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Prescription for Necessary Medical Equipment Denied
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

CHARLESTON, TENNESSEE -- Over two years ago I started having severe headaches every time I went to bed. Multiple doctor visits resulted in MRI, neurologist visit, physical therapy, and several medications. Nothing made any difference. By the middle of 2017 the occurrences increased in intensity. By now, I'm not able to sleep except between the attacks that came about every 90 minutes.

Finally, in December 2017 I found a description on Mayo Clinic's website that described in complete detail what I was experiencing. I immediately made an appointment with my doctor and he offered "an experiment." He sent me home with an oxygen machine to use while I slept. Mayo Clinic's website confirmed that the attacks I was experiencing were treatable with oxygen. After a three night trial, all my attacks stopped, I slept, I felt normal for the first time in over two years. I went back to tell my doctor and he told me to keep the machine until he could contact my insurance and order the machine for me.

What arrived was an oxygen tank that would only last 12-13 hours. I immediately knew that would not work. But because that was all that I was told my insurance would pay for, I tried it. Here is the result: I would go to sleep, and a cluster would wake me up. I would grab the oxygen line and turn on the machine. When it subsided, I would turn it off to save oxygen. Try to go to sleep, wake up again, turn it on, turn it off... Since the pain had already taken hold, I was never able to get complete relief because clusters will cause migraines. So for four days, I had migraines during the day, and the repeated cluster attacks at night.

I called BCBS to find out why I was rejected for a machine that would run all night. The woman on the phone told me she was "writing all this down." The next day I went back to my doctor to discuss options. He told me he would "investigate, and contact BCBS and let me know." The next day the oxygen company (Lincare) called and said they were bringing out another full machine to replace the empty one.

The very next day, LINCARE called and said, "BCBS has denied paying for a machine for you and an oxygen tank. We will be coming to take it back." After the call, I called BCBS to make an appeal and gave a detailed history to Michael (who was very patient and sympathetic). He told me he would submit it as an expedited appeal and I would get an answer in 72 hours. When I hung up, I had a good cry from all the frustration and confusion and also quite a bit of hatred for an insurance person that will deny a request based on a form.

In about an hour, BCBS called me back. They said they were reviewing my appeal, but needed my doctor's number. (WHAT?). So I gave it to her. Then, in a few minutes, she called me back and said, "Your expedited appeal has been changed to 'regular processing' because we could not reach your doctor."

Every medical prescription I have tried to fill with BCBS has been denied and I've had to appeal to get it covered. Overall, I am a healthy person and I've resorted to natural medication to replace the prescriptions. This, however, has me over a barrel. If I can't sleep, or rest, or function normally pretty soon the medical profession by the stupidity of BCBS will have me on multiple medications to get me what they will call "medically necessary." May God do to them and more also as they have done to me.

Lost Premium Payments
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

DELAWARE -- Since Jan 1, 2018 I have been trying to get my family policy reinstated because of alleged non-payment. I provided proof of payment which was acknowledged several times. They received it, but "Unfortunately, we can't find it, let alone show it has been cashed." Until they do, they refuse to reinstate. WHY SHOULD I HAVE TO BE DENIED INSURANCE BECAUSE HIGHMARK CANT MANAGE THEIR ACCOUNTS?

At this point, I'd even pay the fee to stop payment on the original check, and FEDEX them another payment. This is unfair and irresponsible on the part of Highmark. I plan on calling our insurance commissioner, but what's going to do for me while in need of medical coverage!

Best Possible Experience With an Insurance Company
StarStarStarStarStarBy -
Rating: 5/51

UTAH -- I spoke with Licet from the Claims department about a billing issue with my newborn's first hospital bills. She called the hospital with me on a three-way call and was so incredibly helpful. I actually felt like she was trying to help me instead of the feeling I usually get with insurance companies. Everything was fast and efficiently handled and I am thrilled to have such a great insurance company!

Worst Company Ever
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

ORLANDO, FLORIDA -- I never write a review but by far this has been the worst and has actually encouraged me to leave one about them. They do not care about the customers. They leave you on hold for over long periods of time, once one of the reps forgot to put me on hold and I heard her talk rudely about me because I was complaining about my policy. I really dislike this company and I will not recommend them to anyone.

StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

ATLANTA, GA -- I have had Aetna, MetLife, UnitedHealth Group, and Blue Cross, and Blue Cross is BY FAR THE WORST insurance company I have ever had to interact with. Everything they do is inefficient and terrible. Every time I call the wait is over an hour, only to be transferred or connect somewhere else, that also has an hour long wait. THIS IS A TERRIBLE USE OF CUSTOMER'S TIME AND LEAVES A MOUNTAIN OF UNRESOLVED ISSUES. If the company were efficient in the first place, I wouldn't have to waste my time calling.

Let me start from the beginning. I have time, because I am on yet another hold with BCBS that is predicted to be over an hour. I signed up for BCBS as an independent business owner, I pay out of pocket for all of my insurance coverage. It took them 3+ weeks to approve me for enrollment, even after I had sent over documentation from Aetna saying that my plan with them was no longer available and had been terminated. Finally, I found out I was approved, not by an email or arrival of an ID card, but because my account was charged $247 without a word.

During the process of trying to get approved for enrollment, having site login issues, etc., I would call BCBS and have a wait time of over an hour every single time. I reached someone and she offered to connect me to someone else, when she transferred me over, after already waiting over an hour, the wait time to talk to another associate was an hour. Basically BCBS asking me to spend two hours of my time WAITING without any resolution, only to maybe have to be transferred to another associate with more wait time.

After I was charged, I tried to avoid at all costs calling again because the whole process was just so incredibly inefficient. Lo and behold, here we are a month later, and I still have no ID card, no proof of insurance, no website login, and a bill lying on my desk. I tried to log in to pay the bill and it says I don't exist in their system (tried via email, member ID number that is listed on the bill, and social security number).

So currently, I have a $247 charge, another bill, and apparently no insurance. And am currently 15 minutes deep into what promises to be an hour long wait to speak to anyone at the company. You can't get a customer service email without successfully logging into the site, so I am forced to call.

I don't understand. Do you have 4 people working in the whole company? That's the only way that I could imagine would be an excuse for how inefficient and terrible your processes are. I would never recommend BCBS to ANYONE who can avoid it. If changing insurances weren't so troublesome, I would cancel this so fast. If anyone ever asked me about BCBS, I will send them running in the other direction. My fiance also has BCBS and has had the same issues, with hr long wait times for calls and unresolved issues. THIS COMPANY IS TERRIBLE. UHG and Aetna are 1000000 x better. Please heed my advice, and go elsewhere.

Bad Customer Service
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

ATLANTA, GEORGIA -- I was admitted into the hospital. When I came out and go to get medicine I am told I don't have any medical coverage. When I call BCBS they said my policy was terminated and date given was right before the hospital stay. Why was it cancelled? "Oh probably some error". Will you reactivate? "Yes".

A week later go to pick up medicine, no coverage, call the state office, "You don't have any coverage and we are not taking any payments from you. You have not had any coverage with BCBS since last year." At that point I realized what type of ignorance I was dealing with so I called my human resource dept to let them handle it which they did. But one woman tried to help me so if you have to speak to someone at BCBS ask for Josie, she was the best. But even she couldn't deal with BCBS State office. They don't care what they tell you. I cancelled my insurance and moved on. Won't deal with them anymore.

StarStarEmpty StarEmpty StarEmpty StarBy -
Rating: 2/51

NJ -- I am a teacher, and the school where I was offered a job was enrolling its new employees in a plan with AETNA in an HRA as of 01/01/2017. I was used to having BCBS, but I was paying $347 a month in addition to a $50 co-pay to see a neurologist or any specialist. This was in addition to paying $15 for my medications monthly, which cost roughly $75 a month altogether. Keeping this plan was no longer a viable option.

I found the form for termination of coverage online. I filled it out, scanned it, and sent it in. I received an email stating the file was "completed and closed", thinking that my coverage had been terminated. I then received a bill in the mail asking for two premium payments in the amount of $347 each, which is what I'd been paying for all of 2016. One for January and one for February. I decided to call these people and settle this.

After being hung up on, told I was wrong, and should have "followed directions" (the only directions stated I had to either fax or e-mail the form to them, which they denied having) I was told to "call the Marketplace and terminate your coverage." I had the sent email AND form directly in front of me.

I called the Marketplace and dealing with them was much easier than dealing with these fools. You can barely understand them when you call for any type of assistance. All they know how to say is "I apologize", "Would you like me to transfer you to an escalation specialist?, or "This issue is not for my department. I will transfer you to such and such department." They are not receiving a premium payment for services I did not use in 2017.

Cancel You Without Notice- AFTER You Pay
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

OKLAHOMA -- Bought the Highest Medical and Dental plan offered on and paid $400 (I'm unemployed). First there was nothing to say that you would be paper billed after giving all of your info and it seeming like your payment would just be taken. Got a letter stating the bill was never paid (mentioning both plans), frustrated... I called and was willing to give them my bank statement to show I had paid. Never mentioned that they were only missing the $22 dental portion the whole conversation. They said "yes", they received it.

Next month, made a payment, it was $44 more. Asked why, they said it was dental and that we never paid... Ok, paid the 2 months after complaining we had called, why did they not tell us. Bill from dental cleaning comes back unpaid and Dental cancelled for non-payment. Nothing they could do, we did not pay for 30 days. Nothing you could do????? You could have told me the first call I made about the lousy $22... Really???? Seems like an all out scam.

Now I am going to pay out of pocket for an exam that should have been free... and an amount, that after paying a total of over $800, unemployed, is impossible. Not only that, but they cannot re-instate me and I have to wait until Nov. 1st to re-apply for benefits. This is not OBAMA people, this is INSURANCE companies. Don't think they are not finding ways to be more profitable. I am sure you will have to fight tooth and nail for every claim with these guys. There are places here in OK that will take Blue Cross Blue Shield, but not from OK. Blue Cross should shut down this section of business.

65 Years Old
StarStarStarEmpty StarEmpty StarBy -
Rating: 3/51

NATION WIDE -- I am currently employed Department of Justice and 65 years old. My health Insurer is Blue Cross Blue Shield. BCBS wants me to fill a form stating that they are the only insurer and I do not have Medicare part A or B. To speed up the process, I asked if I can fill the form online or, they can send me the form and I can fill it and fax it to them. None of the request is available.

Now my question to all people over 65, I am paying the premium the same as the rest of the employees in my office. Why do I have to do this, is it because I am 65? BCBS said that's why. I think this is age discrimination. Any employee younger then 65 don't have to fill any form.

We all pay the same premium. So why is BCBS trying to prove, saving money, or trying to create miserable time for senior. If BCBS is trying to save money for not be listed as the first insurer, I understand it. But the burden should fall on them, but not the policy holder. I would love to talk to any lawyer who is willing to file a law suit against BCBS, and I think there will be many other seniors like me.

The Worst-- Without A Doubt.
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

PROVIDENCE, RHODE ISLAND -- When I got hired at my current job, I was pleased to find out that Blue Cross Blue Shield of Rhode Island allows girlfriends/boyfriends/common law spouses to receive healthcare coverage through someone else. My girlfriend has been without insurance for far too long, and this looked like the perfect opportunity to finally get her some. And she needs it, too-- she's got varying medical conditions that are far too expensive to be paid for without insurance. Nothing life threatening, mind you-- but they're conditions nonetheless.

When a year passes, that's when you're allowed to put a spouse/significant other on your insurance as a "domestic partner." Great. BCBSRI mailed me a list of documents they'd need to prove that we weren't trying to screw them over (as an aside, this took nearly a month to arrive in my mailbox, despite the fact that they're about 4 miles from my house). The list had 6 or 8 items on it, only two of which were required for proof. No problem. I picked the "prove you've been living together for over a year" and "get a notarized relationship agreement" options.

I mailed them a copy of my lease (that she and I are both listed on) as well as a document I wrote up and had notarized, stating that we've been in relationship for the past 36 months. Everything is going fine, and my girlfriend will have insurance within a week or two. Or so I thought. Two weeks went by and I didn't hear a peep from BCBSRI. I finally realized that something probably got messed up, so I called.

They informed me that her coverage was denied. When I asked why, I was told it was because I "didn't supply the sufficient documentation," which, as you know by reading this, is untrue. So I asked what I should do, and they told me to send it all again. So I did. I call them again, explaining my whole story. I'm now told that what I mailed them wasn't enough. They need something like a joint checking account or joint ownership of a vehicle. I told them that was insane, because the paper I have says "Here's 8 options, PICK TWO." And that's exactly what I did. They ask me to send the stuff again. So I did.

Another week goes by with no notice from them whatsoever, so I call again. This time, the story is different: They claimed that they never got the notarized agreement, but they did have the lease. This is false. They were mailed in the same envelope, so unless some employee lost the paper (which is my guess), they have both documents. The guy asks me if I can fax over the contract again. Once I do that, he'll put in a request to get everything done quickly and he'll be in touch. I faxed over the agreement and never heard from him again.

Yesterday, I called again after I got a letter saying that she was denied coverage. The reason for her denial was that (you guessed it) I provided insufficient documentation. Again, this is entirely untrue. I spoke with a customer service representative and explained the situation for the billionth time, and he said that he'd put a note on it marked "urgent" and he'd call me back in the morning (today). I never got that call. About an hour ago I called again and really gave the guy a hard time-- I need this fixed not now, not yesterday, but THREE MONTHS AGO.

"Immediately" doesn't begin to describe how quickly this needs to be done. He said he has no say in the matter, which is true, but he'd put another note on it to get it expedited. He informed me that since she was denied coverage (the reason doesn't matter), I might have to file an appeals claim that could take up to a month to be resolved. I explained to him that an appeal was absolutely not even close to a viable option, and that this has to be fixed NOW. We don't have another month to sit around and wait. He says he's going to have someone call me in the morning, but I refuse to believe that.

The long and short of it is this: BCBSRI is an abysmal company, full of people who A) have minimal-to-no-intelligence, and B) apparently never, ever speak to one another. What they're doing (and continue to do) to my girlfriend and I is unacceptable, and you can bet if I had another insurance option, I'd leave them in a heartbeat.

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Blue Cross / Blue Shield Rating:
Star Half star Empty star Empty star Empty star
1.3 out of 5, based on 43 ratings and
92 reviews & complaints.
Contact Information:
Blue Cross / Blue Shield
225 N. Michigan Avenue
Chicago, IL 60601
312-297-6149 (ph)
312-297-6609 (fax)
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