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Scumbag Insurance Company
Posted by Allisonm on 07/10/2008
MINNEAPOLIS, MINNESOTA -- Blue Cross Blue Shield has to be one of the worst health insurance companies in the country. I called them up prior to purchasing a device for treating sleep apnea because I wanted to make sure I picked an in-network provider. The customer service rep directed me to their web site, which in turn referred me to hundreds of different dentists. So my options were to either start getting on the phone to determine which dentist of these hundreds might actually treat sleep disorders, or I could go with the dentist recommended by my sleep clinic. Of course, this particular dentist is out of network. Fine, after the deductible they'll pay 80%, right? Wrong. My dental appliance was $2200.

BCBS payed $500 based on an allowable amount of $700. This was after I was assured by yet another CS rep that they would pay the 80% without mention of the cap. So I called them. Again. Unfortunately, instead of just being ignorant, the CS agent I got this time was also incredibly rude. Ultimately, they can place some arbitrary amount on what they consider "allowable" depending on which providers they're in bed with. And you better hope you pick the right one.

It's disgusting and the only thing a consumer can do is hope you never need medical care, set aside a kitty for your own health care needs and hope that karma takes care of all these dirt bags that are profiting off people's suffering. They're not in business to keep you healthy, they're in business to line their own pockets.
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Posted by tnchuck100 on 2008-07-10:
I don't understand what is the connection between sleep apnea and dentists?
Posted by old fart on 2008-07-10:
Sleep apnea? dentists?... one of these things just doesn't belong here....
Posted by Ponie on 2008-07-10:
Yeah--reading this post is like pulling teeth.
Posted by pipedude on 2008-07-10:
Most sleep apnea devices are custom fit to the teeth of the user.
Posted by tnchuck100 on 2008-07-10:
Thanks, pipedude.
Posted by Anonymous on 2008-07-10:
So, if I read correctly, the whole basis of the complaint is that the CSR failed to mention that the reimbursement is capped at $700? These caps are spelled out pretty clearly in my health care paperwork...did you read yours first? It might have saved you from an unhappy surprise.
Posted by DBone on 2008-07-10:
That sounds correct for dental insurance. They dont pay as much as medical insurance. You should have worked this thru your medical insurance, and I am sure it would have been paid for.
Posted by Anonymous on 2008-07-10:
Safest way to go with any provider is to get the pre-d: predetermination on what they'll cover. What the rep probably said is they'll cover 80% of "reasonable and customary" charges, which is a figure that they determine. It doesn't mean they'll pay for 80% of whatever a customer decides to buy.
Posted by Anonymous on 2008-07-10:
Dental coverage isn't as good as regular medical benefits are. My dental coverage covers up to $1500 per person per year above and beyond the normal bi-yearly checkups/cleanings. If any other dental work is needed, that $1500 can be used up pretty fast. It's important to a)understand your benefits completely and b) talk to your dentist about a payment plan for any amounts not covered.
Posted by jenjenn on 2008-07-10:
This post is absolutely ridiculous. If you had trouble navigating the provider directory, you could have called back & they could have assisted you with that.
C-PAP machines are purchased as durable medical equipment, through DME providers. They are not purchased through a dentist. It's your own fault you did not stay within the network. "...nd you better hope you pick the right one." It looks as if your laziness cost you a lot of money.
Posted by Anonymous on 2008-07-10:
I agree, Blue Cross is as corrupt as they come. I applied for ins (excellent health, low blood pressure, low cholesterol) and they rejectedme but were happy to offer me a high risk policy. Plus they charge you to apply. Stay Away from Blue Cross!!!
Posted by TiredAndRetired on 2008-07-10:
Mentioned the reported problems about BC/BS to my Doctor today when I went in for a physical and he said they went from pretty good to horrible when they went from non-profit to profit. Now instead of patients getting the money, the shareholders do.
Posted by Anonymous on 2008-07-11:
jenjenn-A dentist can be a DME provider. It is a common complaint about BC/BS (and most insurers) that they tell patients and providers one thing, and do another.
Trixta-It does little good to ask for a 'predetermination' on coverage. Every pre-certification contains a phrase like (in bold): "This does not guarantee payment or coverage."
Dentists are frequent referrers to sleep clinics. Very frequently, dentists evaluate people with snoring problems, TMJ pain, and sleep apnea.
It's nice to recommend that people read their coverage paperwork. It is something completely different for the average person to understand it. Sleep apnea can cause patients to have problems with concentration and comprehension due to sleep deprivation and low oxygenation during sleep. It may be a reason the OP was less than diligent in his/her coverage research...and not laziness.
Posted by timtafco on 2008-07-31:
Yes..there are SCUMBAGS..HERE IS MY RIFF..

My Leg is Falling Off..
Wellmark Blue Cross is Denying Service



Thank you for reading my plea.

My name is Tim Taffe, and I live in Iowa City.

I am writing you since I have exhausted every possible resource.

My problem has to due with multiple right hip replacement surgeries, all performed in Iowa, at Burlington General Hospital and Great River Hospital. Next Monday I am scheduled to have the third replacement installed at Fort Madison Hospital, by the previous surgeon, Dr. Mitchell Paul, whom I trust and value.

My surgery is scheduled for next Monday August Fourth.

The first device was manufactured by Depew Corporation. It dissolved, and attacked my bones..this is called polyethylene disease. The replacement device was sold by Zimmer Corporation, and the product has been withdrawn from the market. The device has shifted.

There is now no connection between my leg and my hip. Only muscles and soft tissue keep me connected.

I am in great pain, I cannot sleep well, and I walk on two crutches. My right leg is now two inches shorter than my left. A few years ago I could play tennis very well. Now I cannot walk.

I will be attaching a letter from Dr Paul herein, he describes my serious health jeopardizing situation.

The point of this letter is that Wellmark Blue Cross Blue Shield of Iowa is rejecting my claim.
They also will not return my phone calls.

I am actually a licensed Iowa Insurance Agent, and know that they are totally in the wrong.
This is referred to as "Claims Control"

They claim it is a pre-existing condition. The definition of "pre-existing" is one that has been attended to in the six months prior to the effectiveness of a group policy. I had not visited or consulted for not six months, but rather for six years. There seems to have also been an inference that my problem may have been caused by a Chiropractor. That is not the case.

I was unable to continue the job position, I am now essentially unemployed, and insured on Cobra.

I have contacted the Insurance Commissioner's Office, where everyone was very polite, however, no comments or actions have been taken against my claim against Wellmark. I have not been helped.

Please note, I am also a Wellmark Independent Agent, so this situation is rather precarious. And this is certainly not the impeccably miserable level of policy holder service which I have thought went with a Wellmark policy.

I have shooting pains down the back of my leg, and Wellmark is not even returning my telephone calls.

Please...I really need immediate intercession. Thank you. Again, Fort Madison Hospital is ready for surgery on Monday August Fourth, Mr. Tom Amenell of FNCH has been told that they may provide service to me but there is no guarantee that Wellmark will honor the claim.

Thank you,
Tim Taffe
Iowa City
319 533 6869


FYI – I spoke with Scott Potter at some length. In a nut shell, while he is getting a HCFA (CMS 1500) and a UB (CMS 1450) from Dr. Paul’s office, he does not think that will cause them to state the procedure will be covered. Essentially (this is in my words), Blue Cross wants to allow for something to turn up in their records search after the physician, hospital, radiologist and anesthetist have billed for their services that would allow or cause them to deny payment. This does not mean they will deny, just that they reserve the right to deny payment. I asked if the records search could be conducted prior to the procedure to answer the question to which he responded – No.

Thomas M. Amenell

Thomas M. Amenell, CPAM

Director Patient Financial Services

Fort Madison Community Hospital

5445 Avenue O

Fort Madison, Iowa 52627-0174

(p) 319-376-2155

(f) 319-376-2176

Posted by pissedoffchicka on 2010-10-26:
reasonal and customary (allowed amounts) are set by your state's department of banking and insurance. if you tell them you don't have internet access, prity sure they'll walk you through it. every bcbs has a list of in net providers
Posted by fromthepast on 2012-12-02:
As I read Mr. Taffe's post, I could definitely understand and appreciate his concerns. Hopefully, others could see "between the lines." There is no guarantee of payment, the services need to be performed and billed before a determination of payment can be made. The difficulty that Mr. Taffe experienced seemed to be that there was a pre-ex clause on his policy and fear that it COULD apply. With that much pain and money it stake, extreme frustration is very understandable. I am thankful to know there are so many caring individuals there to assist – and they will not just tell me what I WANT to hear in difficult times.
Posted by CHRIS2FER on 2013-02-22:
Seems that a lot of BCBS employees are on here defending this crooked company
Posted by Dump blue cross on 2013-10-20:
I can tell you, if you're insured by blue cross, check into switching to health partners. Blue cross in my experience has the mindset of my way or the highway. There is a reason Health Partners is rated so high, and it all has to do with customer service, which blue cross doesn't understand that concept. This company is only focused on corporate profits, which is sad. My experience with Health Partners in the past has been nothing but exceptional. Do yourself a favor people, save the headaches stay away from blue cross.
Posted by merry setley on 2014-01-30:
'Amen' to Dump blue cross. They are the absolute worst. Although they were very quick to deposit my payment (over $600), I still do not have an ID card a month later. The temp card was not accepted by dr. or pharmacy. IF I ever receive my card, it will have to be re-issued t/ a different PCP. Although the BCBS rep assured me over the phone (prior to purchasing policy) that my dr. of the last 20 yrs. was in the network, this was untrue. When I called to schedule an appt., I was told that the dr. was not in the network. Then I asked that a dr. LISTED ON THEIR PROVIDERS PAGE be placed on my card. Today I called to make an appt. and you guessed it--NOT a member of their network. Numerous calls have gone unanswered: 47 min. on hold, then transferred to the 'correct' department, line went dead. Emails are partially answered.
Do not choose BCBS for your ins. needs!
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BCBS Failure to cover Medicare supplement while out of state
Posted by Gduke on 12/28/2010
JACKSONVILLE, FLORIDA -- Beware of using your BCBS Medicare supplement while out of the state. They will not cover out of the state coverage other than Physician, Accident, and Emergency. I found out the hard way. My out of State Physician and heart Specialist sent me for tests at what I thought was approved network providers for specialist tests. I had checked on the BCBS site to see what out of state provider was listed and had asked the provider if they were approved providers and was told they were. Later I began receiving bills that had not been paid by BCBS. I wrote them a letter contesting the non payment and never received a reply from them. As I began to discover they had turned down numerous bills and never notified me that they were denying me the coverage I called them and stated I had checked on their site to make sure that I was using ba approved provider. I was then told that BCBS of Florida does not provide out of state providers in network. Since this has transpired over a period of several months and BCBS never notified me that they were not covering me while out of state it has resulted in me having to pay quite a large sum out of pocket. I have paid a monthly fee for me and my wife of over $135 each pm for Medicare advantage 65 premier select and now have found out my coverage is only good if I am in the state of Florida. I have now asked for BCBS to terminate my policy with them and have taken out another Medicare advantaage program with another provider.
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Posted by karleebarlee on 2010-12-28:
personally, i think it's always good to call and talk to a live person instead of check a website for something like that.
Posted by Anonymous on 2010-12-28:
Didn't they send you any explanation of benfits showing that they were denying coverage? BCBS is not going to personally call you and tell you your bills are denied. That's what the EOB's are for.
Posted by saj80 on 2010-12-29:
With the exception of an emergency, you probably needed prior approval; merely checking a website does not satisfy this requirement. What does your benefit book tell you? My guess is you have not read it, and as you found out, making assumptions can be very expensive.
Posted by victor on 2013-11-06:
deducing from what you are paying $135.00 for 2 people you have the cheapest plan. if you wouldve chosen plan F at $135.00 just foryou(the best plan) you woulndnt have this problem. my sympathies.
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Does not cover Mental Health???
Posted by Ataloss? on 04/12/2010
We have had both of my (healthy) daughters on BCBS for many years, paying ridiculously high premiums. Last year, my oldest daughter told me she thought she had ADD. To save ourselves and BCBS, we did a study through Future Search. After free testing, my daughter was indeed diagnosed and put on ADD medicine. The changes were remarkable!!!!! She went from a B and C student to straight A's almost overnight. It also boosted her self esteem as she thought she was "dumb". After a year in the study and no out of pocket to us or our longtime Insurance carrier, we then took our first RX to be filled. To our amazement, the $156 a month medication that was Prescribed and that she had done so well on was not covered???? I informed out Dr. who then wrote a diferent Rx for a much less expensive medication that we could afford (no thanks to BCBS who had faithfully been taking our money every month for YEARS) but would not cover a much needed medication for our daughter. I then called to ask if we used Drugstore.com or any Mail in Rx to save money what portion would they pay. I got an extremely rude man who told me the system was down, try back in an hour or two. I asked if he could answer "general" questions about this Rx coverage. He then in formed me BCBS offers no mental Health Coverage. Wow, really. I wish I had had my daughter tested by a Physician that was not doing a study. I would have been out of pocket some money, but would have learned a year ago to quit giving money away to a Provider that does not Provide!!!! What a waste!!

I am actively searching for a different company this minute. I will let EVERYONE I come in contact with hear this story as well. When choosing a Health Plan, check into what "Mental Health" is and if it is covered. I do not believe my daughter has a Mental Health issue, but they say ADD is. I guess as just an excuse not to pay. Very sad.
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Posted by drugdoc121 on 2010-04-12:
You said "I do not believe my daughter has a Mental Health issue, but they say ADD is. I guess as just an excuse not to pay. Very sad" Now I am not excusing how BC/BS treated you but on this one point, I am afraid, they are right.
Attention Deficit/ Hyperactivity Disorder is listed in the The DSM or The Diagnostic and Statistical Manual of Mental Disorders. It is published by the American Psychiatric Association and covers all categories of mental health disorders and physicians consult it as their "bible" to help diagnose psychiatric illnesses. So yes, ADD IS considered a mental health illness. On the plus side, your daughter is doing wonderful and that is nothing to sneeze at. Good luck.
Posted by sumdog on 2010-07-14:
Which BlueCross? Keep in mind, each state has it's own BlueCross and they're all independent. BlueCross BlueShield of TN isn't the same as Empire BlueCross BlueShield of NY or Anthem BlueCross BlueShield of Ohio. They're totally separate companies.

I'm guessing you were on an individual plan? If you get a plan through an employer, it usually includes a lot: medical, mental health, prescription drugs, vision and dental. But most Blues only offer one or two of these services. Everything else is contracted out.

For instance, BlueCross Blueshield of TN contracts out all prescription drugs to Caremark/CVS. Employers usually go with the health insurance contract for the subplans, but some companies are large enough to be self-funded and they might select their own RX or mental health insurers. For long term drugs (ADD medication, anti-depressants, et cetera), they'll even have a second company that provides those drugs cheaper by mail.

Very few insurance companies offer these subplans by themselves, especially to individuals. So you're likely to run into this with which every health care provider you get.

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Anthem Blue Cross/Blue Shield sucks!!!
Posted by Sickoftheircrap on 01/28/2010
INDIANAPOLIS, INDIANA -- Anthem Blue Cross/Blue Shield is, by far, the worse insurance company I have ever had to deal with as a provider. The unethical jerks who run the company decide about 18 months ago to pay patients the fees due to out-of-network providers so they could then, ostensibly, pay the provider. Yeah, right!!!! The only reason these psychopaths came up with this policy is to strongly strongly discourage out-of-network providers from seeing Anthem policy holders. Period. I have lost thousands of dollars as a result of patients keeping the money that Anthem sent to them for MY services. Anthem damn well knew that this would happen. It is the primary reason why they implemented the policy. They truly have degenerated into one of the worst insurance companies subsequent to them going from not-for-profit to profit around 1999. Stay away, run away from these jerks!!! Check out all other options for insurance. You will be glad that you did, believe me!!!!!
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Posted by goduke on 2010-01-28:
Hey, Mr. Provider, why not just get into their network?
Posted by Xylie on 2010-11-13:
Well,guess it's just not the clients they screw over.What I don't like,is what I'm reading in these threads that they say it's covered to all parties involved,untill it's over and done with,them when the doctor,hospital,dentist,prescriptions,submits for payment,all of a sudden,it's not covered?They just put me on it,and I can not afford to be without any of the above,no,can't take that chance,I'm switching,imediatly!
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Bad Customer Service
Posted by Ashni on 11/06/2009
I wanted just basic information on billing for a physical, Customer care could not provide me with that and I asked for a supervisor name. As expected she put me on hold and never got back on the phone again. I wish it was that hard for them to collect premiums.
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Worst Insurance Company
Posted by GretchenSM on 10/21/2009
Tried to upgrade from high deductible plan to better coverage and were denied--company grossly distorted medical history to create a litany of pre-existing conditions ( i.e. daughter goes to doctor for irritated eye and all the sudden we have 'chronic conjunctivitis.')BCBS of SC did see fit to cash our first month's premium even though they denied our application. Had to be reimbursed. Oh, the premium for our application to cover a healthy family of four...over $900 a month.

Daughter had pneumonia--racked up over $6000 in medical bills and somehow we still haven't satisfied our deductible. Its corrupt and unbelievable.
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Posted by Anonymous on 2009-10-21:
I was paying BS a little over a grand a month to cover my family(wife and daughter),this is when I had insurance thru a previous job.They didn't want to cover my wife because she has had heart issues since birth..I did get to change coverage,but only after the year was up..
Posted by JR in Orlando on 2009-10-21:
How exactly does the term "healthy" family correlate to a daughter who by your own admission, has irritated eyes and has gotten pneumonia that costs over $6,000.00 to cure. You may think of that as a healthy family, but those facts doe not sound like it.
Posted by Nohandle on 2009-10-21:
BC/BS has so many different plans it's almost impossible for someone to determine what's best for himself or his family before the fact. TW is correct. Most times you are "locked in" for a year and then you can make the changes unless you are with a group plan. Even with a group plan here it's whatever plan was chosen not a pick and choose among the employees. Pre-existing conditions would be my biggest nightmare. My mom waited a year to be fully covered.
Posted by Anonymous on 2009-10-21:
That's where I'm lucky. You could start work here nine months pregnant and our BC/BS would have to cover your delivery. There's no such thing as a preexisting condition with any of our group plans. Also all appeals of denied claims or coverage is ruled on by a designee of my employer and not the insurance company. All rulings are final.

I feel for people who don't have the same kind of all inclusive nothing ever denied health coverage that our elected congressmen and women enjoy. You'd think seeing how well that kind of coverage works for them they would do something to help out the rest of the Americans. You'd think.
Posted by JR in Orlando on 2009-10-21:
Pre-existing conditions provisions are necessary for insurance policies. The concept of insurance is that people join together and share the risks. The problem is that some well people must join, in order to pay for the health care of the sick.

If there were no pre-existing condition provision, why would any healthy person buy insurance. They would just wait until they had a serious problem to buy the coverage they need, e.g. doctor suspects cancer, buy policy - No cancer found, drop policy. I read that was occurring in Massachusetts (?) which does not allow pre-existing condition provisions.

If you were any insurance company, would you want to sell a policy to someone who recently has had chest pains?
Posted by Nohandle on 2009-10-21:
LOL Stew. I'm waiting for the time there's no need to carry Health Insurance. Wait until you need it and then sign up. You would be automatically covered for everything. Perhaps that will work for Homeowners Insurance and Auto Insurance as well. I could save a boatload in premiums. Sign up, have my bills paid and then cancel until I needed them again. Sounds like a plan to me. Show me the dotted line.
Posted by Anonymous on 2009-10-21:
JR, I have BC/BS. My employer mandates that in order to be considered as one of our health care insurance providers then they must cover preexisting conditions. Almost all the major HC providers have an offering under OUR RULES for us to choose.

Our premiums (my share + my employer's share) are less than a lot of other plans I've seen that offer far inferior coverage. If we can do it without the sky falling then why can't others?
Posted by Nohandle on 2009-10-21:
Come on Stew. You are with the largest employer in the nation. Of course they can mandate anything they like. Their cost per employee vs the same cost per employee with a small company don't even compare and your benefits far exceed that of a small employer. Again, someone show me where to sign up for a pre-existing condition for Health, Auto or Homeowners. I'll cancel all coverage I have in a moment and sign up when I feel the need.
Posted by Anonymous on 2009-10-21:
NoHandle, Call me crazy but I think there's a huge difference between automobiles/houses and humans. Are you kidding me? Seriously, are you going to equate a dent bumper or hail damage with somebody's health? Seriously? You do realize there's a difference between humans and inanimate objects.

Okay, as far as your first four sentences goes YEAH. Exactly. Get it?
Posted by Nohandle on 2009-10-21:
Of course there's a hugh difference in automobiles/houses and humans. I believe we were talking about the differences in coverage. You are fully insured for everything. Many are not that fortunate and find themselves in a situation they wanted no part in. Do you get that?

Why can't the little fellas in a small company have the same coverage for the same price that you receive? Probably the same reason your Mom and Pop grocery store can't purchase food at the same price Walmart's pays. Volumn my friend, nothing else. Now hush and play nicely.

Again, when the time comes we are automatically signed on with any company regardless of pre-existing conditions I'd like to be a part.
Posted by skelly39 on 2009-10-21:
JR, I have to take exception to your first comment. Pneumonia and an eye irritation do not an unhealthy person make. People get pneumonia all the time. I had an eye irritation about a month ago, and I've had pneumonia before, but I don't consider myself to be a physical wreck. Didn't go to the doctor, and probably good thing I didn't so I wouldn't get booted off my policy. And $6000 is exhorbitant, but take a look at what doctors bill vs. what your insurer pays. If your insurer doesn't cover all of it, do you think you get the discount they do? No. You don't.
Posted by Anonymous on 2009-10-21:
Nohandle the difference between you and I is that I would never tell you to hush. I'm always open to differing points of view. I guess it's the analyst in me and the good manners of my upbringing.

On one hand you state the answer yet on the other hand you fail to realize you did so. Indeed, why can't the little mom and pop outfit get the same coverage for the same price? Same health insurance companies, right? Yes my benefit per premium dollar is better than most mainly because as you stated there is a bigger pool of participants in which to socialize the paid out benefits. Hmmm, so as you accurately surmised the more people in an insurance pool covered under a single payer then the less the cost it is to each participant in that pool. Interesting concept. Oh yeah I forgot in your pool it's either sink or swim. Well excuse me while I do a few laps.
Posted by JR in Orlando on 2009-10-21:
NoHandle - I agree wtih you. One of the issue that keeps coming up is whether we should treat health insurance like auto insurance and base premiums on life style. If one drives reckless, one pays more. Yet, people expect to pay the same for health coverage even though their eating and life styled has caused them to be obese, high colestral and diabetic. I'm all for jacking up the rates on people whose life style creates greater risk of illness.

skelly39 - its not that getting these things make you a physical wreck, it just shows this family does have medical problems - at times.
Posted by Nohandle on 2009-10-21:
I don't recall telling you to hush Stew and I also had excellent manners taught to me during my upbringing and haven't forgotten those manners either. And do a few laps here anytime you like. I'll pour in some extra HTH.
Posted by Anonymous on 2009-10-21:
Why stop with reckless lifestyles. One's health especially in the later years is more determined by heredity than life style. I say if you got a history of cancer in your family tree then screw it you don't get NO COVERAGE for any cancer. Your parents should have thought about that before they had kids. Heart disease is hereditary as well. Your old man fell dead from a heart attack THEN NO COVERAGE for you. That would be insane.

And you smokers -- Since you're already committing slow suicide let's speed up the process. We'll gladly cover the cost of a gun and ONE bullet. Get it right the first time there will be no coverage for a second bullet.

I'm growing to like this risk based health care akin to auto insurance and driving records. If by cost or denial of coverage we can weed out the weak then we'll strengthen the strain. Create a master race of the super healthy. That should cut health care cost considerably. Save a lot of money. Like they say don't throw good money after bad people.
Posted by Nohandle on 2009-10-21:
Looking back, I did tell you to hush. A thousand pardons. Slap me across the head, I have it coming.
Posted by JR in Orlando on 2009-10-21:
Stew: As a society, we would never find it fair that someone driving 100 mph regularly and having many accidents, should get the same auto rate as someone driving the speed limit, with no accidents. What is fair about making some family with young kids pay for the on-going health care of an obese older person, who gouges on red meat and smokes cigarettes. That person should pay more in premiums or deductibles as the result of their chosen life style. People can't control their heredity, but they can control what they put in their mouth today.
Posted by FluffyTheMudpie on 2010-02-06:
I currently have Golden Rule insurance and they cover NOTHING. We've racked up tons of medical bills for my 19 month old son and myself since being with them, all for routine stuff. So we tried to get a more expensive policy with BCBS that would also cover maternity, we were thinking of having another baby. To my dismay, they denied my son and I. There were a whole list of reasons, which is amazing because I thought we were healthy. My son hasn't got a thing wrong with him, but he did get screed for heart problems (was normal) and audiology issues (also normal). I've had a c-section and have a mild hearing loss from birth.....apparently those are grounds for denial. And this policy was costing over $500 a month for my son and I. Now the only option is to get on my husband's work insurance but that will cost us $900! We will have to do that I guess. What happens if you CAN'T do that but make too much to get on medicare? I swear the healthcare debate in this country is absolutely ridiculous.
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Apparently they Don't Want My Business
Posted by MostMiffed on 08/01/2008
OKLAHOMA CITY, OKLAHOMA -- I have never in my life heard of a company making it this difficult to do business with them. It's laughable.

It's a simple thing, really. I only want to give Blue Cross Blue Shield of Oklahoma my business. My husband and I reside in Arizona. He and his previous wife are divorced. Under the custody order we are required to pay his son's insurance premium. We currently have him covered under Regence Blue Shield in Washington, but he and his mother recently moved to Oklahoma.

First, we tried to transfer the policy. We were almost through with the process when we recognized that the policy Blue Cross Blue Sheild of Oklahoma was signing him up for was not the standard Health Check policy we were trying to transfer. This after waiting more than FOUR months for ANYTHING to transpire! At that point we were instructed to call a different number in order to proceed with the policy we needed - in effect, start over. We declined and thought it might be quicker to start fresh and not work directly with the company.

We filed an application through esurance, for the Health Check policy, as their rates were most competitive. Still, Blue Cross Blue Shield of Oklahoma put roadblocks in our way. We explained to them from the start that we needed the insurance premium billed to us but that the insured resided in Okla. This is how we currently have it set up through Regence Blue Shield, with no problems.

After many emails and phone calls it turns out the ONLY way for us to get coverage for him is if we provide an Oklahoma bank account for automatic withdrawal. NO EXCEPTIONS.

The first thing that pisses me off is not once, through the entire process (which was started in March)were we told we were required to have an account in Oklahoma for this policy. My Arizona bank provides electronic withdrawal, and last I checked, the value of a dollar was the same from state to state. But no, I HAVE to open a special bank account in the fine Oklahoma City so they can withdraw the premium. How CONVENIENT!!! Now THAT is what I call great customer service!!!

Let me reiterate: I have never in my life heard of a company making it this difficult to do business with them. It's laughable.

Proceed with the application, let me provide you with a billing address or bank info and let's do business! Why is this so hard?

Oh, and forget transperency. YOU try to find a customer service email ADDRESS on their website. If I had it, believe me, I'd provide it.
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Posted by tnchuck100 on 2008-08-01:
It definitely sounds like they are jerking you around just because they can.

Personally, I would NEVER give any company direct access to my bank account.

Check with the Oklahoma insurance regulators and see if, in fact, this company can force these requirements on you. It should not matter how they are paid as long as they are paid on time. Don't give up yet.
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StarEmpty StarEmpty StarEmpty StarEmpty Star
Complete And Total Lack Of Customer Service.
Posted by Lewperry on 04/14/2014
DURHAM, NORTH CAROLINA -- To make a long story short, they have no customer service. None. You can't get anyone directly. NO ONE. So every single time you have to go through customer service h***. I'm now sitting on hold, yet again, because of THEIR mistake. I tried to remove myself from our policy in January, keeping my family members on the policy. Well to say they've screwed it up royally would be a huge understatement. They only "split the policy. Their mistake but they want ME to pay. How's that work?! Their excuse is, "there is no paperwork." Well, that's because your person screwed up. Needless to say, I'm pretty unhappy. So, 22 minutes on hold and the clock keeps ticking.

I keep thinking that Durham is not a bad drive. But if I did go I'd never get through the front door so why bother. Customer service? Not on your life. Pathetic. I've truly, truly never experienced customer service at this level...... and I'm including DMV experiences.
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Posted by Shayen on 2014-04-17:
I am not surprised to hear of the bad service. BCBS outsources their CS department to a 3rd party who pays the reps $8.50/hour. How can they expect to have a quality employee who is educated and articulate for $8.50? They rarely can but apparently they don't care.
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Posted by Meganshelby92 on 03/26/2014
GEORGIA -- Customer service for Blue Cross and Blue Shield is horrible. They need people to take a class on how to answer the phone and be respectful to a client! Very rude and wanted to talk over me! Very displeased with how one of the representatives helped me I have been transferred 6 times to the same department and no one can seem to answer a minor question about online bill pay! Come on now its your job to know and to help people when they need it not be a total ass about it!!!
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Refusal to pay for meds
Posted by Stljohnj on 03/25/2014
CHICAGO, ILLINOIS -- I do not have a pituitary gland. It was removed due to a tumor. I then had radiation when the tumor started growing back. BCBS knows this because they paid for it. I take a lot of meds due to this chronic condition. I made a mistake simple as that. I long hard day and somehow after I took my nightly injection I placed it in the freezer instead of the fridge. According to BCBS once I receive the meds if anything happens(lost, stolen or ruined), it is my responsibility to replace them at $500.00 dollars. So I have to go almost 2 weeks without meds which will mess me up for close to a month because of their ridiculous rules. Mistakes happen. Also the entire way their system is set up is a rip-off. My plan says that I have a copay of $30.00 for specialty drugs but the vial only lasts 25 days and they make me pay the extra 3 vials per year because of the way the vials are measured.

That isn't my fault. My plan has me paying for $30 for a 30 supply. Hours and hours on hold and nothing but the run around and in the end. Go call the insurance commissioner I can give you the number if you like. WOW!
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