Blue Cross / Blue Shield Health Insurance - Page 2

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Coverage Dropped After 12ys With Company
Posted by on
Rating: 1/51
TOPEKA, KANSAS -- I have had a health insurance coverage through my husbands work with Blue Cross Blue Shield of Kansas for 12 ys. March 1st of this year my husband retired from his job and is on Medicare. I was told I could continue my insurance for 36 months through the cobra plan. I was on this plan for one month when I went to my pharmacy for a medication refill. I was told the insurance denied payment because I was no longer covered. What a shock that was!

After many many phone calls in which I was transferred to probably almost everyone that worked for the company (it seemed like I was transferred that many times anyway) in which most had no idea what they were doing or why I was dropped I finally got someone in management. After a lengthy conversation it was my understanding that my coverage was dropped because of a minor misunderstanding at the time I changed to the cobra plan. Now they refuse to reinstate my insurance. It took me over 20 phone calls in a two week period to find this out.

Is this the way to treat a person that has been a loyal customer for 12 ys?
All they want is your money. They don't care rather you are covered by health insurance or not. Stay away from Blue Cross Blue Shield of Kansas. They are not a reliable insurance company anymore.
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Failure to provide coverage due to an issue not even covered by the policy!
Posted by on
ILLINOIS -- BC/BS-Texas has shown themselves to me to be a dishonorable organization. I applied for health insurance coverage and have no serious medical problems at all. Coverage was denied due to a sleep aid I use. I appealed their decision and included solid reasons for their improper decision and included a letter from my doctor. Sixty days later, another letter of denial is received...with virtually the same text as the original. No signature, no accountability. Also, I cannot help but wonder how much of their decision was influenced by non-Texans, esp. folks from Illinois (Chicago) and, perhaps, California. If the truth could be discovered, we would probably learn that no human was involved in their decision at all, only computers.

On the positive side of this fiasco, I am glad to learn NOW that this company operates with no integrity or character.
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Anonymous on 03/31/2011:
So you think they denied your coverage cause you're from Texas? Um OK
azRider on 03/31/2011:
I think they denied coverage based on your 'Sleep aid'. I'm just guessing here, but if you have a device to help you sleep, it may be due to some other condition that could impose health costs on something they would cover. perhaps heart related or stroke related. so they based the decision on possible future claims they might have to pay. You may have to shop around, and in the end get a policy that has some type of wavier to it limiting what is covered due to the aid.
Anonymous on 03/31/2011:
If your sleep aid is a CPAP machine, then you were diagnosed with obstructive sleep apnea which is a serious medical condition if left untreated. If you have not talked to an actual person at BC, then I suggest you call them to verify their decision so you can better understand their denial. I think shopping around is also a good idea, as az suggested.
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Auto Pay Rip Off
Posted by on
CALIFORNIA, CALIFORNIA -- On February 7, 2011, my husband wrote a letter to Blue Shield of California requesting that cancel his policy and the autopay from our account effective immediately and faxed to the telephone number provided by Blue Shield. On February 28, 2011, they take $250 from our checking account. I call them and tell them that we have a letter and fax confirmation that the request to cancel both policy and autopay was sent on Feb. 7, 2011 -- they claim they did not receive and now will not cancel the premium unless we provide a letter from employer's insurance stating he is a different insurance. How can they tell you that you cannot cancel a policy that you no longer want!?
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tnchuck100 on 03/01/2011:
Things like this should always be done via certified mail/return receipt requested. "We didn't receive it." is a common phrase companies used to justify taking your money.

In the future NEVER give ANY company access to your checking account.
Jeane on 05/31/2011:
I also wanted my policy canceled. Went to my credit union to tell them to stop the auto pay. The man a credit union was very nice and called BC/BS for me. I told them that by the 15th of the next month I had other insurance. They said well we will have to get into your account... with those words I "politely" told them ..oh no you don't!!!!! Just to make sure I took almost all of my money out of that account. The man at credit union told me they make it easy to set up auto pay and difficult to stop it!
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Posted by on
BCBS OF GA, GEORGIA -- I filed for Health Insurance, In mid September, Around the 11 or 12th.
Never heard anything back. On October the lst, I received a letter, Congratulation me that, "I had been accepted", BCBS. The letter stated
that, My application was accepted on 22 September 2010. The letter was dated the 23rd of September and mailed. I recevied it on 1 Oct 2010.
The letter stated I owed 254.00 So I called and made my payment.

A few days later, I got another letter stating, I owe $254.00. I called
and gave them my confromation number. 2 weeks later I got another letter
stating I owed $254.00 due on the 22 Oct 2010. This letter was received on 14 October 2010. So I called again, The first lady I talked to, didn't have a clue. An told me, it was a prorated amount. For the month of October.. Now, My total amount was only $254.00 a month. My policy is for $254.00 a month. She couldn't help me.

The Second lady I talk to, told me It was for September the 22 to October the lst. She told me it, was prorated, for those days.

Now I wasn't notified until, October the 1st, that I even had insurance, with BCBS, but they were wanting me to pay for those days anyway.
I didn't receive, my card until, October the 6, 2010.

Am I the only one, that sees the problem here. I not going to pay you for something I had zero knowledge of having. All they could say is "
We sent the letter"

This is the very reason why the federal government is taking over the insurance industry. And if you think its bad now, wait till they get it.

If I'm having these kind of problems, in the first 2 weeks, just imagine
trying to file a claim. So I cancelled BCBS. I asked the 2nd lady.
"Why didn't the just email me or call me to notify me about the start date?" She said, "it was against policy, for the to call a customer"

Guess what? She called me a few hours later asking me about my policy.

What a joke!

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leet60 on 10/14/2010:
It sounds like there was some confusion about the "proration". However, if you were accepted as of 9/22/10 and your monthly payment was $254.00, another payment would be due on 10/22/10. It sounds like the amounts were correct but the time frame of the policy being in force was misunderstood by their own representatives. Sad really.
Freddy2Times on 10/15/2010:
Uh, so, I'm seeing some sorta cruddy treatment here, but not a total scam, or anything extraordinary for health insurance.

You signed late September, and got charged for that month. Mid-late October, you got hit for another monthly charge.

It could be argued, that since you paid for service, you had service- and if you didn't avail yourself of it, it was on you. This would happen with a phone or cable company for sure, although I do understand that you'd like a little more personal care from your health insurance.

If you have a policy that was paid for, they are legally obligated to look up your number, usually via your SS, card in hand or not. And you'll have this same or a similar issue with any other major health provider.

And the phone service people for your health care folks are just that--phone service. Not customer care, not policy help, nothing but phone service. :(
pissedoffchicka on 10/26/2010:
even tho you didn't receive your cards until 10/06, that didn't mean you weren't insurance. it takes 7 to 10 business days for mail to get to you from them. so if you were accepted on 9/22/10, that letter would have gone out that night and been in the mail for the next morning. which was wed. then thur, fri, mon, tues, weds, thur, (7 days so far) you receive info on 10/1st a Friday, day 8! so you were covered and could have submitted for rembursement for any medical clm you accumulated in those 8 days, but instead, you threw a temper-tantrum about it and dropped having insurance all together??? who's the real moron here?
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Misleading or inept agent
Posted by on
METAIRIE, LOUISIANA -- I dealt with an inept agent from the local Blue Cross Blue Shield office in Metairie, La. If you can avoid doing business with this agent, I strongly advise it.
His business practice is unprofessional and inefficient.
In the four weeks I tried to use him as an agent, he never returned a phone call once, sent an important form to an incorrect email address for me, failed to shorten a waiting period by making a phone call himself, and had an assistant phone me once for something he could have done himself. He concluded the service to me by sending a particularly nasty email to me telling me I had been rejected ... after I waited four weeks to buy insurance (expensive plans at that).
For our first meeting about my plan options, he did not tell me any information I couldn't just read in the pamphlets he handed me. He sold us one of the most expensive insurance plans he offered but really did not go over the benefits or the problems with it.
He did not bother to go over my other options or to even tell me what might happen if I am denied. The drive to Metairie was a huge waste of time.
BUT, it gets worse. He then never answered any of our calls in the following week and then when we finally emailed him, he said email was better for him.
He emailed a very important form to my boyfriend's email instead of to mine and then never called to follow up to make sure we received it. I was waiting for it to arrive by US Mail, like he said it would.
When I finally did not receive it after a week, I left a near frantic voice mail for him. In response I got an email saying it was attached to a former email sent to my boyfriend. (We were buying the plan together).
I then asked that he please call me if something important is sent this way again.
BUT, then it gets worse. When my doctor failed to fax a complete form for the application, he emailed me and asked me to call her and have her resend the form.
He could have saved time and possibly kept our business if he just would have called her himself and skipped about six extra days and extra phone calls.
He was completely ineffectual and the whole business left a bad taste in my mouth for this company. We are taking our business elsewhere.
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biomajor on 07/25/2010:
He does sound rather scattered, but on him calling your doctor and requesting the form, I don't think that he can legally because of the confidentiality of the information.
SamD. on 07/27/2010:
I sorta figured that might be the case. But he still sat on that incomplete document for more than one day. He was not proactive at all.
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Blue Cross Cancels Policy March 1 and Notifies of this April 20th!
Posted by on
On April 20th a letter was written to me to advise me that my Medical Coverage with Blue Cross Blue Shield under Cobra was cancelled as of March 1, 2010. As you can see, this is 6 weeks later! In the last six weeks I have had several expensive tests at the hospital and have seen two specialist for a medical condition. All of the tests were pre-approved by Blue Cross during the past 6 weeks. I was not aware that my coverage was cancelled, even though they accepted my payments and cashed my checks, and now I will be responsible for thousands of dollars in medical bills.
This is an atrocity! Something must be done about Blue Cross Blue Shield and they need to be held accountable for their lack of service to their customers.
I lost my job a year ago, and having insurance has been critical to my survival. What now?
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Alain on 04/28/2010:
In the states I have lived in and the one I'm currently in an insurance company must notify the client before cancellation and there is also an appeals process that applies. I'd check with your state's insurance commission on this. You can usually find a phone number on your state's website or call the general phone number and see who they recommend you speak to. You want to talk to a live person about this and not just send an e-mail.
mrsgpt552 on 05/30/2013:
I was also dropped from the cobra plan. I was not notified of this cancellation. It took me 2 weeks and many many phone calls to find out my coverage was cancelled and they refused to reinstate it.
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Blue Cross and Blue Shield of RI Incompetent at Best
Posted by on
PROVIDENCE, RHODE ISLAND -- I highly recommend that you look elsewhere when considering BCBS of RI as your health care PROVIDER. After the birth of our third child, my husband took the day off of work so that we could take a special trip up to Blue Cross in person to add our daughter to our insurance plan. We did this, so as not to have any "miss haps" in light of all the health insurance nightmares attacking Americans in every state. We purposely asked, more than once, if all of the paperwork needed was there, since we did have a home birth and did not have the blesssing from administrative staff at a hospital. We clearly did not have a competent or experienced agent, but she assured us that our file was complete and that we took all of the necessary steps to insure our infant daughter under our EXISTING plan. I continued to receive bills and paid my premium on time.

A month passed and I brought our daughter for her next checkup and low and behold our daughter was not in the system When I called about it they did not even have record that she was born. At that point, the application period had ended to add new family members, and now we would have to go through underwriting to have our daughter added. Also, in the meantime we would have to pay the highest premium for that month plus a month in advance to the tune of $3226.67, paid in full immediately, our we would loose coverage for a family of FIVE. We are self employed, of a new business and at that point did not have access to that kind of money.

Talking to BCBS representatives was like communicating with people speaking a different language, they all looked at the same file and they all said something different. I spent days on the phone trying to sort this mess out. They sent a letter claiming they just needed paperwork, but clearly when speaking to an agent looking at our file, they had never even heard of our third child. They simply used our lack of paperwork from our pediatrician, as a cover. Since we were getting a discount under the Plan for Individuals and Families program, they apparently did not need our business and dropped us as members. It was the most shocking case of incompetence and negligence that I have experienced with a business.

I have proceeded to warn people about this business and tell them to look elsewhere. But I am afraid it is just the health insurance industry as a whole. It is robbing the American people blind. They have used the safety and vulnerability of our loved ones against us. They have us by our throats and by our checkbooks. We, as a people, need to speak out!

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Lost My Address? Yeah Right!
Posted by on
MINNESOTA -- So I have had health insurance with Blue Cross for about 10 years and have had no major health problems. Last year I found out I needed minor surgery. It cost BCBS about $10,000. I figured I finally got about 3 years of premiums back - so to speak. I take it they didn't like that because just after my surgery when my premiums were due, they didn't send me a bill. I called when I realized it was 2 weeks late and they said that "somehow" their computers had "lost" my city and state, so when they mailed my premium bill the post office sent it back to them. Yeah right.

The customer service person asked me my city and state, typed them in, and said "hmmmm that's weird, the computer says that address is fine". Duh, you have been sending me bills to that address for 2-1/2 years with no problem. Somehow after I had surgery, they "lost" part of my address. How convenient for them it would have been if I had been one month late to pay. They would have cancelled my insurance and not allowed me to re-apply for 2-3 years. They blamed it on the post office, yet no one at BCBS tried to contact me to tell me my bill had been returned.

I would like to know how you get the job of the person at BCBS who goes through the computer erasing parts of the addresses of people who have too many claims. Betcha he/she gets paid a lot of money.
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goduke on 01/28/2010:
That's a pretty amazing conspiracy theory.
Anonymous on 01/28/2010:
hah! yeah interesting. Healthcare in our country is totally wacked.
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Health Insurance refuses to pay for covered services for mentally ill schizophrenic homicidal child
Posted by on
LOUISVILLE, KENTUCKY -- We have paid for TWENTY FIVE YEARS for Blue cross Blue Shield (Anthem) insurance plan through my husbands work. Our adopted son was diagnosed with very early onset schizophrenia paraniod type with homicidal intentions (he repeatedly has tried to kill us and 7 other adopted sibs) He was admitted to residential facility and evaluated by the state of Missouri mental health that found him to be SO DANGEROUS that they state he is legally NOT ALLOWED to return home, yet Blue Cross says after ONE VISIT with a pschiatrist in which son denied visual/auditory symptoms (he always does so that he can get out and try AGAIN to kill us) that son "no longer meets medical need". BC/BS refuses to accept statements son made to his roommate that he "IS going to get out to kill his mom" as evidence son is still medically/psychiatrically unstable! This insurance is defrauding the public they will directly cause the deaths of NINE people so they can keep your money. Think of the mental anguish a schizophenic endures and that they will deny care that is covered in their policy!
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MRM on 06/30/2009:
Whoa! This child is a serious health risk to the society. Isolate him now before its too late! And I also agree with Soaring Consumer.
Soaring Consumer on 06/30/2009:
Contact your state's insurance commissioner and medical board right away.
Principissa on 06/30/2009:
I agree with Soaring Consumer. My goodness this child needs help. He is a danger to you and the rest of society, he needs help fast.

Keep fighting, don't give up.
goduke on 06/30/2009:
There's something really odd going on here. BCBS does not make the determination that the patient is medically or mentally unstable. They just make the decision if (1) the condition is covered under the plan, (2) whether any requirements for the treatment have been met and (3) if the treatment which is being prescribed matches the diagnosis (I.e., medical necessity).

What exactly is it that you are wanting BCBS to pay for?
spiderman2 on 06/30/2009:
Is there a social worker at the mental health facility that can help you get coverage through Medicaid or the state? Good luck to you.
Anonymous on 06/30/2009:
my goodness! the allegations you stated against bcbs are very, very serious, you are claiming that they *will* be responsible for the death of 9 people. are you absolutely sure that you want to post that kind of an accusation out on the internet for millions to see?

your adopted son's primary caregiver is the one that should be making recommendations e.g. whether or not he should remain locked up and whether or not he poses a physical threat to you or anyone else. goduke is absolutely correct, bcbs's job is to determine whether or not they will cover his care and treatment, they are not qualified doctors that determine what care one should or should not be receiving, nor do they make the decisions whether one is or is not stable. is it possible that you're simply just angry that bcbs isn't covering all his expenses and are lashing out?

MundoCaniDog on 06/30/2009:
BC/BS will not cause the deaths of nine by not paying for something you feel is covered under your plan. You will. You are denying the care, not BC/BS.

Just because BC/BS does not pay for something does not mean you cannot pay for it yourself.
Anonymous on 06/30/2009:
I am pretty sure if the situation is as dire as you indicate, the state would take over the care fo the child.
Stenia on 07/15/2009:
FYI KingJames It the insurance companies that determine the cost of medical expense not the doctors. That right raven2002 let put more responsible on the tax payers shoulders. Where do you think that monies come from the state? That right Mundocaidog if they could pay the expense themselves why brother having medical insurance?
Anonymous on 07/15/2009:
I think spiderman has a good suggestion. The social worker may also be able to guide you through your insurance issues. That being said, if this was my child, I would pay whatever I needed to, out-of-pocket, to make sure they received the proper treatment. I would take out a second mortgage, personal loan, whatever, if need be. I would not put anyone in my family in jeopardy because of an insurance company denial.
Anonymous on 07/15/2009:
Stenia, IF the situation is anywhere near as dire as described, the state would be legally required to take over care of the child....for their protection as well as others. The simple fact of having seven other children in the household who this kid has supposedly attempted to kill multiple times would mean the state would HAVE to be involved.
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BCBS Continuation Insurance
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NORTH CAROLINA -- After my husband was laid off his job in late June, we were told we would go into state continuation insurance instead of cobra. My husband dropped his plan but as his spouse I was allowed to keep the policy. They kept raising my price on my policy until I could not pay it, I was told by BCBS that I could go on a federal plan that started on September 1st. I said great because I would have to pay only 35%. Well, now they say that I do not qualify because my husband stopped his policy too soon. But they don't tell me until two months later. Now I cannot get any insurance so I am extremely upset with BCBS.

For one person, I was paying 734.49 Monthly. There is a lot more complaining I could do but I just hope this helps someone to use a better insurance company.
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dan gordon on 05/14/2009:
Has nothing to do with BCBS. Its federal law dealing with Cobra. I'm in the same boat and while paying the Cobra premium is high with the subsidy it became a great deal. When the subsidy started they backdated premiums for 60 days and allowed a new 'grace period' for signing up. You need to check with the Cobra administrator for your hubbys plan, not BC.
kidrockfan on 05/14/2009:
I did check with cobra and the employer had less than 20 employees so it was on to state continuation. I could not qualify because my husband stopped his policy on June 31 . you have to be enrolled before 9 1 to be eligible for policy did start on 9 1, but because it was my husbands policy it did not count. thanks for your was bcbs that I had to deal with 3 different people told me 3 different things.
voiceoff on 01/06/2010:
These people are playing with fire and will be burned ( in the afterlife if not here). How can anyone be so heartless to make rules like that in the first place?; its a disgrace. It's a bunch of stupid rules to deny good decent people any peace of mind.
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