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Blue Cross / Blue Shield - Page 3

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84 Reviews & Complaints

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Changing Medications
Posted by Crissangeleyes on 03/21/2014
ROCHESTER NY, NEW YORK -- I changed from one company that I was totally happy with because of the premium increase. Through The Affordable Health Care Act (Obama Care) I met with a navigator who assigned me to Blue Cross/Blue Shield.
It has been nothing but a nightmare so far. They refused to pay for my mammogram, because I require an ultrasound after the mammogram, now they are refusing to approve my migraine headache medication that I have been taking forever via my Neurologist and previous health care provider.

Money is everything with these people. They are trying to substitute the pills with pills that cause tinnitus, which is a condition I already suffer from and also, I found out through research, they give it to dogs with arthritis! They have been rude on the phone and even sent me a letter telling me that I could not have my old med back.

Now I am on Vicidin and nausea drugs and they have to pay out of pocket despite a premium I pay them monthly because they claim I have a "deductible". I do not understand why they will not approve the Naproxen sodium 550mg I was taking because they weren't going to pay for it anyway!

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Poor Customer Service
Posted by Q4844895 on 02/07/2014
Been on hold three times, shifted from department to department. Hung up on me twice by automation phone system. They won't have as many claims if you can never get hold of anyone. Going on 70 minutes now!
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Posted by nikalseyn on 2014-02-07:
Which begs the question----why do you have them as your insurance company? How are they at paying claims, tho? I had BC many years ago and found their "customer service" so bad that I got out after only one year. Why would anyone put up with nonsense like that? Find another insurer.
Posted by bArb on 2014-03-07:
This "please wait representative will be with you shortly" is crazy! 2 Hours wait today, 1 and 1/2 hours Wednesday....still cannot get someone to pick up the phone! Haven't been with them 6 months....but I promise I am looking elsewhere! This is just CRAZY!
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No Coverage
Posted by NEHOMA on 01/23/2014
Moved from Ohio to North Carolina. Called BCBS with address change. Was advised they don't issue policies in North Carolina. Tried several times to get release letter from BCBS so could get coverage from another company,. After threat of calling insurance commissioner in Ohio, got letter.
Found out after arriving North Carolina BCBS does issue policies in North Carolina.
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Horrible Telephone Wait Times; Can't Order ID Cards
Posted by Kelly.email2 on 01/22/2014
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.

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Dishonest and Misleading About Coverage
Posted by Misakilove on 01/07/2014
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.
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Horrible Customer Service, Misleading Information Causing Me to Pay Extra Deductible!!
Posted by Lamyukheung on 12/26/2013
ORLANDO, FLORIDA -- In order to avoid any hidden terms/ fee, I called ahead to check if delivery is 100% covered with my plan at my selected hospital and I was told it is 100% covered. only after more than 10 months when I called to inquire about something else that they told me the service I used 10 months ago was not 100% covered and they are going to re estimate everything + I will have deductible to pay for that. VERY rude and unprofessional customer associate. They don't even know what is included in my plan and every time I call, they will give me a different answers/ terms. very frustrated and disappointed. it's just useless to call and talk to those operators that are not informative, they even gave me wrong information about my plan which ended up causing me to pay extra money due to their wrong information. I even tried to talk to a supervisor and she was like a robort just kept repeating it's the policy and she couldn't do anything about it. not even an apology for what her co workers did wrong and for my loss of time and money due to their misleading information. that supervisor just told me to contact my HR as they are not responsible for that. it was Blue Cross Blue Shield's customer associates who gave me wrong information and I have to pay for their mistakes!! very angry and frustrated.
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Customer Service # Listed on Card Is for Out of Service Cell Phone
Posted by Jstkpmvg on 12/16/2013
STERLING HEIGHTS, MICHIGAN -- Customer service # for Blue Cross is listed on back of card but got nothing but busy signal - found out the # is for an out-of-service cell phone not associated with BC at all.

Called many other BC #'s but was told "We're not customer service- just call the # on the back of your card" Finally had someone helpful enough to give me the correct # and asked me to read the # on the back of the card to them- the number didn't show up in their database.

How is it possible that a big, rich company would not periodically check, and call it's own #'s to make sure everything is working properly? How could they issue cards with the main contact # incorrect? I'm a new customer, is this a sample of what I'm going to be dealing with at BC?
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Claims Denial
Posted by Gtamargo1 on 10/28/2013
GAINESVILLE, FLORIDA -- I have a son with autism, he has the proper diagnosis by the University Psychiatry dept. When he was 5. BCBS cannot deny our claims for speech therapy but they play with us denying claims for months up to one year in 2010 to later apologize and say it was a clerical error. Now 2013 here we go again, they have lowered the allowed amount for a one hour session of speech therapy to $53.73 and they are breaking the bills in two and then paying 60% of the smaller amount, in the mean time my debt to the provider continues increasing every week and every time you ask for an explanation you get a different answer. It is the same m. o. As in 2010.
It is exhausting and unnerving.

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Denied Denied Denied
Posted by Bryan_baker41 on 09/27/2013
My son has a heart condition. He is almost five and still can't walk. He was denied for leg braces and denied for a walker. He needs to walk to get his next heart surgery. I hope everyone of those people can feel my frustration and pain that I'm going through one day. They make money off other people's pain and suffering.
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Posted by nikalseyn on 2013-09-27:
You must be more specific. Why did BC deny the services/medical appliances?? Surely, they would have told you.
Posted by azRider on 2013-09-27:
why was he denied? did you ask for a review on it?
Posted by trmn8r on 2013-09-27:
It's pretty hard to evaluate a complaint like this without knowing a lot of details, for example if you believe he should be entitled to these items by the policy and the reason(s) the insurance co gave for denying coverage.
Posted by cmthru on 2013-09-27:
You can appeal the denial. Did they give you a reason for the initial denial?
Posted by Tezrien on 2013-09-27:
Please please please, call the Shriners and get your son set up with them.They are non-profit, will not charge you a dime, and will help you and your son get the care and medical devices he needs. They will even transport you to and from their medical facilities. They helped my little sister when she was young( She has Cerebral Palsy). Here is a link to their website.

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Posted by Jodyrasch on 07/31/2013
As a breast cancer survivor, I am diligent about my health. My annual mammogram is not covered at 100% per my call with BCBS today. It is only covered if it is routine. Because I have a previous diagnosis and need a diagnostic mammogram, Ii is only covered at 80%. SHAME ON YOU BLUE CROSS BLUE SHIELD!
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