Blue Cross / Blue Shield - Page 2

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1.2 out of 5, based on 50 ratings and
106 reviews & complaints.
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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!
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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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The Worst, Most Incompetent Customer Service Imaginable
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

GRAND RAPIDS, MICHIGAN -- My employer assigned my family to blue cross/blue shield recently after being with another provider for 15 years. We had dropped blue cross/blue shield 15 years ago because of extreme incompetence in their billing and customer service. I had suffered a back injury that required a lot of procedures and rehab 15 years ago. Blue cross/blue shield couldn't process the bills that my approved doctors submitted and failed to enter the right billing codes, etc..., then proceeded to send the bills directly for me. Then came the late notices.

Meanwhile, myself and the doctors worked to get it straightened out and the next thing that came in the mail were notices from Blue Cross/blue shield indicating the bills would be forwarded to a collection agency. That did it for me. The stress of dealing with this POS company was a negative factor in my healing process. It took about a year to straighten things out with these idiots, the whole time it took for my back to heal. I think I would have healed faster if it wasn't for BCBS. Now, though no choice of my own, we are assigned again by my employer to this so-called health care provider.

Earlier today I went to their website to register my new health card and set up an online account. Their site would not allow me to complete the registration so I called their toll free number. That's when the flashbacks of 15 years ago began. After going through their pathetically long menu, waiting and waiting and waiting, I talked to somebody for a few minutes, mostly answering inept questions and waiting, to find out she couldn't do anything. So she sends me off to somebody else. Same thing. After the 4th person, I finally got registered. The main problem was their system had a totally different Id # than what is on my Id card. Figure that out.

I then had a few questions about my coverage. She couldn't find the answers and transferred me to someone else. Same thing, so she gave me a phone number to call. I called it and after talking to 2 more people I was transferred back to the same people who gave me the phone #. The next person couldn't help me and suggested the phone # I had already been given and tried. I told her that phone number was not helpful. She then transferred me to somebody else. Same problem.

I hung up, called customer service again and was finally talking to somebody, after much difficulty, who dug in a little deeper and found the simple answers I needed about the copay required for x-rays and MRI's, lab work, and surgical procedures. Nothing difficult. After all, they are a "healthcare" company, aren't they? Hardly. They're no more than a profiteering company with the word healthcare in their name. They are an incompetent organization that should be involved in something else than healthcare.

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Worse Experience of My Life.
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

SAN ANTONIO, GEORGIA -- I applied on marketplace in Dec of 2013 for Insurance from 2 separate companies, one for medical and BCBS for dental. Within weeks I received information from my medical insurance, which I paid for. I never received anything from BCBS. I assumed that because I never received anything that they didn't get my application or I would get info in April because the deadline was set back.

I finally received information from them (a welcome packet, bill, and my BCBS dental card) in April. I paid my premium in May. After paying my premium I received a bill for $216.XX. I called BCBS to find out why I was being billed that amount. I was told that it was everything I owed them from Jan until present for coverage. I explained the situation only to have them tell me that they couldn't change the date on my insurance and I told them I wanted to cancel. Then I got a notice that said that my insurance had been canceled Feb 1, 2014.

I called to request a refund for the amount that I paid. The insurance was cancelled before I had ever paid it and the whole thing is a mistake with their system. I was told by a CSR that I should have never been allowed to pay for the insurance and that I should expect a refund check in 7-10 business days. That was July 21st. The lady gave me a reference number, her name, and her employee ID number.

Today Sept 3rd, 2014 I called to find out where my refund was. I was told that the CSR should have never told me that I would be getting a refund and that the money I paid in May went to my Jan 2014 bill and that's why I got a letter saying I was canceled in Feb for nonpayment, which does not make any sense whatsoever. After spending at least 4 hrs. on the phone over a course of 3 months, I am being told I am not getting a refund and that I could appeal it if I wanted. So I paid for insurance I never had and BCBS is trying to keep my money and somehow pinning their system errors on me. BCBS is a NIGHTMARE!

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Prescription Drug Coverage
StarStarStarEmpty StarEmpty StarBy -
Rating: 3/51

PHOENIX, ARIZONA -- Blue Cross/Blue Shield of AZ lists on their Prescription Benefits Web Page drugs covered. Even though Chantix is listed on their Covered Prescriptions my prescription was denied. After speaking with a representative at BCBS prescription Benefits, I was told that MY PLAN did not include a benefit for that prescription (smoking cessation products/devices). I asked "why was it listed on the web under my prescription benefits?" I was told that the majority of BCBS plans do not provide for smoking cessation products.

With all of the anti-smoking campaigning that goes on these days, why on earth would a health insurance provider deny someone the opportunity to quit smoking? That is just ludicrous! It's time that insurance providers like BCBS get their act together and start providing people with the benefits that really count. I guess I will need to wait to get some type of cancer, since they WILL cover that! How STUPID is that?!

Blue Cross/Blue Shield it's time you stopped misrepresentation/misleading information posted on your website. Or at least get your tiny letter disclaimers correct "Coverage may vary by benefit plan". Maybe it should really read "This Item may not be covered under your plan." When you say "Coverage may vary by benefit plan" you are giving the false impression that benefit plans cover this item, but in some other degree. That's just like if you bought a box of waffles and on the box in very small print it said "Waffle count may vary by box."

So in some cases you get 12 waffles, other times you get 4 waffles and sometimes you get no waffles at all. Sounds like a sweet deal for the waffle maker but not for the consumer. Come on BCBS step up and do the right thing and start helping people that want the help, after all, you wouldn't exist without us.

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Nothing but trouble even before any claim ever filed
StarStarEmpty StarEmpty StarEmpty StarBy -
Rating: 2/51

MASSACHUSETTS -- I joined BCBS on 12-7-12 during the enrollment period and selected the check box election to have premiums deducted from SSA benefits and immediately began getting premium bills for the $28 monthly cost. I called and was told auto-deduct would begin in March, and was given a confirmation number for the call/incident, but the paper bills kept coming so I called again and got a 2nd ref. # after hanging on my prepay cell phone for close to half an hour. The representative promised all would be well beginning in June. I then sent a double payment for the 2 month period till June.

I then received another paper bill for a rate increase, completely unexplained, and another bill for a full month, plus the rate increase. It seems that explaining anything to customers is the worst form of torture for the reps at this company. I had already tried to register at the BC website in order to send a detailed msg of this incident, but after two hours of trying to jump through all the cyber hoops to complete the registration and trying this application at least 6 times and getting dead end msgs, I called the "problem with captcha" number on the button and learned from the representative that online registrations were not allow for Medicare recipients.

So, rather than posting this anywhere on their comprehensive website, they've decided to just let us folks dangle trying to do the impossible while pseudo errors are cited as appearing in their registration info & of course the members think it's their error. This lengthy description is the definition of corporate disdain. Nowhere does it state on the site that Medicare members can't register, so it seems BC has decided that their wasting a few hours trying to do the impossible is a good exercise to impart the lesson. At this point all that's left, as intended by them, is to make another phone call - the only means of communication provided for us 2nd class members.

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Failure To Pay Bills
StarEmpty StarEmpty StarEmpty StarEmpty Star-
Rating: 1/51

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.

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Insurance companies and cost of Remicade
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NORTH CAROLINA -- After 2 years of an undiagnosed illness, I was referred to a University Hospital. First visit was basic - previous history, getting new bloodwork done, etc. Second visit, doctor starts me on an infusion of drug Infliximab or "remicade". I had never heard of it, but went ahead with the process. Tiny bag - 400mg, no big deal, it was just a slow drip, that was all. Went back again next month for another dose, same amount. Doctor said bloodwork looked good. I was feeling much better. Doctor says I have an immune disorder. Go again 3rd month. Feeling like a human being again. Doctor is glad I've improved. New bloodwork looks really good.

BIG problem. Blue Cross sends me statement for "pharmacy" charges it will not cover for $38,000 for (2) Remicade infusions. And they still have one more bill for about $20,000 yet to send me!! Found out the hospital failed to get a pre-approval from insurance company before using this medicine on me. Several hospital officials told me, since it was the hospital's fault, I would not have to pay. The drug would just be replaced by the drug representative. Not so. My statements are now in collection agency hands

And I have to find a lawyer. I am at my wit's end. Insurance company paid for everything but the medicine. Oh, I checked with a local pharmacy to see if I could buy "remicade" if I had a prescription. Yes, I can, but it would be in a 100mg vial at a cost of approximately $825.00 to me. Multiply that times four and you still don't get $20,000 like the hospital was charging my insurance company for 400mg.

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Mammograms
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GEORGIA -- I was at a regular doctor checkup and I am 33 years old, they found a lump on my breast and referred me to have a mammogram and ultrasound to diagnose the lump, I got 2 bills, one form the facility and one from the radiology clinic. BCBS paid a total of $67.00. I am paying out of pocket $500. They state a routine mammogram is paid at 100% by them. But if you have a diagnostic due to a lump or anything else they are not responsible for 100%.

Why is it if you have a medical issue that is really needed to be looked at, they will not pay? I think this should be looked into further and ALL mammograms should be covered by 100%, it's bad enough to go through the stress of finding a lump, then finding out you have to pay so much out of pocket when it does not state that anywhere in the benefits book. Shame on them to make one any more important than the other!

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Intentional misrepresentation
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BCBC has separate service departments for customers and providers. Customer Service is not allowed by policy to speak to a provider nor let a provider listen to a conversation between them and a customer. A customer is not allowed to speak to Provider Service nor listen to what Provider Service tells a provider. This is the case even when the provider and customer approve of the other listening in for the purpose of resolving contradictary information. WHAT ARE THEY HIDING? It is obvious that they tell provders one thing and customers another and they don't want each to know. They want customers to blame the provider for not doing what BCBS says the provider should do but won't let the provider do!!!!!!

I won't do business with them anymore. This is nothing less than FRAUD!

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