Blue Cross / Blue Shield Consumer Reviews - Page 5

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.

NEWARK, NEW JERSEY -- I have invested a month or more calling this company and these customer service representatives. Every time I speak to a different person and there is no direct number I can call. It is like starting over EVERY TIME I speak to someone. I have to reiterate everything again. They have a computer in front of them and I have reference numbers for the calls and they still cannot give me one simple answer. I am trying to get in-network coverage for a dental device that helps a medical condition. The provider I am working with has called them also about their services.

Earlier, this week I talked to them for the 10-15th time. They told me I would receive an answer in two days. I called today and they don't have any of the information I PROVIDED for them this week!!! Last week they emailed me a list and I called 26 companies to see if anyone within a 50 mile radius had this device. None of them did and most didn't even know anything about what I was talking about. When I called back to give them this information, they said that policy stated THEY now had to call all the 26 companies also. I have provided them tax ID#'s, diagnosis codes, and appliance codes. This has gotten ridiculous and now they want to start all over.

These ploys or incompetence to give me a timely answer have made me very frustrated. I would NEVER NEVER NEVER choose this company again or suggest to ANYONE else to use them. The only reason to use them is if you want unprofessional, incompetent, unreliable and negligent insurance provider to work with whom will ignore you and NEVER GET YOU ANSWERS IN A TIMELY MANNER. I am now waiting for a supervisor to call me. YEAH, like that will happen!!!

ILLINOIS -- If anyone is considering BCBS, I would think twice about it. In addition to their increases annually, they also add on additional increase when your Birthday ends with a 0 or a 5. In investigating options, I decided on another plan to reduce my monthly premium. When I requested an application to be sent to me, it took about a month, meanwhile my premiums has already been increased by 33%. When I sent in the new application, I waited and waited for a response.

I was told in a letter I was missing a page that needed to be signed. I prompted faxed in the page. All of a sudden two weeks later I received a letter stating they are closing the application process because they did not receive my signed page. When I called them, I was told I could re-fax it, and request the application process to be re-opened. Now one would think that process should not take that long. I also requested that a rush be put on this since it was their incompetence that caused the delay. I am guessing it was that remark that put my application on the bottom of the pile. When I called 21 business days later, they said it was still being process.

Not knowing what that meant, I asked to speak to a supervisor. Oh my gosh, that request takes 24 to 48 hours before one will call you back. I think I have spent more than enough time trying to get a status of my application. I was told yesterday by another supervisor, I should check in 7 to 14 business days to get a status. To add insult to injury, the supervisor ends her call with "is there anything else I can do for you today?" Seriously? She did nothing for me today and nothing for the last 41 days when I initially sent in my application. There has to be a company out there who will provide good health insurance, and at the same time act like they really care about their members.

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 different 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 informed 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.

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.

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 Shield 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 transparency. YOU try to find a customer service email ADDRESS on their website. If I had it, believe me, I'd provide it.

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 they're 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.

I bill for DME companies all over the United States. BCBS is by far the hardest company to bill for. Getting intouch with the correct department is almost impossible. I spend hours just trying to get intouch with correct department to tell them about their mistakes. I absolutely am baffled by the way BCBS is set up. If your employers cooperate office is in a different state then where you are getting service, or for whatever reason, claim go through local BCBS, then to pts actual Home plan, response/denial/payment, sent back to local then to provider. I can not get benefits from local, and I can not get claim status from Home Plan, so say a home plan wants info. they always so "please have provider send additional information", then most times local BCBS doesn't even tell us until we call to see why 3 months later no response on a claim. OR we are told send all medical documents, but local forgets to send to home plan or its home plan tells local that this is not what they are looking for and local does not tell us. We call back to local- because home plan will NOT discuss claim even tho they are the ones to ultimately approve of processing of claim- they say home plan was looking for something else, we say what are they looking for? Response: I don't know I'll send inquiry to home plan, and the viscious cycle continues. Sometimes our claims are held up for over 6 months!!!!

Why do they make it so difficult to get information. We are not doing anything illegal, these patients pay their hard earned money for health coverage, yet the providers who give the services to better their health can not get paid without exteme attention to detail and mistakes made on BCBS end. Also, deductibles are so high pts might as well pay out of pocket! Instead of having to pay out of pocket and for "coverage". Some days I am so disgusted by this company I feel no hope for the health industry. It should be illegal to opperate this way.

DALLAS, TEXAS -- Wow! Finally a place to vent. Hello, my name is "Tonya". I had a "HMO" plan with BCBS from 2005-2008. I needed a lapband procedure because of morbid obesity. I attended a free seminar in Arlington, TX. After setting things up through my "pcp" as BCBS requires, I was given the ok to proceed. The lapband doctor and his staff worked with my "pcp" and BCBS to set things in motion.

According to the lapband nurse, BCBS had approved me for the lapband surgery. I was given several pre-surgical, medical steps that BCBS said that I had to complete before surgery could be done. But I was pre-approved. The lapband nurse told me that on (2) different dates that the approval is good. I complete the BCBS requirements (several months of doctor assisted weight loss attempts, psyche evaluations, seeing a nutritionist or dietician.). Once all was completed a few months into the process the nurse is about to send BCBS the required information only to be told that BCBS is now refusing to honor the approval.

I called to find out what the heck was going on. Their reason was this. BCBS took a PPO customer service representative and had them work a HMO unit during the days that my approval was given. Supposedly the representative should not have approved the procedure but did.

Lapband wasn't a covered procedure for my plan. Well, why did they approve it to begin with? I lost, time, sleep, money and suffered more sickness and stress due to their negligence. I was told to file an appeal and did so! No positive results (they refused to reimburse my out of pocket expenses to the tune of $400.00 as well as the $340.00 dollar lapband doctor's bill for office visits & tests.). I was mortified!!

I called a random lawyer who gave me ramblings. Is there anyone who's not afraid to stand up to these bullies and get fair and due process for us lay people? They should be ashamed of themselves. If grocery & retail stores have to honor their 1st commitment offers (even when not in stock, via raincheck) why can't BCBS do the same? I have no insurance now and due to Blue Cross Blue Shield (Texas) not allowing me to get the lapband, I am more morbidly obese than I was before. This is such an injustice.

Can anyone help me out? Mr. & Mrs. Obama can you include in your "medical bailout" plan a free lapband procedure for folks like me who got screwed by folks like BCBS. Where is our justice? I guess it's just us and our complaints and concerns. This is why I say that BCBS is BS. They suck!! If you can help, please email me at ** thanks!

MINNESOTA -- I picked up my prescription slip yesterday, 7-14-2010, at my clinic. This was a bit of a change in routine as I usually have the prescription slip sent to my home address. You see, the United States government has decided that I am not trustworthy enough to have my prescription processed in the same way as most prescriptions. This is because mine is classified as a Schedule II substance by the DEA. OK, I get it. You wouldn't want this drug getting into the bloodstreams of kids. We see how well that plan has worked.

If the DEA's intrusion into my medical treatment was not enough, now the insurance titan Blue Cross/Blue Shield of Minnesota has decided that my doctor doesn't know how to write a prescription. When I arrived at my friendly neighborhood drug dealer monopoly store the pharmacist told me that my insurance no longer covered the dosage that my doctor said was necessary to treat my condition.

Needless to say, I was furious. I am out of pills! I can't afford the extra copay. I did not budget for the possibility that my insurance company would wait until I needed my "fix" to spring the added cost on me. They treat their insurance customers like junkies. Anyway, back to the main story line:

When I returned home I contacted a BCBS customer service representative. She was very kind. I wonder how she sleeps at night. She informed me that there had been a rule change and the company would only cover certain dosages. She said that if my doctor would not change my dosage to comply the doctor would need to submit what she referred to as a Prior Authorization Form. I was stunned. While talking to her I held in my hand what I considered to be just that. I call it a Prescription.

My clinic says it could be weeks before I get the approval from BCBS. I hope I can hold my job for that long. The last time I went a week without my medication I found myself without a job and without a car. But that's another story.