Blue Cross / Blue Shield

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1.1 out of 5, based on 49 ratings and
105 reviews & complaints.
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Blue Cross Only Pays 20% of Medical Bills
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

KANSAS CITY, MISSOURI -- 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 bite 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.

     
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High Deductible Out of Pocket
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

KANSAS CITY, MISSOURI -- 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.

     
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The Worst-- Without A Doubt.
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

PROVIDENCE, RHODE ISLAND -- 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.

     
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The epitome of arrogance and evil
By -

Jan 25, 2011 I injured my back in a fall at my house and was taken to the ER by EMS. CT done, nothing broken. Was given some meds and told to follow up with my PCP. Started feeling worse and having pain moving down my legs within a week. Went to Walk in at my PCP and they ordered a Stat Same Day MRI, the results of which, they sent me to a Neurosurgeon for consult due to the issues found on the MRI as well as my symptoms (MRI showed a bulging/herniated disc at L4/L5). I couldn't do PT after 6 additional weeks of trying to hopefully get better, nothing was working.

They scheduled a discogram to examine the Disc structure. The discogram confirmed the suspicions. Not only was the disc herniated but I had a Grade IV tear in the disc with significant leakage into the canal. The MD who did the discogram agreed with my neurosurgeon that due to the damage and the DDD in the disc that fusion was the only sensible option due to likelihood of reinjury or disc space collapse resulting in major issue potentially. I was 2 weeks from having surgery and then the BCBS of NC brick wall came up. They denied my surgery. My Surgeon put in an immediate appeal and he was denied... all because they said it "wasn't medically necessary."

I went through 1st level internal appeal at BCBS which was a bloody joke. Their supposed internal review physician was a bloody family practice MD, they don't know anything remotely about spinal surgery or surgery in general for that matter so WTF... DENIED again!!! This was July... I had a setback and major pain issues that nearly had me admitted due to exacerbation of pain issues and my pain meds were increased... OK filed 2nd appeal. Hearing was Aug 26 (same day as Irene is about to come barreling through our fine town). Thought it went well... Got letter this past Saturday, DENIED again.

Neurosurgeon on appeal says I don't need fusion, I need disc resection (oh the moron also asked about disc replacement but I find it funny because bloody BCBS of NC still think disc replacement is experimental despite the fact that several other BCBS affiliates DO cover it). My neurosurgeon will not do the disc resection because he doesn't think it'll solve the problem long term and is concerned about I'm sure legitimately being held liable if the surgery fails and I end up worse. I think he's dead on on what needs to be done, but once again BCBS thinks they know better.

The sad truth is BCBS of NC only cares about one damn thing. Getting my money and not paying out theirs despite their responsibility to their members. The less they pay out the bigger the higher up douchebags bonuses are (don't lie, we know the truth). I'm sick and tired of my life being ruined by these **. If I could pay for my surgery myself I would and then sue the hell outta them for the cost plus bad faith actions on their part leaving them WIDE OPEN to punitive damages in the millions potentially. I can't be the only person fighting with them over this. If you are in my same situation feel free to contact me please.

     
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How Messed Up the Entire Medical/drug Industry Is in General and How Stupid Obamacare Is
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

TRAVERSE CITY, MICHIGAN -- 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.

     
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Most Unprofessional
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

NEWARK, NEW JERSEY -- 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!!!

     
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Patient Dies While Waiting on Pending Litigation
By -

TULSA, OKLAHOMA -- This is happening EVERYWHERE. Blue Cross and Blue Shield deny benefits to people who pay in good faith when they know that the cost of the litigation + the time spent waiting = dead patient before payout. RUNAWAY CORPORATE GREED! THEIR BLOOD IS ON YOUR HANDS BCBS.

     
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Refuse to pay for covered claims
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OKLAHOMA -- I had an accident when my grandson was sitting in my lap and jumped backwards and got me in the mouth and nose, he broke 2 teeth and knocked the rest of my front teeth lose I went to a dentist and had an exam and x-rays but after being total 12K to repair damage, I told them I was going to get a second opinion and I found a wonderful dentist. They fixed my mouth for 9K. I filed it on my dental insurance and called blue cross and blue shield to see if this was covered on my policy they said yes, that I just needed to download a claim form and send it in that it takes 30-45 days to process a claim, I said OK. That was in August 2009 and that claim still has not been paid.

I have done everything they have asked and sent copies after copies but still they have not paid the claim. I received a letter from them telling me that the dentist that fixed my mouth was not the first dentist I seen. I told them the same thing, he wanted too much to fix this damage 12K and I found another dentist that fixed everything for 9K and I paid out of my pocket. What the dental insurance did not cover which was almost 5K and I was told it was covered by my policy but now they refuse to pay my claim. I have been fighting this from August 2009 and still am.

They said they will be willing to pay the 196.00 for the exam and rays that the first dentist did but not the treatment and surgery. This is crazy! Then I went to see the surgeon about fixing my nose I was not going to get bit by that dog again so they sent in a Pre-authorization which I have a letter that says they received it on Dec. 17 2009, surgery to be done on Dec. 29th 2009. They came back on that one and said Oklahoma got it on Dec 17th but California did not get it until Dec 31, 2009, so it was denied. I lost coverage on Jan 1 2010 due to leaving the company I was working for.

Now I have a preexisting condition that no insurance company will touch and a claim they refuse to pay that was covered on my policy. I still can't breathe out of my nose which causes me serve sinus infections and my savings is gone. I paid my half of my insurances which was 360.00 per month and then had to use everything I had in savings to pay for what my dental did not cover which is what I was told my medical with blue cross and blue shield would cover, that it was a covered item on my policy accident injury. I have tried to play their games and tired of the excuses. I have been left with nothing to do but call and hire a lawyer. Thanks for nothing blue cross.

     
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Blue Cross Lies
By -

CALIFORNIA -- My wife was in rehab at calif rehab to learn how to walk, talk and think after being hospitalized for over a month. My wife was doing well, but still need close supervision when out of bed. One night she was left unattended and fell (Friday evening) took them almost 6 hours to take x-rays & get results (they say nothing broken.) The days following my wife is in pain, a lot of pain. That Sunday her doctor, ** saw her, she observed that my wife couldn't lift her legs and was in a lot of pain. The doctor said she would order stronger pain meds and some pain patches.

A day later my wife still hadn't received this pain medicine. On top of it they refused to keep ice on her, I had to purchase our own ice pack so my wife could get some relief. The minute we complained that she wasn't getting the treatment she should due the fall the director called facey and had someone there within an hour stating my wife was fit to be released from rehab. When I called this person representing my wife doctor she told me she witnessed my wife get from bed to a wheel chair and that was all that was needed for her rehab to be complete.

We asked for a doctor to look at her, they refused, we requested a 2nd opinion, they refused. We were told our 2nd opinion was doctors reviewing her records. No doctor saw my wife, or witnessed that she couldn't function in or out of bed. Then 3 pig women from blue cross got on the phone with me and told me there would be someone there every day to make sure my wife was taken care of, and that my wife would receive all the therapy she needed at home. GUESS WHAT, we got nothing. All this time my wife is in so much pain she is crying all day and night. We go to her HMO doctor, he takes x-rays and sees 3 fractures.

Now these pigs at blue cross stated there were no broken bones so she can go home, they told us my wife would just have to work through the pain. Now that they know they did wrong, are they trying to correct things? Nooooo, in fact they are making sure any service my wife should be getting takes as long as they can make it before she receives this service. Trust me you do not want to have Blue cross as your medical provider. All of this is documented, I would love to provide you with all my notes, names, phone numbers and x-rays to prove what I am saying is correct.

There is more, because we complain they are refusing any treatment any doctor puts in for her to have, they have gone so far as trying to say I am abusing my wife. I have done nothing but fight to make sure my wife gets the medical treatment she deserves and everyone will tell you that. Do I get mad? Yes. Do I get in their face? Yes. But they think they have so much power no one can touch them. Trust me they will be touched, everyone that hurt her, left her for dead will pay, god see's all and they will get what they deserve.

     
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Get It Right!
By -

HELL -- So, my Doc tells me she thinks I have ulcerative colitis this morning. Oh happy day, NOT! Really, it came as no surprise. UC is not a pleasant illness (not that any illness is), but imagine bleeding from your rectum daily in addition to severe stomach cramping, diarrhea, bloating, and gas, not to mention the interruption of your daily life.

Anyhow, I call BCBS to get my CT scan and colonoscopy preauthorized and the jerks have the nerve to ask me why I am having the procedure performed! "Oh gee, I thought I would stick a tube up my ** just for kicks and giggles." It's because my Dr. ordered it, you idiots! Because I crap myself day and night, if you really must know.

Then, after a day of being stuck with needles 1,001 times (dehydrated from constant diarrhea) I drag myself to the pharmacy to get my medicine. Of course, I call my insurance company before I drop off the script to make sure they will pay for the meds and am quoted a price. I even asked the rude man to repeat himself (these people act like they are doing me a favor every time they call). It's expensive, but at least I know in advance. There will be no surprises at the pharmacy. WRONG!!!

I am given an incorrect quote. Now, the jerks want to know what they can do to make it right. How about give me my frickin' medicine at the price you quoted me, morons?! The representative had the nerve to tell me that since I had a 5 day supply that I would be fine until they get the problem resolved. Well, just in case you missed a little important factoid about this month, Christmas is in one week. I'd rather not wake up in the morning doubled over in pain, bleeding from my butt, covered in my own poo. I'd like to have enough medicine to last me until the day after Christmas so my poor children do not have to deal with their mother pooping herself under the tree.

This is just one small issue I have had with BCBS. Can you hear the anger? I'm sure this will be the first of many more complaints to come since I will be in the hospital for a CT scan in two days followed by the old tube up the butt procedure. Great, can't wait.

     
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