CHICAGO, ILLINOIS -- Blue Cross Blue Shield denies me coverage of medication I need without consulting my doctor or myself. Couldn't valuable information be found by contacting the person who prescribed this medication? Does Blue Cross Blue Shield believe that they know what is better for your health than a doctor I see every two to three months? Why don't we pick and choose when and if we should pay our premiums without consulting a huge corporate conglomerate based on falsities? That makes just as much sense.
The death panels are already here, and they work for the insurance companies to deny you the medicines and procedures we need. Insurance companies use their own employed doctors to come up with more and more ridiculous reasons to deny you have proven medical treatments that have been commonplace for years. The hide behind the statements of a "doctor" solely under their employ. This "doctor" makes bonuses off of how many claims they can deny to people who need them.
The best thing this country can do is implement a single-payer healthcare system like every other developed country in this world. Even Cuba has free health care to all citizens and they don't have a car built after 1950 or the internet. The richest country in the world leaves it citizens to deal with the hypocrisy of an insurance company that does not pay out to its customers when needed.
ATLANTA, GEORGIA -- On December 19th of 2012, I went in for a preventative doctor's appointment. Today, March 22nd, two of those bills are still unpaid and the providers are telling me that they will send these to collections if payment is not made in the near future.
BCBS initially denied my claim because of "other coverage." When I called to address this issue, I was told that their system had not been updated and I had to have the Customer Service Rep contact my prior carrier to verify that there was no overlap in coverage. Now mind you, I have had the BCBS policy since Jan 01, 2012 and a claim had already been paid without this issue arising nor is it customary for individuals to carry more than one health coverage.
Why they would assume that their coverage which I pay them for would not be primary is beyond me. They didn't have any prior carrier info on me, just that someone might be out there. Regardless, I did as I was supposed to do, promptly addressed the issue and my claims were marked to be paid on January 09. Between that period and today, I have made quite a few calls and was told basically to be patient, their claims office is taking up to 30 days to process things. It's been close to 90 at this point.
The CSR that I spoke with could not connect me with anyone in claims nor did she appear to know how to even reach claims. I don't doubt this, none of the prior reps ever offered it as an option. I have spent 15 years in auto and injury claims with two major carriers, 5 of that in management. If a CSR could not address the issue, they got the call to me and I addressed it.
I ended today's call requesting a callback and payment of these claims by end of day March 30th. If I get no response, I will simply pay these bills out of pocket and file a Department of Insurance Complaint. With my experience in claims, I understand that volume increases or staffing issues can throw a kink into even the best run organization but that is not the customer's problem and I have been more than patient. Unfortunately, based on their past performance, I don't look for this to be resolved without that formal complaint. For the record, this is my first ever negative review regarding any company, I am just that ticked over this.
LOUISVILLE, KENTUCKY -- My premiums are 400.00 dollars a month and my annual deductible is 2000.00 dollars a year. But I consistently get medical bills over 2000.00 dollars. I have MS and the medication to treat it is very expensive. One company that makes it offered it to me for free which was fine and dandy for BCBS but the medication made me sick so I could not take it anymore.
The new medication my DR put me on wants payment after three months of taking it I get a bill for 4000.00 dollars. I called them and told them my deductible was 2000.00 why isn't the insurance company paying half? They said they would reach out to them after a couple of days they called me back and said BCBS told them my deductible was 4000.00 LIE. Then I applied for financial assistance they came back and said “well, your deductible of 4000.00 dollars has been met but your health insurance company said you should be getting your medication from another pharmacy."
Basically the one that gave me free medication that makes me sick so they have no financial responsibility. These people are greedy money hoarders and have no business in healthcare if you are sick and have BCBS you are out of luck. I will cancel my insurance and deal with the government. I cannot afford to treat my illness anyway so why give them 400.00 dollars a month? Single payer please.
COLUMBUS, GEORGIA -- There are too many months, days, and countless hours during the year of 2014 that I spent on the phone with numerous incompetent and rude employees of BCBS GA. They literally drove me insane to the point I ended up having to go to the hospital for stress related illness on top of my physical illness. They are continuing to cause me stress to this current day over claims that they filed inaccurately (paid the incorrect provider of service... one that I had never heard of, or been to, and that had never heard of me or received the payment that BCBS GA sent me an EOB as having paid incorrectly to them)!
Now, if your head is spinning over that one, BCBS GA was rude to me again when I called them to bring this to their attention and rectify! I filed two formal complaints over issues with them and never heard from them regarding any resolution to the complaints. I am so sick of them... they are like a nightmare that won't go away and leave me alone! I will never, ever, have anything else to do with this company or speak to anyone representing the company! They have proven to me that even the numerous supervisors and recorded phone calls that I had with them that they are also incompetent! You've been warned now so use them at your own risk!!!
CHAPEL HILL, NORTH CAROLINA -- My daughter was in rehab at Pavillon in Mill Spring, North Carolina. They do not accept BCBS insurance so I had to pay the entire amount $24,000.00 out of pocket which I cannot afford. At her discharge they gave me paperwork to file with BLUE CROSS BLUE SHIELD of NORTH CAROLINA and for 4 months now BLUE CROSS BLUE SHIELD of NORTH CAROLINA keeps contacting me with petty reasons why they should not pay, reasons that are completely unrelated to the fact that she had a legitimate reason for admission like the hour code of her admission was incorrect or the code for her daily detox was incorrect or TONIGHT the incorrect place code was entered.
As a physician, it is obvious to me that BCBS is fraudulently avoiding paying my daughter's claim. Also, Pavillon is A SCAM OPERATION more interested in profit than in helping patients.
CHICAGO, ILLINOIS -- BUYER BEWARE! On the healthcare marketplace website they list plans for you to choose from. They are not outright fraudulent but there is vital information that they purposefully do not disclose regarding the BCBS Blue Choice PPO plans. That is the fact that very, very few doctors, many hospitals, clinics and other medical institutions do not accept this form of coverage. It makes the insurance close to useless and you end up paying $500 or so a month for insurance that you cannot use and still have to pay the majority of your medical bills.
If you have to go to a specialty doctor, it may almost be impossible to find one that accepts it. Their regular Blue PPO plans are accepted by a wide variety of medical professionals, however their BLUE CHOICE PLAN should only be taken with awareness of this caveat - it may be hard to find medical treaters who will accept that insurance.
OKLAHOMA CITY, OKLAHOMA -- My wife does not like doctors, has not been to one in over 2 years. After she turned 50 I made her get a blood test. Guess what? BCBS denied the claim completely! Did not even bother to get the insurance reduced rate. Now she has canceled all the tests the doctor requested that are normal for her age. BCBS does not care about preventing anything!!! If you are not dying, do not expect BCBS to pay a penny. Don't know if they will pay anything at that time either. Will not be with them long enough to find out.
HOUSTON, TEXAS -- I would give this a negative rating if I could. Let me explain why. My in-laws switched their Medicare Supplement Care from Aetna to BCBSTX because my father-in-law's prior company dropped all retiree plans. We applied, were accepted, and have made payments for both my mother-in-law and father-in-law. We even put BCBSTX on auto bill pay and made payments well in advance of due dates. Effective date is 1-1-14. They've never received ID cards. Here is my problem. Every time I phone and enter the member number and DOB as requested - no application found.
I have to hold "in excess of 60 minutes" (on hold right now - 1 hr 30 minutes and counting) while waiting "for the next customer advocate to be with me shortly. (Shortly?? Advocate??) When I try to order the cards online I have to set up an account online and enter the member ID number, group number, email address, etc. OK, the ID number is on the invoice so that's not an issue. The problem is the Group number - that is found ON THE CARD. Hello?? This is the most time-wasting, non-customer friendly, absurd process I have ever seen. My advice? Go elsewhere.
CHICAGO, ILLINOIS -- Blue Cross Blue Shield claimed to cover the cost of my IUD Mirena, with only a $20 copay. However, they did not bother to tell me that the required STD test to get the IUD is NOT covered. It cost me almost $200 to get the test. Additionally, they did not pay for the ultrasound my doctor ordered after getting the IUD placed. An ultrasound is very important to get to make sure that the IUD is in place. Now I am charged $1200 for the ultrasound.
Lastly, I was charged $270 for the "office visit" to get the IUD place, and another $90 for the check-up visit, because my insurance only covers one office visit (that is not a medical diagnosis) per year. Why did they not tell me that I would be responsible for paying this? They are dishonest and misleading in their coverage. I am dropping BCBS after this month.
HAMMOND, INDIANA -- This insurance doesn't care about you health in all, they have me out of my insulin for days because they think that I use a lot but I am a insulin dependent and it's my doctor who write the prescription how he seems that I need it. Last time that I talked to them, they told me that I can pay cash for my insulin and send the bill to them, they will decide to refund or not my money, but insulin is too expensive to me. I hope that this information can help someone who is looking for a insurance coverage.