BlueCross BlueShield
2.9
7.2
Overall Score
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classicrun Greenville, SC
I asked many questions and took notes before enrolling in their Medicare Advantage plan. Prior to making any appointments, I read the booklet and called with additional questions and took notes.
The vision benefits were a joke - very limited coverage and providers. They no longer honor any of the major chains like LensCrafters or 1-800 Contacts, only little dinky local people who did not have my frames and my lenses weren't covered. Now onto the dental fiasco. I read the booklet and it was very vague.
HMMM. I called and took notes. Dentures were covered for 50% both in network and out of network. They said the same to my dentist when they called about coverage.
Well it turns out that that is for permanent dentures only. If you have to have a temporary, the cost of almost $1000, is totally on you. This should be clear especially when a customer calls with specific questions. Fortunately, I was able to drop them because open enrollment still was open.
They lost thousands because they refused $330. What a deceitful company and I had had them for 25 years previously.
1 year ago
julie roberts
They’re the largest provider in the country and yet policy terms are stingy and expensive. Their networks are large and options for care plentiful. Their website is also clunky, but not as clunky as other insurance websites I’ve interacted with. Their claims dept has been slow or non responsive in the past, though not every time.
1 year ago
Mauricio Lastres Ashburn, VA
February 2023
I'm making this review in the hopes that anyone reading this during open enrollment will be able to make a better decision. No one expects to have a positive experience with an insurance company. But this one is far below average. The company is trying to boost profits by denying micro claims and it's just causing me way too much frustration. There is no reason for this but to squeeze every dime out of subscribers.
I know our family's medical expenses are not covered. I know that this disease is too "new" and too "expensive" to treat. I get that and I pay for the insurance for emergencies only and for them to cover anything in the off chance that it falls under the "normal" treatment umbrella. So when my doctor prescribed an antibiotic, I assumed it would be covered. Well I assumed wrong. It needed prior authorization. Okay, I assumed it would be straight forward. Well I assumed wrong.
To make a long story short. Blue Shield apparently knows much better than my doctor and I should "try" two other antibiotics first before getting the one my doctor thinks will help my gut infections without causing more systemic harm.
This is a petty petty company. I already pay over $30,000 in out of pocket medical costs every year because they don't cover those doctors and things. Okay. But they couldn't even pretend to want to be helpful and pay for one two-week prescription of antibiotic. Needless to say I will never do business with them again.
I hope to save someone the heartache in the future. Also, talking to people, I learned from a friend that is older that the same thing happened to him 20 years ago. He also never went back to them. I guess things haven't changed at all.
1 year ago
Jill Morris
All my paperwork states that Blue Cross Blue Shield Dental will cover 70% of a root canal every 60 months. However, they divide the root canal procedure into two processes, one prep procedure that costs a couple hundred dollars and second procedure, the actual root canal. Both steps are done on the same day in the same office visit. Then Blue Cross covers 70% of the $250 prep procedure and then applies this prep as the 1 root canal every 60 months. Then you pay the entirety of the $2000 root canal. Keep in mind, when you agree to the procedure its called a root canal. The entire process is done on the same day during the same visit. But then gets subdivided as two codes to avoid coverage. Its shameful. If I could leave no stars I would. This absurd billing practice cost me $2000+ after I've gone 5+ years paying for dental insurance with no claims. Something needs to change.
1 year ago
C Walt Tunkhannock, PA
I am on the verge of suing them AGAIN. A car accident in 2011 law-suit resulted in our receiving money equal to 1/3 of a house. When ever it gets expensive, they put up horrific road blocks. Starting with the ambulance: "that was the wrong ambulance (there is only one) "here is a check for $180 for that over $900 ambulance" (but after I pd. the deductible they SAID it was covered 100%) "we keep billing your car insurance but they deny it" (letter that told them the car insurance was exhausted is in the file) "We have no bill for those dates, we don't know why you are being sent to medical collection" (they are looking at records for the incorrect year) and on and on. I have spent 10 of hours with on on the phone. Calmly, no more. If I get one more call from a bill collector, Spencer, Hebe and Rague will sort it perfectly, with no bother from me.
2 years ago
Stephanie Sponheimer
Worst insurance I have ever had and had to deal with. They give conflicting information to providers. Saying a pre- auth isn’t needed but then denying a claim because there wasn’t one and saying a procedure is covered but then deny it
I have two claims that are being appealed. If you have health issues this is the last thing you want to be dealing with
2 years ago
Diana Mkoyan Glendale, CA
The worst service!
They do not care and do not track the case. The workers are pretty rude and do not follow up with the clients. You make the payment, but in several days you can find out your insurance is not active.
The thing is, Blueshield does not even bother to understand the situation, and they can just bring unreasonable explanations and in the end, say it's not their fault.
Even the supervisors do not think about the customers. They can just inform the agent they are busy and can't talk. That's it!!!
Seriously, BlueShield is only good at receiving money, no normal service, no normal explanations, no following up!!!!!!!!!
2 years ago
Jake M Houston, TX
Blue Shield is horrible. I used a doctor that was on their network and he couldn’t properly diagnose me so he referred me to the emergency room. I wasn’t aware that I had such a high deductible at the emergency room or I would have figured something else out. I did need to figure out my prognosis so I went to emergency room and then later received a bill for over 2,000.00. I called Blue Shield horrible customer service and the lady told me she would have Blue Cross contact me which they never did . I called them back and the guy from customer service said that the lady never started the case so he stopped helping me and said the original lady would call me back. I finally got a call from her and she said they covered the charge and assured me several times it was covered. I continued getting calls from Christi Health about the bill so I called Blue Shields horrible customer service once again. This time a different lady answered and said that they never paid it and that I was gonna have to pay the bill. I complained letting them know I had gone to a doctor and he was the one that referred me and I had never had an emergency. The refused to listen and got stuck with pay the bill or end up with bad credit. I’m paying the bill of course but Blue Cross has horrible customer service.
2 years ago
Annie Naperville, IL
Nothing is ever easy when you try to get help or a question answered.
Some of the people who answer as BCBS customer service are lovely - and they try to help - but the company sucks at accommodating customers - so there is only so much they can do.
Other times - the call sounds like it's from across the world - it's not a clear connection and there is a TON of noise in the background on their end.
I cannot tell you how much time I have spent on hold over the years or going round and round in circles trying to get someone who can solve a problem. Just now - This guy literally just transferred me to a different department (or whatever) who said she couldn't help with the issue - and she transferred me right back to the original number that I called. Whether they mean to or not - the company comes off as only wanting to get your money - beyond that - the rest seems like pseudo-caring about health.
In fairness - I have a friend who worked for them for years in Chicago - and she loved it there. Although - for the work she did - they underpaid her for sure...
On the customer end though - yuck.
I wish there were a better insurance company -- but they all know that they have us over a barrel.
2 years ago
Kelsi Doxey Salt Lake City, UT
I will never, ever go with Blue Cross Blue Shield ever again. We have been with a list of different health insurance companies over the years, and it has been an absolute nightmare to work with BCBS compared to every other insurance company. They will give you the pre-authorization to do a specialty treatments, for example- I had issues with a bad shoulder, bad neck & migraines for years after serval sports injuries, had done years of physical therapy and a long list of and other treatments and methodalities. We had our second baby last calendar year and not only met our deductible but also our out-of-pocket max, they told us we would have a zero payment for the three MRIs that we did of my shoulder, neck and head, and they paid NOTHING. They preauthorized it and then literally paid zero after telling us they would cover it. It was an absolute nightmare to try to fight that. I will continue to be very public about my absolute disgust with this company. They are NOT here to help you. They will deem everything they possibly can as “medically unnecessary.” We are with EMI health now and it has been night and day with EMI being completely willing to cover everything BCBS never would. DO NOT choose BCBS.
2 years ago
Aleah Bell Durant, OK
This used to be a good insurance company. Now for the past 4 years they are horrible!!!
I am glad the marketplace has finally started allowing other insurance companies to participate. Blue Cross Blue Shield has been dominant with no competition for too long!!
They have denied every treatment request for my husband for the past 4 years. we have to appeal and call them over and over and it has caused my husbands Dr to stop helping him. It takes months to get approval for procedures.
Our monthly premium is now almost $4,000.
I pay $550. and we have the tax credit, thank goodness.
So in my opinion, they are out and out Robbing us and the federal government.
2 years ago
Leandra Sivess Carbondale, CO
Blue Shield is terrible, I don't know how it compares to other providers (my company only provides Blue Shield) but I have called and talked to their customer service about 40 times in the last 7 months for a claim that still has not been resolved and only 1 person was actually able to give me insight into the status of it and get me going in the right direction. After that ONE person (after 39 others) was able to get my appeal submitted the medical director reviewed my claim (of my very expensive surgery) and only approved the claim for the surgery and the Doctor, NOT the operating room or operating cost. So if you want to have your surgery covered to be held in the middle of the street, choose Blue Shield.
2 years ago
Danny Diab Houston, TX
For the past few years, I've had to deal with this insurance carrier a number of times. I wouldn't wish this insurance "coverage" upon my worst enemy. Satan himself probably gives better coverage. They find any and all excuse to deny your claim, and even if they legally can't deny a claim, they'll throw up barriers over and over again.
Just as ONE example, I once had to reschedule an MRI without contrast 3 times even though I specifically called - twice - to make sure no pre-authorization was needed (they said it was not). Guess what they did when I went for the imaging? They denied the clinic's claim, noting that pre-auth was required. This occurred twice, and it probably would have happened a third time if an elderly woman, another patient at the clinic, hadn't told me I should call them back and tell them to stick their pre-auth where the sun don't shine.
Also, Blue Cross Blue Shield is a morally bankrupt corporation. Take it from a healthcare insider. They publicly pick fights with hospitals and clinics because they don't want to pay for good quality healthcare even though these healthcare facilities are covered by their plans. Hospitals are struggling to remain open because of filthy insurance corporations like BCBS
The long and short of it is don't use Blue Cross Blue Shield. If you're shopping for a plan for your business, your family, or just yourself, do some in-depth research on a legitimately good company and good plan. Get referrals from some friends. I'm aging out of my plan now, and God knows I won't be going back to BCBS for my family.
2 years ago
jennifer frank Chicago, IL
I had a mammogram which should have been covered under Obamacare but wasn't. I had to pay out of pocket $195.74. I called 2 times. On the first call, I was told it was covered, but this last time I called I was told it wasn't it was considered preventive.
I was on the phone for an hour and when I asked to speak to a manager I was told they'll call me back in 48 hours. How does Bluecross not have a manager available?!?
They also didn't cover my ultrasound because they claim it's preventive. My mammogram did not pick up a lump they found during the ultrasound. One would think Buecross would want to cover this because it will cost them more if I get breast cancer(which runs in my family and I've had lumps) or die. Then they would get no money!!
I AM SO ANGRY because I know for a fact that Obamacare covers 100% of a mammogram...GUESS JUST NOT WITH BLUECROSS!!
The fact that I called and had 2 different answers and that they are plain out denying coverage is so wrong!
2 years ago Edited February 24, 2022
Jay House El Dorado, AR
I had a non-work related back injury that required 36 visits to a chiropractor. They only covered a handful of visits and stuck me with several thousands of dollars in bills. The chiropractor was very upfront about this even before the first session and I tried to talk to my HR, a Bluecross representative that was actually on site, as well as on the phone, and they would not do anything for me. This was months ago.
The reason I'm writing this now is because they just had me call them to ask me a few questions. At first, I thought they actually reviewed the situation and were going to do the right thing. But as it turns out, they were actually calling to find out if I had any plans of hiring an attorney. They were concerned that I was suing.
Really puts into perspective where their priority lies.
2 years ago
Wagner Dona Fort Lauderdale, FL
When a doctor recommends a procedure, such as an ultrasound, based on his assessments upon a patient's visit, that procedure should be approved immediately by BCBS, and not sent to a third party that doesn't know the patient. It is an absurd for this third party to ask the doctor to call and explain the need of such procedure, as if doctors had nothing better to do with their time. Imagine if a doctor is to call a third party every time he recommends a procedure...he would not have time to do anything else. If the doctor is part of the BCBS network, it should be approved without any questions. I pay A LOT monthly for my health insurance, and expect to receive a good service in return.
3 years ago
Rachael Mantsch Borgarnes, BOG
I manually paid my monthly premium (over $300) 2 days before the end of the month and got an email confirming this payment. On the 6th of the month they withdrew the payment AGAIN from my bank account causing me to overdraft and they did not even send an email confirming this. They are refusing to refund me saying that is has now been applied to my November payment saying the money is just gone, and they are refusing to cover my $40 overdraft fee. Don’t get me started on what my $300+ monthly premium DOESN’T cover in the first place. It covered my well-woman exam and labs (which came to $200 total-so less than a monthly payment itself) but no specialized doctors visits or prescriptions. It’s absolutely ridiculous. I told them I was sick of talking to them and cancel my membership as of December. I’ll be finding new insurance.
3 years ago
Talena Mcconico Baltimore, MD
The wait time to speak with a representative is ridiculous. I verify insurances for my job all day. To have to sit and wait to speak to someone for 30 minutes to 2 hours, is time consuming, frustrating and exhausting. When I do speak with someone, the call last no more than 5 minutes. I just don't understand it. If my company had someone on hold for 30 minutes let alone 10, some one is going to have to answer for that. I wish I worked for a company like BC, I'd get to sit and watch the blinking light and ignore it for as long as I choose with no repercussion. I'll have to call BC again about 3 more times today. Your self help doesn't work for me. I have daily conversations with mothers about how they're one month old is added to their policy when it's showing on the Blue Cross website they aren't. So I have no choice but to wait to speak with someone to verify this before I tell mom she has to pay out of pocket for her visit. Our Blue Cross ins plan also suck but that's a rant for another time. Please do better Blue Cross.
3 years ago
Binah Thillairajah Denver, CO
This is absolutely the worst insurance we have ever had! It is like owning fake insurance! I have a card but absolutely no care, coverage or customer service. I called to get an estimate on cost of services - 15 hours later I still do not have an answer. the call was forwarded overseas, it took over 45 minutes of being on hold, the customer care person kept dropping the call and not calling back, when I asked for basic estimate for cost of a particular service they put me on hold for another 45 minutes, told me they’d call me back abd never did, then called back asked to speak to a supervisor and was told supervisors were in a meeting and unavailable, after several days of this I called their bluff and the “supervisor” told me that costs estimates were confidential and could only be released to providers, had my provider call and they were told that costs were confidential and could only be released to memebers… no one cared that I had an emergency and couldn’t get care because I had no idea of costs and I still don’t have an answer!
3 years ago
Ayesha Abdullah Denver, CO
My daughter was diagnosed with an eating disorder last year. She went to an eating disorder recovery center and had all her tests done and also spoke to the psychologists there. When the recovery center reached out to the insurance company to get her stay approved, the insurance company denied it saying that they will not pay for inpatient. The insurance company said they would be willing to pay for a PHP. My daughter tried that, but she was not ready to step down. We finally brought her home and got a dietitian and a counselor to work with her. After working with her, both her dietitian and counselor wrote to the insurance company recommending that she needs a higher level of care. We got all the medical tests done and again insurance denied her in patient. The branch of Blue Cross that deals with mental health is New Directions. I don’t know how any one who has not spoken to the patient and only looks at the medical results can deny in patient; especially if her counselor and dietitian who have worked with her on a weekly basis recommend that my daughter needed a higher level of care.
New Directions is in the business of helping patients with mental health issues get better but I strongly feel they are in the business of only making money and torturing the patient and their families. Twice New Directions has denied in patient for my daughter who is so anxious about food that some days she only has 800 calories.
This year, we tried getting an eating disorder psychologist to work with my daughter. Again, I reached out to New Directions under the advice of Blue Cross. In the Denver area, they could not find any psychologist who was accepting new patients. New Directions gave us the name of a psychologist but when we reached out to her, she said that she was not up to date with the latest techniques. We found a psychologist who was not in network. We asked if insurance would pay because there was no one in network who was accepting new patients and again they denied it. They said there are male eating disorder psychologists who can see her. My daughter does not feel comfortable with a male.
New Directions is one of the worst companies I have had the misfortune of dealing with. They do not want to help in any way. All they want is to make money, and put the patient in mental anguish. Blue Cross needs to look at New Directions policies and how they treat the client. They do not respond at all. I had filled out a grievance form and I did not hear back from them even though the email said I should hear back from them within 30 days.
If you or your family has any mental issues like my daughter, I would not recommend Blue Cross because of New Directions. No one at New Directions cares about mental health. They will try to stall you and make it your problem. Dealing with New Directions and Blue Cross is a nightmare. I don’t know why we are paying such a high premium to the insurance company. Customer service is absolutely horrible!
3 years ago
E Schonlau Fort Collins, CO
I desperately need a surgery. Nothing else has worked. I am 19 years old and I already need weekly infusions and had to withdraw from my first semester from college. BlueCross and BlueShield has refused to cover the surgery. My nurses have talked on the phone for hours, I have tried to appeal, and yet nothing. The fax number for the appeal didn't even work so we had to mail it. They claim the surgery is 'experimental' though it is new the statistics show higher success rates then the only other highly invasive possible surgeries that are unlikely to help me. I don't understand. Insurance will do as much as they can but when all else fails they won't let you try something you desperately need and decide just to let you suffer the rest of your life. I am struggling because I don't see a future.
3 years ago
tonya M Spring, TX
BCBS used to be pretty good but the last couple of years have gone way down hill. I have been trying for over 6 months to get 1 issue resolved but each person I talk to has a different answer, talks in circles, passes to someone else, etc. If you call, you'll be on the phone for hours & if you email, you are lucky if someone responds in 1 week. But even then, you get a long scripted response that doesn't answer your question(s). You might get someone who knows what they are doing about every 6 mo. to a year if you are lucky. Extremely disappointed in how this company has deteriorated & wonder how much of it is deliberate to keep money in their pockets instead of providing decent health coverage. I'd give a negative rating if I could.
3 years ago
Tesla Denise ,
I had alot of issues with my plan and policy and lucky I got Celestina for my agent when I called in with my problem. She was so present and so helpful, Everytime she put me on hold even if they had not got back to her with the answer she needed she made sure I was not on hold listening to that God awful music over a min or two at the least. Celestina keep me updated at every turn and gave me options on how to get my problems fixed. The company itself pre approved me for two doctors after the 6th session they then wanted to tell me that it wasn't in my plan to go to that therpist after now I have created that relationship and that bond and can't and refuse to start over with a new therpist. Shout out to Celestine for making a bad situation better with her upbeat attitude and pacients ears listening to my story and problems as I cried lol. You are amazing and to good for a company that messed with people's lives.
3 years ago
Azza Boston, MA
Dental plan is terrible, hard to get care due to limited dentists accepting insurance. Deserves a zero for charging me double the price for “late fees” after I canceled my Membership THREE times . Still fighting to cancel this membership months later and get them to stop charging me every month. Not even asking for a reimbursement just want it canceled and to stop being charged. Took my account and credit card info off the account, changed my credit card and they are STILL somehow able to charge me. I truly don’t understand how. Absolutely criminal and frustrating, have wasted so much time trying to cancel this insurance. Do not bother signing up in the first place, just a nightmare in the end.
3 years ago
Robin Stoltz Nassif Tarzana, CA
I love it everything I need is covered. The claims are handled quickly and my providers are great. My premium is low and I have no complaints whatsoever.
4 years ago
Hank Speakman Corpus Christi, TX
I feel free to manage my health with my doctors. I do not like to be forced into stupid things like writing a review that must be at least 50 characters.
4 years ago
dale
nothing but good experiences. They reduced my rate during the pandemic without my asking. They have covered everything I have asked them to cover. I think they're great!!!
4 years ago
Larvan60 Galva, KS
I became extremely Ill a few weeks ago and thought that I may have contracted the Coronavirus as this virus's symptoms run a close parallel to Ifluenzas A and B and my symptoms, for the most part, were within the parameter of the virus so therefore, I contacted the only medical people I could due to the time I called which was our local hospital and gave them a description of my symptoms.
I was told that I would have to either wait a couple of days before I could get tested by going to their drive through testing stations or going into the hospital, to their ER and check in there.
My wife called her supervisor and told him what was going on and he ordered her to stay home from work and go into Self quarantine, which she did. At that time, I decided to go on into the hopital's ER check in station to get tested.
When I the doctor and nurse finished their testing, I was told to go home and remain in self quarantine until the test results came in. I was in quarantine for 2 days until I received a telephone call from the hospital, telling me that the results came back Negative and that I more than likely had Influenza but they did not tell me which one I had. I had to figure that one out on my own which wound up being the A strain which was, by far, worse than the B strain.
Approximately 3 weeks later, I received the bill that the hospital turned into BCBS and just the other day, I received the results from BCBS and when I looked at the final bill, I was very glad that I was sitting down!!
BCBS didn't cover a single penny of the bill which is $1450.00 for the test!! Good God, this bill for this amount for sticking a cotton swap up my nose, twice in each side that made it feel like they were going to scrape the back side of my eyeballs, did a quick scan of my chest and take a few vitals?? The whole test concluded within a 5 minute period and I had to lay around in the ER room for about an hour, doing Nothing, seeing NO ONE and that room cost $987.00 per hour, or so it appears to be the going price??
BCBS is the worst insurance provider I have ever seen or had in my entire life and just as soon as I find another provider, I am going to tell them where they can get off!!! And I don't plan on being very nice about it either!! I have had it with those people, their bad habit of Ripping off those who are under their insurance plans!! And, I also have to thank the Steel Worker's Union for their Arrogant Stupidity and Ignorance when it comes t dealing with contracts that effect their members and all other employees. They couldn't negotiate with a freaking MORON!!!
4 years ago
Leslie Miller Katy, TX
Went to the doctor yesterday to get treatment for something. My doctor wrote me a prescription and I dropped it off at the pharmacy. Later I get a message from the pharmacy that my insurance doesn't cover that brand and has a preferred brand. Now the doctor is out and I can't get the brand changed. It's already been over 24 hours since I sought treatment and got the prescription I need. Now that the doctor is out, I can pay out of pocket for my prescription when I already pay these jerks 700 a month or my treatment will be delayed for days or weeks until I need surgery to fix something that could have been stopped in a couple days all because Blue Cross has a preferred brand. This company sucks, always has.
4 years ago
Carol Kalvik
I've had this health insurance since I became a federal employee in 1984. I've had no issues, problems of any kind, or payment disputes with this company.
4 years ago
Tiffany I Gaithersburg, MD
Been with Blue Cross with my employer for over 10 yrs. Never had an issue with coverage. My children’s deliveries along with minor surgeries were covered with no issues.
4 years ago
Shannon P. Bentonville, AR
There is so much red tape involved in accessing my benefits, it's easier to pay cash out of pocket than deal with these crooks. They won't send a bill, statement of benefits or ID card until they receive the first payment. So basically you'll pay for the first month, but still not have access to your benefits. Here is the phone call I had w a BS/BC rep just now. "Me: Hi, I haven't received a bill or an ID card or description of my benefits and my insurance is being denied by doctors I need to see." BS: "Well we can't send you a bill until we receive your first payment." Stupid me, I send them $540 a month and still can not use my medical insurance...what exactly am I paying for???? Grrrr
4 years ago
M Schwartz Sicklerville, NJ
I was told that because im HMO, if i go on vacation they wont pay any medical unless life threatening. My son had blood in urine which scared him while on vacation and his claim was denied at urgent care because it wasnt life threatening
4 years ago
Terry Mama Kennesaw, GA
We have had BCBS for four years. My husband is a UPS employee with a “Cadillac” top of the line plan, and it sucks!! They nickel and dime you for everything. Pray that you don’t need an ambulance or anything out of network. They say it’s covered at whatever the reasonable going rate is for the area, but it’s not. They’ll only pay about half of what your billed, even if every ambulance provider in your area charges the same price or more. Well visits are supposed to be covered at 100%, but again, they NEVER are. Expect a bill for some of it. Crooked company. I wish UPS would go back to Atnea.
4 years ago
Dr Pinder Lake Worth, FL
The insurance is really good (10 years). However, if you are looking for customer service, you will always be frustrated. After waiting on hold for 1 hour plus, I was transferred to wait again. Only to receive another phone number to contact for my answer.
4 years ago
MDG Troy, MI
Very poor customer service and lack of transparency. Representatives are not versed thoroughly in company policies. I received conflicting information after speaking to three different representatives all in the same day. After conferencing in with the Healthcare Marketplace and Blue Cross twice and being promised a specific dollar amount premium considering our tax credit. Blue Cross continued to bill us for a much higher premium ($88 more). I continued to call them for several weeks to try to understand why this was the case. However, they continued to insist we had not paid our previous balances in full and therefore had incurred a balance of $272. After being on the phone with them for an hour (each time, over the course of different dates) they were still unable to explain from which dates we owed them a balance. Especially since I had payment information proving we had paid the premium we had been billed for in full for each of those months. Very disappointed with the lack of thoroughness and being put in the position to be forced to justify we were up to date on all of our previous bills. Such an expensive and large company should keep better billing records. This case is still pending and we have yet to receive a resolution. Needless to say I do not recommend this company!
4 years ago
Eric Chandler, AZ
The company I worked for used BCBS as the plan administrator. The company was self insured. Far too many times claims were denied by BCBS that were allowed by the previous administrators. Example: My doctor and I read the report after the peer-to-peer was denied (final step of appeal) and couldn't believe what we read. BCBS found a doctor in their BCBS Florida network to write that a RFA would be unsuccessful if the back was fused at any location. My wife's back is fused L4-S1 and the RFA was at the T5-7 area. We worked a payment with the doctor, but considering the RFA was so successful my wife stopped her Oxys, it was worth it. Now that we're Medicare, which covers RFAs, we will never use BCBS for a Medigap policy. RFA, Radio Frequency Ablation, is a procedure where a probe inserted in the spine zaps a nerve to "numb" it, lasts about 18-months. Doctor claims are around $2200, of which insurance allows about $800. Maybe if insurance companies paid for procedures like this fewer people would be on pain pills.
5 years ago
Chris Parrish, AL
My husband and I have been fighting with blue Cross and blue shield for a while now. My husband and I have been seeing a doctor for about a year now and we have gone in for different appointments and procedures and everything had been fine and covered until June when my husband had a procedure scheduled. We called ahead to Blue Cross to get preauthorized for my husband's procedure, before calling Blue Cross we talked to our doctors billing department and they gave us the billing codes which we then gave to Blue Cross. When we called, the representative from Blue Cross stated that the procedure was covered and we asked if there was anything else we needed to do which he stated No, everything was covered. A few weeks after the procedure we found out that Blue Cross denied the charges stating we did not have a referral, we explained that when we called there was no mention of a referral and we had not needed one for any of the prior visits or procedures. We had a referral submitted and Blue Cross responded with, too much time had passed and so they are denying the claim. In an attempt to file an appeal we contacted Blue Cross and asked for transcripts and any other supporting documentation involved with this particular claim. They explained to us that we would have to submit a written request and we would have to pay them $40 for the information we are requesting.
5 years ago
Rene Ayala Jarrell, TX
Well every time I have to call this guys
First for start the people how answer the phone
You can ask for some information about your company
And they never know nothing about
They always tell you
Your company that’s not have that program
They take to long to answer the phone and when that happen you will end up with to much frustration
Because of their job
Secondly and list importan
They take to long to aprove something
5 years ago
Chronic migraine sufferer Gurnee, IL
I purchased COBRA coverage between job changes for a month. BCBS rescinded all of my prior authorizations for medication, and then, they drug their feet approving the medications again so that I couldn’t get them on time and fill them the two times I should have been able to under my paid insurance plan. Really crappy thing to do when people need their medications and pay for insurance for that purpose.
Worst part-I will still have the same coverage at my new job. BCBS jerks.
5 years ago
Mike MC Boston, MA
Specifically took an out of network eligible plan so that I could have a wide variety of doctors to choose from. They had a higher deductible and out of pocket. Both aspects I was aware of when i signed up.
Found a out of network doctor who fit my needs. All good. Paid him up front and then went to BCBS for reimbursement.
This is where things go downhill. BCBS has "approved" rates for each ICD code. They were half of what the doc actually charged. Their argument - "this is what we think this code should be charged at in your area". Now the kicker, they would only take half of what I paid even towards my deductible and out of pocket calculations. Now i am stuck with a massive bill while having chosen from the terms clearly laid out upfront.
Was this "approved rate" mentioned upfront - NO
Did they already compensate themselves with a higher deductible for going out of network - YES
Was this in their fine print which you would find after 3 hours of looking at 8 levels deep on their site - YES
So why are they double compensating their bottom line? If you have an approved rate, then just have an open network with no concept of in or out of network.
It's the profit gouging practices like this which will make me hate each and every executive in BCBS.
You lost a customer. Not that it matters to you. I really hope the BCBS executives experience being middle class and being hit with a surprise medical bill that is a result of profit gouging through shady practices.
5 years ago
Maddison Long
This is an extremely lousy and deceptive insurance company that I would strongly not recommend. They sent me a letter offering greater coverage if I provided them data via a form. Once I did so, with zero mention in the letter, there was a surprise mandatory health clinic visit required where they wanted to take my blood and perform tests. When I told them I didn't want to proceed with the health clinic visit that was not at all mentioned in the letter, I requested that they delete my data I had provided them through the form and at first they refused to do so. It took several weeks of calls with Blue Cross, educating them on PIPEDA (our privacy laws) that they were knowingly and willingly violating to finally delete this data. Weeks later I became locked out of my account and had to call them and they let me know they "accidentally" deleted my account and had me re-create my account, wasting a lot of time because of their incompetency and unwillingness to follow our laws.
5 years ago
Stephania Lockport, IL
I am looking for an alternative at this point. The premiums are ridiculous, the out of pocket maximums are unbelievable, and the billing service people don't have a clue about billing. I pay over $1300 a month for 2 people in their 40's. Our family out of pocket is almost $16,000. In March, I happened to log in online to look at some claim information and just happened to notice that my policy showed cancelled. I panicked because my husband was in the middle of arm surgery / infection treatment, and this was no time to not have insurance. After talking with BCBS billing/customer service for a week, they could not find a single piece of documentation showing who requested or why our policy had been cancelled. If I had not happened to log in that day and bring the situation to their attention, chances are they would not have paid the upcoming claims from our doctors and hospitals. Then 3 months later, I get an email stating my monthly draft is changing from $1300 to $2157. Again, I've not requested any changes to my plan. After the billing person threw out 4 different reasons for this, none of which made any sense at all, she finally put me on hold for about 20 minutes, and then said there is some discrepancy from 2016 in which we owe $800. And now she has to escalate it because she can't do anything about it. Another week of dealing with incompetent people. Not to mention all the stuff that isn't covered even though I have their most expensive plan. I am going broke on just a couple of arm surgeries.
5 years ago
Michael Snow Spring Creek, NV
My 10 yo boy was diagnosed with type 1 diabetes. I was informed by my insurance that his medication would be covered at 100% because it is a maintenance medication and he can't live without it. LIE. He is required to take shots before every meal, snack, too high, and a separate shot altogether at night to keep him somewhat balanced throughout the next day. not to mention the chaos of the BGL when he is sick. He is consistently having to stick himself to get a reading. We try to get a continues BGL monitor not just to help him but help my wife and I to keep our jobs when he is out for the summer from school (his school nurse is amazing). We got denied because they said that it is medically unnecessary.
A unrelated surgery he had on his knees and had to get screws in place. They covered that surgery but then he had to get the screws removed and they wouldn't cover that surgery.
My pregnant daughter 21 yo was having blood clotting issues in her lungs because we found out that she is protein C and S deficient. She had to continually take blood thinning shots in her belly. 3 times we had to admit her to the hospital because insurance would refuse to pay for her prescription.
I have 3 other stories to add to this and this had all been in 2018-2019
5 years ago
Amanda Jordan Austin, TX
They made a mistake and billed my old policy, and cancelled my new policy. I've been paying every month and didn't find this out until I was sick with a fever of 103 trying to get in to see a doctor. They made it impossible for me to see a doctor because the billing office was already closed. They couldn't help me that day, but said they would call back the following day to figure it out. Two days later they call me back to tell me that they can't help me with my request, and that I would have to jump through hoops to fix their mistake on my end before I would be able to see a doctor. I had to pay out of pocket for a doctor and my medication because they canceled my insurance even though I had been paying monthly. Also, it tells you that it covers one thing (example:birth control 100% cover) when you are enrolling, but after you sign up, your coverage magically changes.
5 years ago
Antoine Bell
Blue Cross Blue Shield overly scrutinize prescription coverage to the point of nickeling and diming it's customers. They are very inconsistent when it comes to what is covered. You can have a prescription that is covered one month and the next month it's not. Moreover, their automated phone handling service for incoming customer calls is confusing and wastes a lot of time for it's customers which results in unhappy and frustrating customer call. For the amount of money we pay, we deserve better prescription coverage and better first impression phone handling.
5 years ago
pamelaj Catoosa, OK
Worst of all they lie. I have been fighting them for 3 wks, my blood pressure med that I've been on for 12 yrs is no longer covered. They state, and this was on the form I received yesterday, that I have to have tried and failed 2 meds to get on the one I'm on. I DID! 12 yrs ago. When I called, they said that same thing, I said, I DID, well, then it turned into my doctor didn't send that info, THEY DID, then it turned into that I didn't try the ones THEY say I have to try, and it's not 2 but 3! I am sick and tired of the insurance companies deciding that they know more than the doctor. They will screw over and over, and when you point out what is in writing from them, THEY LIE! so now I have to start all over again, after 12 yrs. The fact that between myself and my employer pays over $800 a month, is robbery.
5 years ago
CRUZ LOPEZ Tucson, AZ
Horrible Company! Very inconsiderate of the members schedule when it comes to customer service hours! I've been paying over $565 every month since Oct 2018 and haven't been able to use my plan 1 time! I was never mail a packet! Never got my Member card! Never get a rep because my work schedule doesn't allow it! I cant register online for whatever reason i get errors and then tells you to call a number that closes at 4:30! But they sure do get their money from every check!!! Its a one sided relationship and they got their money and don't care of anyone's situation. If you can find another health insurance provider, do it.
5 years ago
Efren Cerritos, CA
This Health Insurance sucks! Last December 2018< I had an appointment with a Specialist for a follow up treatment. The day before my appointment, the Doctor called me to verify with my insurance because they claimed that I was inactive and changed on another group plan without my knowledge. When I received the two insurance cards for me and my wife, our family primary physician got changed without our knowledge. Blue Shield assigned us a doctor that we did not know and located quite a distance from us. We never called Blue Shield to change our Primary doctor and our plan, however, they went ahead and changed it without notifying us. I called Blue Shield on the day before my doctor appointment, the representative I talked to went to change back to our Primary doctor and said that I was on the same plan as before and would be receiving the new cards in 10 days. Guess what happened, the doctor had a problem with my insurance and I was inactive. I was very thankful that the specialist doctor treated me for free for that appointment. Additionally, the new cards arrived after 26 days compared to 10 days as I was told. My card was changed to my previous primary physician but not my wife. I called Blue Shield today, 1/15/19 to correct the issue and spoke with someone by the name of Alex and made me wait for so long hoping that he was correcting the issue. No, he was searching for the reason why it was changed. Later, he told me that my wife needed to call them herself. I told them that I am the Primary member, however, he insisted that she had to call them. I requested to speak to his supervisor and the supervisor told me the same way although I explained to them that this was an error on their part, not notifying me and they changed our Primary Physician and plan without our authorization and notification. Additionally, a prescription was given to me by the doctor and was not authorized by this Insurance although it was authorized before. BLUE SHIELD sucks and I will be switching to another health Provider. I SHOULD BE RATING THEM AS ZERO STAR, HOWEVER< THERE IS NO ZERO HERE.
5 years ago
Stephanie Rose Saint George, UT
Blue Cross Blue Shield federal employee insurance doesn't care about it's insured!! Mom has multiple sclerosis and ehlers danlos syndrome. With both of those diseases she is constantly in a lot of pain due to issues with her back. She has had a discectomy, an operation to fix a herniated disk, and was told that eventually she will need to have her entire spine fused. Well a pain specialist recently put a light at the end of the tunnel. He told mom about a device, a spinal cord stimulator, that would be implanted internally to her spine and would override the pain sensors in her brain with pleasurable sensations or even no feeling! It was perfect! Mom was told this would be beneficial for her by her primary care physician, her neurologist, and her surgeon. They were excited that she would finally receive relief from her unending back pain. The pain specialist, Zion Pain Management, went through all the paperwork and found that the insurance required no prior approval for this procedure. With that in mind the doctors went ahead with the trial. It worked wonderfully! Mom had energy and was able to walk, sit, sleep, move, live without pain! But then Blue Cross said that they had not given authorization for the surgery so they were not going to pay for it. Then they claimed that this surgery was not medically necessary. They told the surgeon that he would need to cover the cost for the trial himself and that they would not pay for the permanent procedure. Because of that the surgeons would not move forward with the permanent procedure. Mom and all of her doctors have worked to overturn their verdict for over two months. Today though, Blue cross told mom that this surgery was not medically necessary because she was not in enough pain to warrant this type of surgery. She had not been on opioids long enough and had not proven that surgeey was needed. Who do they think they are?! They are using their own quack of a "professional" who from looking at a sheet of paper on a desk has singlehandedly decided that he knows mom better then all four of her doctors and that their four opinions are wrong. Screw them! Mom was crying after hearing their verdict. That pissed me off! Please share this around so that the truth of Blue Cross Blue Shield will be shown. They would rather their insured members be addicted to opioids and other harmful drugs then receive the full help they require. Screw them!!
6 years ago
