Anthem offers private health insurance plans, Medicaid, and Medicare. Some of its plans are HSA-compatible. Anthem also provides members with excellent resources.
Anthem is owned by BlueCross BlueShield (BCBS). Founded in 2004, Anthem BlueCross BlueShield is headquartered in Indianapolis, Indiana.
Owned and operated by BlueCross BlueShield, Anthem offers health insurance to clients in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin. Limited by location, this insurer nonetheless leaves little to be desired in its health plans.
Anthem offers health insurance options that include PPO plans, HMO plans, Health Savings Account (HSA) compatible plans, and short term health plans. Anthem even offers group disability insurance.
Like many competitor insurance providers, Anthem health plans also include Medicaid and Medicare. Those seeking Medicare or Medicaid services can find options with Anthem.
For individuals, couples, and families under the age of 65 who need health insurance, Anthem has a great selection. Plans are divided into four main groups:
From bronze to platinum, these plans are organized by price.
For a bronze health plan, you pay a low monthly payment (premium) for the insurance plan but have higher out-of-pocket costs for your actual medical bill. Bronze plans cover about 60 percent of medical bills.
On the other end of the spectrum are platinum plans, which cost you the most amount of money for the insurance policy but the least amount of money for your medical bills. These plans cover 90 percent of health care costs, leaving patients to worry about a mere 10 percent of the bill.
In between are silver plans, which covers 70 percent of costs, and gold plans, which cover 80 percent of costs.
Each Anthem plan comes with a different deductible, out-of-pocket expenses, coverage-level, and cost-sharing rules. Most health insurance plans cover preventive care and emergency services.
It's easy to see, then, that the choices at Anthem are in no short supply. Whether you're an individual, part of a family, under 65, or over 65, you can find insurance coverage from Anthem.
Members are treated well at Anthem. When you register to be an Anthem member, the company does not leave you to fend for yourself. On the contrary, the patient portal and company website work in tandem to answer your questions and keep you up-to-date on your health plan.
First and foremost, the company has a dedicated phone number for members, and members can count on Anthem 24/7 if they need to contact them for any reason.
At any time of the day, members can check the status of a claim filed through Anthem. Immediate assistance like this is important to customers, and that's why Anthem has other convenient resources, such as LiveHealth Online (their live chat option should you need to speak with a doctor right away).
As a new member, you'll enjoy the Find a Doctor tool to make sure your provider is in Anthem's network. This tool also makes it easy to locate a primary care physician or specialist.
The Find a Doctor Tool make it easy for Anthem members to locate doctors in their area and network.
Whether a new member or an experienced one, Anthem's patient portal offers explanations of your personal plan benefits, a list of your prescription drugs, and any forms you should need (such as for claims).
Anthem cares about its members health, not just their health insurance plans. Anthem offers a personal health assessment that you can take to see what kind of health you have. You can also watch video tutorials on the company website to learn more about how to navigate the patient portal or even about medical insurance, in general, as this industry can be so easily confusing. Truly, Anthem's member resources are designed to keep you healthy and informed.
Anthem stands out among the crowd of health insurance companies by offering several resources and additional services that make a patient's life easier, more informed, and more convenient. Before potential clients even become a member, they can get a free instant quote on the health plan they would want.
Another unique feature for Anthem is their LiveHealth Online resource, which is a live chat tool through which you can speak with a doctor right away about a health question you have.
The company's mobile app is also a free provision, giving you more ready access to your patient portal.
It's worth mentioning here that Anthem's company website is a bonus to using this company's health insurance. A website is not the determining factor of your health plan, of course, but transparency and clarity are key to the customer service experience. Anthem delivers in both respects with the company website.
Anthem makes it clear just by the layout of their website that customer service is important to them. While a company website is just a first impression and not a face-to-face interaction, the website also gives you the information you may want upfront to determine whether a company's health plans are right for you.
Online you'll find detailed FAQs sections (through which you can narrow your search by your state and the health plan you have). You can easily download forms, and request an ID card.
Of course, Anthem offers the traditional communication tools as well, offering member-specific phone numbers.
Overall, Anthem does an excellent job of providing answers to questions, like the terms of their health plans, a way to find an in-network doctor, a view of the patient portal, a health insurance quote, and much more. But if questions aren't answered by the website itself, Anthem several different ways for clients to conveniently speak with a customer service representative directly and get the help they need.
While Anthem has recieved a fair number of reviews, its review count is much lower than other health insurance companies listed on Best Company. It's also concerning that most of Anthem's reviews are negative.
While Anthem is affiliated with a well-known and respected insurer, keep these reviews in mind as you consider plans from the company.
In 2015, Anthem was hacked. 78.8 million of its members were affected by the data breach. In a settlement, affected members received help with credit monitoring and identity protection and some compensation. Anthem has improved its security to keep its members' information better protected.
Anthem itself was founded in 2004, so it is less experienced than some health insurance carriers. Some companies have been around for well over a century, making Anthem very new and still in the process of working out kinks.
As widespread as BCBS is, Anthem plans are only available in select states. These include California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin. This doesn't cover even half of the US, which means Anthem might not necessarily cover your area.
Call our recommended rep over at Anthem below.
My gosh for the pain I have had with this insurance. Pain. Pain. Pain. To give birth I am limited to two places only: the ones I wouldn't even have considered looking at should I have a better insurance. Large places like Wellstar or North Fulton do not have a contract with Anthem. It is just crazy. You'd think, it's Blue Cross Blue Shield, right? Wrong. Especially if purchased through market place. Nope. Nope. Nope. The customer service is great sometimes, especially, if they send the right info. But the coverage itself sucks!!! Absolutely, without a doubt, sucks! And it's not cheap! So, save your money and get a better insurance.
Reasonable costs, efficient, organized, respond quickly, good customer service
I was in the hospital and two nursing homes during almost all of 2019 and they paid almost everything.
If I could give them a negative, I would. I had 4 dermatology appointments in 2019 that Anthem covered. Then in August they denied. Turns out the original claims should not have been covered as doctor was not in network. Anthem is the one who told me to go to this doctor as he was in Network. I'm in the process of switching to my work healthcare on 1/1/2020. I called customer service on10/31 spoke to Julian. Told him to remove my auto draft effective 1/1/2020. Well, on 11/3, I receive a notice stating my monthly payment (which was auto draft) was not received. I am assuming Julian put the wrong stop payment date in. So, now I have to call (again) to get this bill adjusted. I have nothing on the portal to allow you to pay manually. So another phone call. How inept can a company's customer service be? Only 2 more months left and I'm done with Anthem. I'm sure the next company will be similar as all healthcare is screwed up....
I have insurance through my employer and my kids also have a secondary insurance, however anthem never comes through and I have to end up calling to get any claims paid. I have 3 kids and the claims are aplenty with my kids, however I shouldn’t have to call every time a claim comes up.
Anthem was good. they covered most of the my family medical needs and it provided good pharmacy coverage.
I have only been on my anthem plan for a few months but have already had an awful experience. My parents have the same type of plan I do, but have been on it for a few years. I was recently sent to a specialist and through my research and conversations with anthem to figure out my payments, I found out they had been overcharging my parents for 2 years for specialist visits! With my plan, a specialists visit without any extra procedures or additional exams (scopes, etc) should only be $50. Turns out, anthem was billing me for the entire visit, and had been doing the same thing to my parents for 2 years. Anthem sent my claims and my parents back to be rechecked, but I am sure they are doing this to other customers as well. If you don’t question and stay on top of things, anthem will bill you for more than you actually owe. I also found out by anthem that if the doctor bills as an outpatient visit vs. an office visit, you are charged more money, so something to keep in mind if you are referred to a specialist or see a PCP that bills under a hospital.
I use Anthem and am in network with San Jose Medical Group. Same doctor for 10 years referring to same doctor for 10 years. Between my referral and mammogram a doctor is out of network (although online he was in network.. so no way I could tell) and despite all working for SJMG and I was stuck with $550 bill (for a routine mammogram which is included in in-network care for $0). And the report/analysis was lazy and ridiculous. Anthem are AWFUL. So are SJMG.
Absolutely the worst insurance I have ever had. the list of doctors is totally wrong, I can't even go to the emergency room because the hospital closest to me doesn't take this insurance. I'm supposed to be able to go to any emergency room when needed, but if they are "OUT OF NETWORK" nothing is covered.
Spent all day trying to get information off website. Spoke to what they call technical support. Gave me a incident number. Said would email me when corrected, nothing. Then called customer service the girl was nice asked her to send me all of my EOB’S since a certain date seeing I couldn’t pull them off website. She did. Cant open it cause she sent it through a secure email and their website won’t let me register to open it. Email states if your having difficulty with secure email call technical support. Gone for weekend. Seriously? Your having website issues where members can’t get on and get the info they need, and IT goes home. I am now without the information I needed until Monday. Where I work IT always makes sure All is running smoothly. If not they just don’t go home. But then again we care about our customers. Trying to Edit this to read UNHAPPY CUSTOMER!!
If I could give NEGATIVE stars i would. To make a long story short, Anthem has repeatedly rejected a request for my mother- a HEART FAILURE patient- to receive an at home life vest that will monitor her heart and act as a defibrillator if she goes into cardiac arrest (which she is at an increased risk for). Even after conversations with multiple cardiologists who advised it would be in my mothers' best interest to receive this vest, Anthem has rejected the claim. How do these people sleep at night knowing they are causing probably 1000's of families the trouble, worry and tragic burden they have caused mine?
I have awful experience with Anthem, they seem unable to process out of networks claims at all. Multiple calls ( for one claim i called 9 time), talking to managers, etc. Many times depite the calls and my grievance letters, nothing happened. I wonder if they use clients' money to loan them on short term loans market. 7 out of 10 customer service agents have such limited training, that i have to explain to them what to do. Not a good company!
Changed my pharmacy with out telling me.
I was recently diagnosed with ocular lymphoma and after having biopsies, scans, and blood series, I was given the least evasive treatment recommendation from specialists including hematologists, oncologists, Wilmer Eye Institute specialists, and surgeons. I was given the direction to use proton radiation treatment for my particular lymphoma and its tricky location. After submitting 3 appeals as well as have doctor to doctor consults, Anthem Blue Cross, Blue Shield health insurance continues to refuse coverage for my cancer treatments. Proton Radiation has been around since 1990 so hardly new technology and it’s very targeted technique avoids lifelong side effects since only kills effected cancer cells vs everything in its path. Anthem apparently ( but who knows, may deny that too!) only considers cheaper radiation (photon) or chemo (don’t need since cancer hasn’t spread elsewhere) with greater known lifelong risks since the laser goes through the entire body destroying everything in its path so will likely cost them and me more in the end. A very short “sighted” policy! What good is it to have technology if those of us who could really benefit are refused coverage? Having cancer (also finding out a month before my daughter’s wedding who I would like to SEE walk down the isle) I am hit with the expense of paying out of pocket! I’ve been employed as a 64 year old for most of my life investing my monthly paychecks toward Anthem and this is the response I get for my investment! Shame on you Anthem BC/BS. For the benefit of others who may be faced with this situation I will continue to fight. My congressman is writing a letter & I’ve reached hundreds of people through my GoFundMe campaign as well as businesses in northern Virginia through my work and the Virginia Insurance Commissioner. L
If I could give this company negative stars, I would. I have been an ongoing battle with them, which has led to me not being covered for the last four months. The short story is.. I have proof of submitted payment and email confirmation from the company. Unexpectedly, two months later I receive a letter in the mail of coverage termination. I never received any prior notice via email or mail. Btw, never received insurance cards when asked, and never received any information via email or mailing prior to notifying my of cancelled coverage. After countless phone calls that only resulted in false promises, lack of communication, and continuously starting over at each call, I finally spoke to a kind, helpful woman. She did some research and come to the conclusion ANTHEM was at FAULT for a glitch in their system. I was to be reinstated for the past four months coverage. She said in about three weeks you will be notified that your reinstatement would occur and your coverage would be active. Two weeks late, I received another letter in the mail that my insurance will not be reinstated with no explanation. I have left voicemails and emails, and still have not heard back. This company has the by far the worst customer service and I will never use their services and I hope other readers won't as well. Choose ANY company but this one. Anthem is a disaster and sadly the customers are the ones who suffer.
Provider website is a joke. No one in my area will even take the Pathway x plan. Even using their own website the doctors on the list do not take the plan.
I take a testosterone drug. The drug that Anthem Insurance wants me to use is much more expensive than the one I'm currently taking. the drug that I am taking Is Not An approved drug through Anthem so they will not allow me to claim the money I spend on it and put it towards my deductible even though it is less expensive than the drug they want me to use. Tell me that's not ridiculous. Find a different insurance company that has some sense!
They denied coverage for the birth of my twins. They hide behind the hidden idea that we should have enrolled them in the plan in the first 30 days. No one at anthem nor LVHN hospital ever told us this during that thirty day time during which our claims were allegedly being denied. No paper and no email was ever sent saying we were denied. Our coverage we pay $3k a year for should have covered our children being born but this is the snake skin they hide behind. Customer service is a joker reading a script with no humanity at all.
Anthem is by far the worst insurance carrier I have ever had the displeasure of working. They do not want you to be healthy and receive help, they just want your money. During last year I have sought chiropractic assistance and I have had a surgery done on my wrist. In the Anthem benefits section of my policy, I am granted 30 SEPARATE visits for chiropractor and physical and occupational therapy. That is 60 total visits. However, instead of being honest and transparent, Anthem double counted all 20 of my chiropractor visits. Which means that instead of having 30 physical and occupational therapy visits available once I started rehab from wrist surgery - I only had 10. Why would 20 chiropractor visits count as 40 total visits between two SEPARATE benefit categories. If this wasn't bad enough, I called to get this issue resolved. I was informed that it would be resolved within 30 days, at which time Anthem would call to inform me of the resolution. However, 6 weeks passed and Anthem never got back to me. 4 calls to Anthem later and they have no explanation to why my 20 visits were counted as 40 visits, and they were not willing to correct their mistake. Therefore, I was only granted 10 physical therapy visits when I needed more. Additionally, they rejected the appeal submitted by my PT doctor, saying they would not allow me any more visits - despite their dishonesty and mistakes made on my behalf. Please, if you are looking for a new health care provider, steer clear of Anthem. They will lie to you as you continue to pay them for services they do not provide. It is clear to me why they have 1 star rating - and I can only assume it is because 0 stars is not an option.
Worst customer service ever! The business model appears to follow a program that simply denies services as a standard. I have been denied surgical services despite living with debilitating pain. I can't tie my own shoes or put on my own socks. When I stand up from a seated position I have to pop my hip back in place to simply walk with a limp. I have had one hip replacement and was denied the service for months until finally receiving approval the day before surgery. I am going through the same process on the other hip which continues to worsen. I am continuing to get denials from Anthem claiming my needs are not medically necessary. I have had opinions from two doctors claiming all options have been exhausted aside from surgery. The last thing I want to do is have surgery but want to continue to live an active lifestyle without a limp and pain. My surgery has been strategically scheduled due to my career as a teacher. Despite overwhelming evidence that surgery is the only remaining option, Anthem continues to claim it is not medically necessary and continues to deny me but gives me the option to start a 30-60 day appeal process! This means that I will have to wait another year to get surgery due to my work schedule. Meanwhile I continue to live with debilitating pain and dependence on my wife's help to dress myself. I know several others in the Anthem group plan that are or have been denied surgical services despite the need for knee braces or canes needed to simply walk. Anthem managers continue to tell me the doctor hasn't proven the need despite the notes they have shown me that have been presented to Anthem. They are not honest and are not fulfilling the contractual agreement or medical needs of their customers. How can this be legal?
Have worked with them for years. You cannot trust the administration. they lie to you.
Every negative review that you read is correct. I have dealt with them as a member and even after trying to get a claim settled. I believe they knew I was changing companies and they didn't cover bloodwork I had done, something that was always covered before. Customer service did nothing but run me in circles for months and now I'm stuck paying $756. If they were the last insurance company on earth I would do without, would cost about the same without the headaches! Please, look elsewhere for insurance.
Some of the worst customer service I have ever encountered, and this was just calling to get information on whether I would be eligible or not. Once the representative got rude with me, I thanked him for his time, and ended the call. If this is the type of customer service you get with this company just to get information, I can just imagine how rude they would be if I were a member and called in with other concerns. Would not recommend this company to anyone!
They don't cover anything! I've already spent nearly $1000 over the past two months to figure out why I am having pain and other problems. I will be having laparoscopic surgery to check for endometriosis and a hysteroscopy to remove a large uterine polyp the doctor found. My "insurance" is paying nothing, so I will receive a bill in addition to the payment I had to make up front before the surgery. Unfortunately, this is the joke that my employer has chosen, telling me that they really don't care about employee health. When it comes time to renew I will probably just cancel since it will save me over a thousand dollars a year, depending on the cost of my husband's epilepsy medication, which I can then use to pay the doctor instead of paying both. This isn't health insurance, it's just a scam--you pay in and they cover nothing!
If I could give negative stars I would. The absolute worst insurance company. They cover nothing but charge you high fees. It blows my mind that it is even legal for this be considered insurance. If you have the opportunity and option, go elsewhere.
Would give them 0 star, if I could. They are my secondary health insurance from a school that I now work at in Missouri. I am a retired teacher from Illinois and have Healthlink as my primary insurance from the Illinois Retired Teachers System. Healthlink is excellent insurance and pays for most of my prescription cost and doctor visits, except for a $20 copay. Anthem pays nothing towards my prescription cost and will not pick up the $20 copay that my primary insurance will not cover.
I would give zero stars if I could. It’s expensive and every time we use it we get exorbitant bills. It’s always a pain
I have called 10 times in the last 2 months trying to pay my premium and start coverage. Nobody at this company has even half a brain and knows what they are doing. So I am going with a different company.
You pay a high premium for the platinum plan expecting to have excellent coverage - they don't cover have the medications someone needs even if their doctor submits an exception, it is always something. They changed the platinum and raised it's rates but covers less. They made in office services an out patient procedure requiring the patient to pay more out of pocket even when it should be covered. They are more concerned with their bottom line than providing coverage for the cost of their insurance. The customer services reps are super nice and totally understand- but most of all do not disagree with the rip off insurance companies primarily Anthem is. They are not in the business of providing coverage - just collecting premiums. If it was a personal choice I would go with another provider but this is what my company offers. It's amazing that preventative care and medicine needed to remain healthy and out of the hospital cost more than if I just let myself get sick and have a hospital stay.
Appalling- have spent close to six hours on the phone with them since January. Every time I call I am told I have called the wrong number ( which is the one on the back of the card) . Reaching a person I'm told 'I don't deal with small groups'. One claim was denied due to 'lack of referral' and they were two blind to see that the PCP was the treating physician, when I admonished them and asked why would a doctor write a referral for himself they were stumped. Having waited 6 minutes to speak to a person I have no been waiting 17mins on hold. My claims are always paid in the end, but the work involved is horrendous.
I tried to use their version of Find a Doctor/Provider on their App. It did not work so I called the help line and they hung up on me. I wanted to know a covered sleep clinic (there are 6-7 around me). I called customer service & spoke to Maggie who had no idea so she sent me to Francine with Behaviorial. She had no idea so she gave me to the clinician Carla who had no idea. I asked each could they not look up covered Sleep Clinics since they are widely available. None could do this. They all asked about my state of mind & whether I had thoughts of hurting myself. After a week of not sleeping and then interacting with them, those thoughts certainly started looking like a possibility. I have had Anthem for 6 months now and they truly have been awful with customer support.
Anthem was our provider for about 20 years. as far as I remember we never had any issues and any claims were all paid fairly quickly with no problems.
I've shopped around for years and ended up with Anthem, throwing my hands up. Aside from the obscene premiums, it's even an uphill battle to RENEW a policy! Every year it's the same thing. I do everything I'm supposed to do, and the new policy gets screwed up. Hours on the phone to get it straightened out. Out of the blue in 9th month of coverage, regular charges from GP get denied because they used last year's member number and say that I'm not covered. Emergency ambulance services not covered because 911 ambulance was "out of network". The administrative problems are endless. I just don't know if any other company would be better. I'm paying $1175 for an individual- I'm an early retiree at 60 years old. I don't think I'll make it to 70.
Grading is actually -1000 Anthem became my primary insurance in June 2018. Since that time none of claims has been paid. Anthem keeps looking for somebody else to pick up a load. Mostly Medicare which I don't have. I have stage IV terminal inoperable cancer . I'm on my last resort trial right now. That is why per Anthem we owe now close to $ 50 (fifty)K. What a joke! Our out of pocket maximum 1,200.00, and it was met by March. Thank you, Anthem for your ethics and compassion. Now I have to deal with you and collection during my very short time left!
I've been very pleased with our health insurance coverage through Anthem. Their customer service is helpful when you have a question. They also provide you with a lot of providers in the network.
Refused to pay for the HPV vaccine. Do they think it causes autism or something? Never gives an estimation of what services cost. Does not take responsibility on covering claims and instead says that it's my responsibility. Ok, can I have the key to your office to make sure it gets done?
Service has declined noticeably from late 2016 through present (Q3 2018). Claims take very long to process. Simple email inquiries now take 1-2 weeks to get a response. What is going on over there?
I believe they are a fair company that really tries to do the right thing in terms of coverage. I would recommend them.
Anthem BC/BS is an excellent insurance company. The customer service is excellent. And the plans are simple and easy to understand.
They fight every prescription, they cancel without notice, they have cancelled us twice in a year because of mistakes they have made including misapplying payments. I have a laundry list of issues. If you have a choice, don't choose them.
Too much mail. Confusing billing Customer service could be improved hate the auto menu "press 1 etc
This insurance company is the worst. My husband's employer switched to them at the beginning of the year from BCBSKS. What a mistake! They do not want to cover anything and make you and the medical center continually jump through hoops. I am glad we only had them for three months before my husband lost coverage and I could switch to my employers insurance. We are still fighting to get things paid. What a joke!
Stay away from this company at all cost. They have the worst customer service. They blatantly misinform and have the most incompetent staff. They deny and postpone needed care and lie about in network providers. Worst experience ever in dealing with insurance company.
I have literally battled non stop with this company for the last 5 months. Blood tests that are FEDERALLY required when you are pregnant (HIV test, other std panels) they refuse to cover and don't consider it preventative care when in fact it is and is a part of prenatal care. I recently had a genetics test to prepare myself and fiancé in case we had to go through what my uncle did, my family is a deletions syndrome carrier as well as downs syndrome, my fiancé is a downs syndrome carrier as well. Because of the genetic mutations on both sides, my doctor wanted the natera test done, I was told at most I'd end up paying 200 out of pocket. Ok no biggie. Imagine my surprise in January when I got a bill for the first set of prenatal tests and panels only to see of 1200 dollars, this garbage insurance company only covered 300, so I had to pay 900 out of pocket for the std panels and the glucose test. 2 tests that are usually covered by any other insurance company. So over the last week I noticed a denied insurance claim. The natera test. For the deletion syndrome and the downs syndrome. 8,000 dollar bill. Yes, 8 grand! So yesterday I get an email stating they'll pay 3k of it, of the 3k I have to pay 529, and I'm responsible for the remaining 5k. Excuse me? Come to find out that 5 grand won't apply to my out of pocket which my out of pocket max is 4 grand, it also won't apply to my deductible because they consider it "experimental" actually this test has been around for quite some time and most doctors prefer it over the quad test. I am livid. I get a bill for my ultrasound yesterday as well, of the bill, they covered 20 dollars, 20 measly bucks, I have to pay the remaining 289 of that. I'm sorry why do I even pay this company for coverage when clearly they cover nothing. Next thing they'll say is giving birth is "experimental". I do not recommend this health insurance company. Find someone better. You may as well have cobra for what you pay with no coverage. No matter if it's in network.
I have used Anthem for a number of years and would recommend avoiding them at all costs. The customer support will lie about what is covered and not have any culpability. They did to me and were not held responsible. After submitting several documents many times (after Anthem lost them or claimed they didn't receive them), i went through first and second level appeals, only to be turned down for claims that they simply lost or did not disclose phone records for. Of course they always say...We cant be responsible for what our reps say! Catherine L. handled all of them. How disgusting to be the criminal lackey for a company that purposefully leaves off information on appeals and shows no consideration for the time and effort the insured has gone through to even get the information in their hands. My experience has been that this company serves itself and no one else and does so at a high cost to the consumer.
Caremore Pairing with Anthem has created total confusion for users and for the medical care givers. The card will not work with the pharmacy I have been using for several years. Cannot get a refill on a medication that I am out of for hypertension when using my new card.
I have been absolutely disgusted by this company and their lack of caring or willingness to provide health care for which I PAID. My primary care physician changed medical groups and dropped me. They provided over 20 new primary care physicians that they said I could change to, I called every single one of them and none of them would except my insurance plan or their information was incorrect. After finally getting a primary care physician, I was seen for a problem with numbness in my hands. The doctor referred me to a physical therapist, and again, every single referral I received from Anthem was bad..They did not accept my Anthem plan any longer or the contact information was incorrect. Anthem refused to honor my doctors request for me to see a specialist and also refused diagnostic testing to see what is going on in my arm. It has been five weeks and the condition continues to be prolonged. I'm normally very peaceful person but I am outraged and absolutely disgusted by this company.
E. J. Scarfogliero
In April, 2017, my daughter, who was 5 months old at the time, suffered a stroke as a result of an AVM rupture near her brain stem. The ER doctors recognized what had happened after performing an MRI and realizing they were not equipped at that hospital to handle it, the attending ER doctor called for an airlift to the nearest children's hospital that could perform the lifesaving emergency surgery my daughter needed. The surgeons gave her a 50/50 chance being her condition was so grave but thankfully, she pulled through the emergency craniotomy, but required another to address another AVM that was found during the first surgery along with two angiograms. Almost immediately, I received the notice that the first surgery was being denied. More denials came in the months that followed causing my wife and I undo stress in having to chase down the necessary documentation that was already sent to the insurance to insure that the providers were paid. After my daughter was released from the hospital to complete her rehab at home, a special chair was ordered from the therapist, this was in July, 2017. That order was continually denied and even after it was finally approved, delivery of the chair was held up. We finally received the chair at the end of September. Now, I'm dealing with the denial for the airlift! The reason they give for the denial was that it was not medically necessary, that ground transport could have been used. After Anthem continually denied that they did not receive the records from the airlift company, I took it upon myself to file the necessary paperwork to get copies of the records that the airlift company had sent to Anthem on 2 different occasions. When I received a copy of those medical records, the airlift request clearly states that a pediatric intensive care specialist was required and that my daughter was too unstable for ground transport. What more do they need? Calls to their customer service department only give you the run around. Emails to them take 4 or 5 days for a reply. Once you actually speak to someone, they know nothing and have to call you back. If you're lucky enough to get a person's contact information, they never answer the phone or call you back if you leave a message. The hospital and their staff did everything necessary to save my daughter's life, they never asked if I had insurance, they did their job. Insurance's purpose is to make the policy holder whole, not to profit and cater to shareholders. This is the insurance that my employer offers and I have the highest tier, the “Cadillac Plan” if you will. I hate to see what the lowest plan they offer is like.
wow, on two occasions i asked specific questions and got the run around. not sure where all the monies goes but it sure isn't to customer service. stay away. two different procedures were priced way over the national average, one was 6,000+ and the other 4000+ when the national average was 1600. offered no alternative or solutions other than call your doctor.
You have to fight every step of the way.