit around and wait. He says he’s going to have someone call me in the morning, but I refuse to believe that.
The long and short of it is this: BCBSRI is an abysmal company, full of people who A) have minimal-to-no-intelligence, and B) apparently never, ever speak to one another. What they’re doing (and continue to do) to my girlfriend and I is unacceptable, and you can bet if I had another insurance option, I’d leave them in a heartbeat.
Terrible
I have had Aetna, MetLife, UnitedHealth Group, and Blue Cross, and Blue Cross is BY FAR THE WORST insurance company I have ever had to interact with. Everything they do is inefficient and terrible. Every time I call the wait is over an hour, only to be transferred or connect somewhere else, that also has an hour long wait. THIS IS A TERRIBLE USE OF CUSTOMER’S TIME AND LEAVES A MOUNTAIN OF UNRESOLVED ISSUES. If the company were efficient in the first place, I wouldn’t have to waste my time calling.
Let me start from the beginning. I have time, because I am on yet another hold with BCBS that is predicted to be over an hour. I signed up for BCBS as an independent business owner, I pay out of pocket for all of my insurance coverage. It took them 3+ weeks to approve me for enrollment, even after I had sent over documentation from Aetna saying that my plan with them was no longer available and had been terminated. Finally, I found out I was approved, not by an email or arrival of an ID card, but because my account was charged $247 without a word.
During the process of trying to get approved for enrollment, having site login issues, etc., I would call BCBS and have a wait time of over an hour every single time. I reached someone and she offered to connect me to someone else, when she transferred me over, after already waiting over an hour, the wait time to talk to another associate was an hour. Basically BCBS asking me to spend two hours of my time WAITING without any resolution, only to maybe have to be transferred to another associate with more wait time.
After I was charged, I tried to avoid at all costs calling again because the whole process was just so incredibly inefficient. Lo and behold, here we are a month later, and I still have no ID card, no proof of insurance, no website login, and a bill lying on my desk. I tried to log in to pay the bill and it says I don’t exist in their system (tried via email, member ID number that is listed on the bill, and social security number).
So currently, I have a $247 charge, another bill, and apparently no insurance. And am currently 15 minutes deep into what promises to be an hour long wait to speak to anyone at the company. You can’t get a customer service email without successfully logging into the site, so I am forced to call.
I don’t understand. Do you have 4 people working in the whole company? That’s the only way that I could imagine would be an excuse for how inefficient and terrible your processes are. I would never recommend BCBS to ANYONE who can avoid it. If changing insurances weren’t so troublesome, I would cancel this so fast. If anyone ever asked me about BCBS, I will send them running in the other direction. My fiance also has BCBS and has had the same issues, with hr long wait times for calls and unresolved issues. THIS COMPANY IS TERRIBLE. UHG and Aetna are 1000000 x better. Please heed my advice, and go elsewhere.
High Deductible Out of Pocket
Beware of Blue Cross & Shield hidden charges high deductible, so outrageous. It’s ridiculous just go to see $100, out of pocket. Then Blue Cross will say “that’s not in the coverage plan. You will have to pay extra.” What is in Blue Cross plan – to take your money, don’t pay the medical coverage, leave you with big expenses that will take you forever to pay the medcial expenses off. Some insurance Blue Cross is leaving you with medical expenses so Blue Cross can save money. All Blue Cross is is a bunch of money hungry vultures who will clean out your savings.
Blue Cross Only Pays 20% of Medical Bills
I went to the doctors 3 times. I paid my $40 co-pay 3 times in a row. I get one bill for $158. Another bill for $105, $263 that blue cross did not pay, which blue cross did bother to tell me that this was not covered. Blue cross is only paying 20% of your medical bills. Then blue cross raise my insurance of me 2 times in a row. Blue cross CEOs salaries alone $200000 a year. Blue cross will not tell you about deductible and the co-pay just go to the doctors’ offices.
If your doctor’s bill is $300, Blue cross will only pay $50. Then you got to pay $250 out of your own pocket. Why? Blue cross only pays a little bit of money, then you got to pay the rest out of pocket. Blue cross is nothing but a bunch of money hungry vultures draw your life savings.
Worst Company Ever
I never write a review but by far this has been the worst and has actually encouraged me to leave one about them. They do not care about the customers. They leave you on hold for over long periods of time, once one of the reps forgot to put me on hold and I heard her talk rudely about me because I was complaining about my policy. I really dislike this company and I will not recommend them to anyone.
The Worst, Most Incompetent Customer Service Imaginable
My employer assigned my family to blue cross/blue shield recently after being with another provider for 15 years. We had dropped blue cross/blue shield 15 years ago because of extreme incompetence in their billing and customer service. I had suffered a back injury that required a lot of procedures and rehab 15 years ago. Blue cross/blue shield couldn’t process the bills that my approved doctors submitted and failed to enter the right billing codes, etc…, then proceeded to send the bills directly for me. Then came the late notices.
Meanwhile, myself and the doctors worked to get it straightened out and the next thing that came in the mail were notices from Blue Cross/blue shield indicating the bills would be forwarded to a collection agency. That did it for me. The stress of dealing with this POS company was a negative factor in my healing process. It took about a year to straighten things out with these idiots, the whole time it took for my back to heal. I think I would have healed faster if it wasn’t for BCBS. Now, though no choice of my own, we are assigned again by my employer to this so-called health care provider.
Earlier today I went to their website to register my new health card and set up an online account. Their site would not allow me to complete the registration so I called their toll free number. That’s when the flashbacks of 15 years ago began. After going through their pathetically long menu, waiting and waiting and waiting, I talked to somebody for a few minutes, mostly answering inept questions and waiting, to find out she couldn’t do anything. So she sends me off to somebody else. Same thing. After the 4th person, I finally got registered. The main problem was their system had a totally different Id # than what is on my Id card. Figure that out.
I then had a few questions about my coverage. She couldn’t find the answers and transferred me to someone else. Same thing, so she gave me a phone number to call. I called it and after talking to 2 more people I was transferred back to the same people who gave me the phone #. The next person couldn’t help me and suggested the phone # I had already been given and tried. I told her that phone number was not helpful. She then transferred me to somebody else. Same problem.
I hung up, called customer service again and was finally talking to somebody, after much difficulty, who dug in a little deeper and found the simple answers I needed about the copay required for x-rays and MRI’s, lab work, and surgical procedures. Nothing difficult. After all, they are a “healthcare” company, aren’t they? Hardly. They’re no more than a profiteering company with the word healthcare in their name. They are an incompetent organization that should be involved in something else than healthcare.
Bad Customer Service
I was admitted into the hospital. When I came out and go to get medicine I am told I don’t have any medical coverage. When I call BCBS they said my policy was terminated and date given was right before the hospital stay. Why was it cancelled? “Oh probably some error”. Will you reactivate? “Yes”.
A week later go to pick up medicine, no coverage, call the state office, “You don’t have any coverage and we are not taking any payments from you. You have not had any coverage with BCBS since last year.” At that point I realized what type of ignorance I was dealing with so I called my human resource dept to let them handle it which they did. But one woman tried to help me so if you have to speak to someone at BCBS ask for Josie, she was the best. But even she couldn’t deal with BCBS State office. They don’t care what they tell you. I cancelled my insurance and moved on. Won’t deal with them anymore.
Worse Experience of My Life.
I applied on marketplace in Dec of 2013 for Insurance from 2 separate companies, one for medical and BCBS for dental. Within weeks I received information from my medical insurance, which I paid for. I never received anything from BCBS. I assumed that because I never received anything that they didn’t get my application or I would get info in April because the deadline was set back.
I finally received information from them (a welcome packet, bill, and my BCBS dental card) in April. I paid my premium in May. After paying my premium I received a bill for $216.XX. I called BCBS to find out why I was being billed that amount. I was told that it was everything I owed them from Jan until present for coverage. I explained the situation only to have them tell me that they couldn’t change the date on my insurance and I told them I wanted to cancel. Then I got a notice that said that my insurance had been canceled Feb 1, 2014.
I called to request a refund for the amount that I paid. The insurance was cancelled before I had ever paid it and the whole thing is a mistake with their system. I was told by a CSR that I should have never been allowed to pay for the insurance and that I should expect a refund check in 7-10 business days. That was July 21st. The lady gave me a reference number, her name, and her employee ID number.
Today Sept 3rd, 2014 I called to find out where my refund was. I was told that the CSR should have never told me that I would be getting a refund and that the money I paid in May went to my Jan 2014 bill and that’s why I got a letter saying I was canceled in Feb for nonpayment, which does not make any sense whatsoever. After spending at least 4 hrs. on the phone over a course of 3 months, I am being told I am not getting a refund and that I could appeal it if I wanted. So I paid for insurance I never had and BCBS is trying to keep my money and somehow pinning their system errors on me. BCBS is a NIGHTMARE!
How Messed Up the Entire Medical/drug Industry Is in General and How Stupid Obamacare Is
Basically my family is pretty healthy and we’ve always seen naturopathic doctors or treated things ourselves. Which means that we take responsibility for our own health and wellness and take care of ourselves. But then Obamacare came on the scene and we decided to go with health insurance. So because insurance doesn’t cover our usual naturopathic doctor, we had to get new doctors and we picked the best ones we could find in our area covered by our insurance. And I suppose for the industry they are doing a good job and being thorough. But every time I interact with drug industry-trained doctors I am frustrated by their limitations.
They don’t seem to understand health or eating right, or herbal supplements or anything that I regularly turn to for good health. What’s more, if I pick up any drugs they suggest and read their labels, I cannot bring myself to take them because the possibility of negative side effects (worse than anything I am suffering) are huge. Basically with how expensive insurance still is and how little use I have for it (insurance doesn’t cover useful things like nutrition supplements) and how much I still have to pay before the deductible gets paid off – it just doesn’t make any sense financially.
If anything catastrophic happened the hospitals in our area let us get on a payment plan with 0% interest. Insurance might be useful if they covered the naturopathic doctor and the nutritional supplements recommended by the ND. A single payer instead of regular insurance would be even better (like the Green Party suggests – the same plan as our good senators and their families get). I have had so many bad reactions to pharmaceutical drugs that I don’t dare take them, and herbal supplements work so well for me, that it just doesn’t make any sense at all to have insurance or see a regular doctor.
Most Unprofessional
I have invested a month or more calling this company and these customer service representatives. Every time I speak to a different person and there is no direct number I can call. It is like starting over EVERY TIME I speak to someone. I have to reiterate everything again. They have a computer in front of them and I have reference numbers for the calls and they still cannot give me one simple answer. I am trying to get in-network coverage for a dental device that helps a medical condition. The provider I am working with has called them also about their services.
Earlier, this week I talked to them for the 10-15th time. They told me I would receive an answer in two days. I called today and they don’t have any of the information I PROVIDED for them this week!!! Last week they emailed me a list and I called 26 companies to see if anyone within a 50 mile radius had this device. None of them did and most didn’t even know anything about what I was talking about. When I called back to give them this information, they said that policy stated THEY now had to call all the 26 companies also. I have provided them tax ID#’s, diagnosis codes, and appliance codes. This has gotten ridiculous and now they want to start all over.
These ploys or incompetence to give me a timely answer have made me very frustrated. I would NEVER NEVER NEVER choose this company again or suggest to ANYONE else to use them. The only reason to use them is if you want unprofessional, incompetent, unreliable and negligent insurance provider to work with whom will ignore you and NEVER GET YOU ANSWERS IN A TIMELY MANNER. I am now waiting for a supervisor to call me. YEAH, like that will happen!!!
Cancel You Without Notice- AFTER You Pay
Bought the Highest Medical and Dental plan offered on Healthcare.gov and paid $400 (I’m unemployed). First there was nothing to say that you would be paper billed after giving all of your info and it seeming like your payment would just be taken. Got a letter stating the bill was never paid (mentioning both plans), frustrated… I called and was willing to give them my bank statement to show I had paid. Never mentioned that they were only missing the $22 dental portion the whole conversation. They said “yes”, they received it.
Next month, made a payment, it was $44 more. Asked why, they said it was dental and that we never paid… Ok, paid the 2 months after complaining we had called, why did they not tell us. Bill from dental cleaning comes back unpaid and Dental cancelled for non-payment. Nothing they could do, we did not pay for 30 days. Nothing you could do????? You could have told me the first call I made about the lousy $22… Really???? Seems like an all out scam.
Now I am going to pay out of pocket for an exam that should have been free… and an amount, that after paying a total of over $800, unemployed, is impossible. Not only that, but they cannot re-instate me and I have to wait until Nov. 1st to re-apply for benefits. This is not OBAMA people, this is INSURANCE companies. Don’t think they are not finding ways to be more profitable. I am sure you will have to fight tooth and nail for every claim with these guys. There are places here in OK that will take Blue Cross Blue Shield, but not from OK. Blue Cross should shut down this section of business.
Give Me a Callback Number
they’re outfitted with headsets & have no control over what calls go where. As soon as they get off the phone with you, another caller is passed along to them on their headsets. There is no follow-up. There is no real concern with helping customers. Needless to say, I am still waiting for my issue to be resolved, and in the meantime I am being denied health insurance coverage I was paying for, up until this month when BCBS took it upon themselves to *return my money and cancel my coverage.*
Every time I call they have a different reason for the screw-up. They are good at rationalization, but as bad as can be on resolution. You, Blue Cross Blue Shield of New Mexico customer, are at their mercy, and they have NONE.
Dropped as a Customer, Reinstated at Twice the Rate and Now They Demand a One Thousand Dollar Payment.
I was paying $155.00 per month for current coverage. Then their new system came through. I waited too long to pick a new plan and they picked one for me at over double the rate $375.00. Now, they are demanding a one thousand dollar payment by September first. I should point out that they refunded the last payment before they “doubled my rate”. I had a hard enough time with $155.00. I think they should at least review the new rate before they put it in place. I am not paying a dime of it! I’ll take my chances with Obama’s fine.
USELESS.
Not that I think they will do a damned thing about it if I complain… Please tell me why I am paying $200 a month for insurance I can’t use. I hate this HSA bologna. I need to pay $200 a month, pay for all meds, doctors visits and procedures out of pocket until I have paid $4500 (NOT including the premiums in that $4500) and THEN they might cover something??
I cannot afford $4500 plus $200 premiums. THAT is the reason I have insurance. And THEN I get a claim rejected because the procedure isn’t “recognized” as effective in diagnosis? It was effective, it let me know whether or not my 6 year-old was extremely sick. However now I can’t even afford to pay for the surgery he needs. I feel like it would be better if I quit my job and went on state insurance. Money hungry JERKS. They aren’t out to help ANYONE. They have made it impossible to be healthy. WAY TO GO.
The Morons of the Insurance World.
Ok, I try not to rant too much unless I get REALLY pissed. Blue Cross and Blue Shield of Oklahoma are the biggest group of morons I have ever dealt with. Every time I have to call in I feel like they actually get less intelligent. Not only do they always ask to talk to my 4 yr old to see if they can talk to me, I filed claims – per their instructions that they received Dec 15th – they still have not processed. 1.5 weeks ago I received a letter saying that they finally finished one of the claims and would be sending money to the provider.
I called in and said no, they needed to send me check because I had paid that bill in full. They said ok. Now I call in to check the status of my other claim and get told neither were processed. Oh and the refund I was waiting on is my extra I had paid for my monthly premiums. They are refunding me that. I guess I magically pulled that claims pd letter out of nowhere and Blue Cross and Blue Shield of Oklahoma doesn’t like people to pay their bill in advance.
Prescription Denial
Excellus BlueCross BlueShield is the worst health insurance company I’ve ever had to deal with. I encourage all employers and customers to avoid this company at all cost. I was diagnosed with Narcolepsy 23 years ago and have been treated for it since then. A clinical pharmacist from Excellus has determined that my medication is “Not Medically Necessary” and they refuse to pay for it.
The medication helps me not to fall asleep at inappropriate times. It’s not a cure but it does help. Excellus BlueCross has trumped my neurologist. When did we get to the point of an insurance company determining what’s best over a Medical Doctor! I’ve filled an appeal. While they go on with their lives, they deny me the right to just have a half way normal life.
BCBS of GA Sucks!!!!!!!!
I suffer from Allergies which is not uncommon in TN or for most individuals around the country. I go to a Little Clinic at Kroger to see a Nurse Practitioner because she is good and knows my allergy history. Per my insurance card, I pay an office visit of $25. The Little Clinic billed BCBS of GA the $25 office visit but it turns out that BCBS of GA changed the billing because apparently they made a secret decision internally without communication to its customers that you will be charged a Specialist Office Visit Co-Pay for seeing a Nurse Practitioner.
How the hell is that fair? One, they don’t tell anybody and two, why should I pay a Nurse Practitioner a Specialist Co-Pay when she is not? To add insult to this situation, the Little Clinic is setup in the BCBS of GA systems as a regular office visit. They are GREEDY and this company is a complete SCAM!
Your Money Only Pays for Your Right to Carrying the Card
Spent hours on the phone trying to gain an understanding of why my claims were refused. In the end it appeared because they would have not made any money off of me. Only had 900 dollars in claims and had already paid them $200 for 3 months. Thanks to the Obama (everyone must have insurance). The process here is you call them and email and they get back to you saying “I can’t answer your question but I’ll forward;” followed by no one ever getting back to you.
Forward ahead a few months and you call back and they say no luck for you but thanks for the money; I take that back, not even a thanks. I would advise you to run from this place because I am and even though I am not writing all the crap I just want to say they are awful and best of luck to all.
Complete and Total Lack of Customer Service.
To make a long story short, they have no customer service. None. You can’t get anyone directly. NO ONE. So every single time you have to go through customer service **. I’m now sitting on hold, yet again, because of THEIR mistake. I tried to remove myself from our policy in January, keeping my family members on the policy. Well to say they’ve screwed it up royally would be a huge understatement. They only “split the policy”. Their mistake but they want ME to pay. How’s that work?! Their excuse is, “There is no paperwork.” Well, that’s because your person screwed up. Needless to say, I’m pretty unhappy. So, 22 minutes on hold and the clock keeps ticking.
I keep thinking that Durham is not a bad drive. But if I did go I’d never get through the front door so why bother. Customer service? Not on your life. Pathetic. I’ve truly, truly never experienced customer service at this level… And I’m including DMV experiences.
Refusal to pay for meds
I do not have a pituitary gland. It was removed due to a tumor. I then had radiation when the tumor started growing back. BCBS knows this because they paid for it. I take a lot of meds due to this chronic condition. I made a mistake simple as that. I long hard day and somehow after I took my nightly injection. I placed it in the freezer instead of the fridge. According to BCBS once I receive the meds if anything happens (lost, stolen or ruined), it is my responsibility to replace them at $500.00 dollars. So I have to go almost 2 weeks without meds which will mess me up for close to a month because of their ridiculous rules.
Mistakes happen. Also the entire way their system is set up is a rip-off. My plan says that I have a copay of $30.00 for specialty drugs but the vial only lasts 25 days and they make me pay the extra 3 vials per year because of the way the vials are measured. That isn’t my fault. My plan has me paying for $30 for a 30 supply. Hours and hours on hold and nothing but the runaround and in the end. Go call the insurance commissioner. I can give you the number if you like. WOW!
Changing Medications
I changed from one company that I was totally happy with because of the premium increase. Through The Affordable Health Care Act (ObamaCare) I met with a navigator who assigned me to Blue Cross/Blue Shield. It has been nothing but a nightmare so far. They refused to pay for my mammogram because I require an ultrasound after the mammogram, now they are refusing to approve my migraine headache medication that I have been taking forever via my Neurologist and previous health care provider.
Money is everything with these people. They are trying to substitute the pills with pills that cause tinnitus, which is a condition I already suffer from and also, I found out through research, they give it to dogs with arthritis! They have been rude on the phone and even sent me a letter telling me that I could not have my old med back.
Now I am on Vicodin and nausea drugs and they have to pay out of pocket despite a premium I pay them monthly because they claim I have a “deductible”. I do not understand why they will not approve the Naproxen sodium 550mg I was taking because they weren’t going to pay for it anyway!
Horrible Customer Service, Misleading Information Causing Me to Pay Extra Deductible!!
In order to avoid any hidden terms/fee, I called ahead to check if delivery is 100% covered with my plan at my selected hospital and I was told it is 100% covered. Only after more than 10 months when I called to inquire about something else that they told me the service I used 10 months ago was not 100% covered and they are going to reestimate everything + I will have deductible to pay for that.
VERY rude and unprofessional customer associate. They don’t even know what is included in my plan and every time I call, they will give me a different answers/terms. Very frustrated and disappointed. It’s just useless to call and talk to those operators that are not informative, they even gave me wrong information about my plan which ended up causing me to pay extra money due to their wrong information.
I even tried to talk to a supervisor and she was like a robot, just kept repeating it’s the policy and she couldn’t do anything about it. Not even an apology for what her coworkers did wrong and for my loss of time and money due to their misleading information. That supervisor just told me to contact my HR as they are not responsible for that. It was Blue Cross Blue Shield’s customer associates who gave me wrong information and I have to pay for their mistakes!! Very angry and frustrated.
Customer Service # Listed on Card Is for Out of Service Cell Phone
Customer service number for Blue Cross is listed on back of card but got nothing but busy signal – found out the # is for an out-of-service cell phone not associated with BC at all. Called many other BC numbers but was told “We’re not customer service – just call the # on the back of your card.” Finally had someone helpful enough to give me the correct # and asked me to read the number on the back of the card to them – the number didn’t show up in their database.
How is it possible that a big, rich company would not periodically check, and call its own numbers to make sure everything is working properly? How could they issue cards with the main contact # incorrect? I’m a new customer, is this a sample of what I’m going to be dealing with at BC?
Labcorp for all our laboratory test
BCBS now only allow us to use LabCorp to do our laboratory diagnostic tests. The problem is that LabCorp cannot handle the increase in the number of patients. The staff is not enough and not qualified. The consequence is that when we need to have blood drawn for a test, we have up to two hours waiting times and if you are the unlucky one who gets the “not so good” nurse, get ready for some painful bleeding. And also running the risk of your sample getting mixed up (this nurse drops the tubes on the floor so you never know).
The other extra problem is that LabCorp does not open until 8 am so if you have to be at work at 8, you need to ask for the morning off just for a blood test! You need to consider the waiting time and if you need to fast before the test, be prepared to not be able to have your breakfast until 9:30 or 10 am. I would like for BCBS to stop forcing us to use LabCorp and allow other laboratories (as it was before) to do these diagnostic tests.
Refills for Pre-Authorized Drugs
I have had so many problems getting refills for my drug that has to be pre-authorized. Even when the drug is pre-authorized I have to call to get it sent. They seem to make excuses every time I ask for a refill not to get it to me on time. I suppose they have to cut costs somehow to enable the CEO to get $60 million a year. I have no option but to use Blue Cross so I can’t even do anything about it. Blue Cross blames Express Scripts and vice versa when anything goes wrong.
Billing error
My husband set up our payment as an automatic monthly payment. We got a notice in the mail on the 25th dated 22nd stating we had until the 29th to pay for coverage (27th and 28th were weekend)?!? When I called customer service the recording stated that we were paid up by auto payment and owed no money. I stayed on for the operator and she said we owed that month because a mistake was made on setting up the auto payment. We were set up to fail! We ended up sending the check overnight/certified. Don’t trust these guys!!!
Worst Customer Service.
They have the worst customer service. Ask you for all details for 10 minutes and transfer to another department. There, you will repeat the details for 10 minutes and then again transfer. How frustrating. With the changing advanced technologies, these type of services don’t help. A smarter system with smart people is needed. Worse.
Horrible
Customer service for Blue Cross and Blue Shield is horrible. They need people to take a class on how to answer the phone and be respectful to a client! Very rude and wanted to talk over me! Very displeased with how one of the representatives helped me. I have been transferred 6 times to the same department and no one can seem to answer a minor question about online bill pay! Come on now it’s your job to know and to help people when they need it not be a total ass about it!!!
Poor Customer Service
Been on hold three times, shifted from department to department. Hung up on me twice by automation phone system. They won’t have as many claims if you can never get hold of anyone. Going on 70 minutes now!
No Coverage
Moved from Ohio to North Carolina. Called BCBS with address change. Was advised they don’t issue policies in North Carolina. Tried several times to get release letter from BCBS so could get coverage from another company. After threat of calling insurance commissioner in Ohio, got letter. Found out after arriving North Carolina BCBS does issue policies in North Carolina.
Blue Cross Of Idaho Is The Worst Insurer For Contracted Providers
They randomly deny claims and make it very difficult for single providers to get appropriate reimbursement for rendered services. They pay for a code 90837 for 5 dates but pay for them on the other submitted dates and then make it impossible to collect on the submitted claims. THEY SUCK!! Like no other in the state of Idaho.
Insurance Fraud
I have complained several times to Blue Cross Blue Shield of Alabama about the company I formerly worked for covering people who are not employees on their company health and dental plan. They won’t do anything about it! It’s been over 7 months.
General Frustration in Dealing With Customer Service
Foreword: I recently was informed that Michigan B/C B/S Dental was turned over to an independent third party in the handing of claims. This is the second and last year I will be dealing with them! First, the 800 number is full of prompts, too many to go through. Second, once you get a person they redirect you to the CSR you were suppose to be directed to! Third, CSR personnel attempt to be helpful but they are file pushers! We will get back with you… and nothing! Fourth, their providers list is outdated and providers are few and far between. A few have not accepted BC for more than a year! The providers who are still left are very reserve in dealing with them. Fifth, in 2019 they finally pay claims for non-provider coverage but with a heavy surcharge.
Fifth. Went into their grievance procedure with a dentist that we NEVER heard the results of our claim even after leaving numerous phone messages! The dentist in question lead us to believe they were within the BC Dental System, billed us ahead $3200 of services and was told later they were never on the list! Silly me that the front office lied to us twice but BC says they would intervene but it was all a hoax!
Total Scam
This is the biggest rip off ever. When you try to get a claim processed it takes months and they make you resend everything and then when you send what they ask for, they add all these other things you have to send, which is insane. They barely cover anything if you go to a dentist of your choosing. I had a tooth extract that cost 1000 dollars and they covered 45 dollars of it. Then if you have a problem, you can’t talk to the same person twice. They don’t give you a person’s name or employee number like at other insurance companies. IT’s complete and utter madness.
This is such a ripoff and has no value. You end up paying monthly fees that they don’t even cover more of than in a year. IT’s funny because they really could make a lot more money if they actually offered something of actual value but what they are offering is a complete rip off of no value so people drop the coverage. It even has a bad reputation at all the dentists’ office. There is a true dental crisis in this country and you can Google it. It’s a result of the greed of the insurance companies. But hey don’t worry about this! March in the streets and take up arms because Trump said the wrong thing. That’s all that matters in our warped society. Never mind one in four Americans will lose all their teeth after the age of 50.
Dental Claims Denied and Not Paid
Do not get Blue Cross Blue Shield Dental insurance. It is the absolute worst insurance. They will not pay claims and will deny almost everything. I recently found this out the hard way after obtaining several crowns for my teeth. The 47 page handbook says crowns are covered. I thought no big deal, crowns are a pretty standard dental procedure. Then I got my explanation of benefits explaining they would not be covering my crowns because the tooth was not more than 50% decayed. I scoured the handbook and could not find this explanation anywhere in it. I did find a 3 page section of what was not covered and the word crown was nowhere to be found on those 3 pages.
I challenged the customer service department to point out where in their 47 page handbook I could find any information about crowns not being covered. They could not point out a single example of this anywhere. When I inquired about how to cancel my policy they advised I could not and essentially hung up the phone. Dishonest, deceitful and dirty they are for sure. I will stop just short of calling them criminals but nothing would surprise me with this worthless insurance company. A one-star rating only because I can’t give any less.
Lies Told by BCBS Dental FED VIP
I am trying to get a tooth implant. BCBS does not have any in-network dentists within 35 miles driving distance of my home in Rehoboth Beach, DE. But BCBS states that there are dentists in-network in NJ, which requires me to drive on top of the Delaware Bay water. This is insane, but they actually wrote to me stating this is their requirement.
Further, I asked to get advance approval for an implant & they stated that even though implants are on their schedule, because it is their policy to provide only the cheapest procedure, which would NEVER be an implant, since dentures are cheaper – though this would require pulling out all my other teeth. YES, I have this in writing from them. I tried to complain to the OPM, but they said this is not an area they address. I called BENEFEDS, but they said this was entirely up to BCBS, regardless of how full of bullpuckey this is. No Federal Employee should EVER use them.
Possibly the Most Abominable Customer Care Ever -- Avoid These People. They Are the Plague.
which did not address my question at all. He simply lied to get rid of me.
I finally found the correct answer: It is GO TO A DIFFERENT INSURANCE COMPANY. DO NOT TRY TO DEAL WITH BLUE SHIELD CUSTOMER SERVICE. The sad part of this is that my main supplemental medical PPO with Blue Shield is great. But now, I hate the whole company, so I’m looking for a different supplemental PPO.
Poor Customer Care
I will be on Medicare as of tomorrow and wanted to continue my dental coverage with Blue Cross/Blue Shield. I was given the runaround for a month on hold talking to this one that one who sent me to a recording who sent me to pick an option. All I wanted to do was secure a dental plan for 2018. Well I finally figured God was sending me a message when I thought I was talking to a dental representative and it was only a switchboard operator. What a mess. First they pull out of Atlanta Metro from ACA. Then a person tries to get a health plan and NO ONE can answer a simple question. I hope that they go down the tubes where they belong!!!
Apparently This Insurance Is Just Above "Don't Have Anything" SUCKS!!!
I went to the dentist because I cracked my filling… I was going to have to pay $409.00 and the original bill was $490.00. Which means the insurance I pay on every month for my entire family is not worth it!!! BCBS State coverage for employees is a joke! Shame on you BCBS STATE EMPLOYEE PEBA INSURANCE!
Basic Teeth Cleaning NOT COVERED
I had a mistake not to call to the insurance (BlueCross BlueShield Health & BlueCross BlueShield Dental) to find ahead if my dental office in or out of network. I went to my dental office for years. This time I went there just for the basic teeth cleaning ($297.00 total with X-rays). The dental office has submitted the claim to BlueCross BlueShield Dental Federal Employee program. The dental insurance has declined the claim. That dental insurance is a secondary insurance compare to BlueCross BlueShield Health Insurance.
First the claim should be submitted to BlueCross BlueShield Health insurance because an underwriter sits there. If Health insurance would approve the claim it would send the claim to dental (BlueCross BlueShield Dental ) for coverage. Because my dental office is out of network the health insurance has denied the claim. The dental insurance has denied the claim too. And this is for a basic teeth cleaning once a year, NO other dental procedures during a year. And I pay for dental and health insurance every 2 weeks.
I will change the dental insurance and possibly the health insurance as soon as it will be possible. Draw YOUR conclusions from my story. DO NOT CHOOSE BlueCross BlueShield Dental Federal Employee Program unless you like to donate your money to them.