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This Is Awful Insurance and Awful Customer Support
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

RALEIGH, NORTH CAROLINA -- This is a very unhelpful and rude company, I tried for over a month to cancel and they charged me again. When I contacted the online chat service they told me they were unable to help and cancel my insurance. Don't waste your time or money, they do not help you and overcharge you.

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They Are Not Clear and Will Take Advantage of You
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

TAMPA, FLORIDA -- I have health and dental insurance with Blue Cross Blue Shield for both myself and my daughter. When I signed up the salesperson sold me a health plan and I was debited for it and waited for my cards that never came. A month went by and I got sick and needed to go to the doctor and when I had them try to look me up in their system since I didn't have a card they couldn't find me. Come to find out, I was never insured.

When I spoke to their customer service team, they couldn't find my contract or anything about me in the system with a health plan. Then I tried to go back to the salesperson and he would either never answer his phone or return my calls. After two weeks of trying and even asking for supervisors to no avail, I left a very fed up voicemail for the guy that sold me the policy and he finally called me back.

He acknowledged there was an issue but that I couldn't get the money back. I was insured I guess in that 30 day window, but then wasn't because something on the paperwork didn't check that it was an auto-debit ongoing from my checking account. So I decided to just hang up and find another company to get insurance with since it was such a production. One little fun fact is about a week later I did get a refund for the amount... But seriously so much hassle for nothing.

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The Epitome of Arrogance and Evil
By -

Jan 25, 2011 I injured my back in a fall at my house and was taken to the ER by EMS. CT done, nothing broken. Was given some meds and told to follow up with my PCP. Started feeling worse and having pain moving down my legs within a week. Went to Walk in at my PCP and they ordered a Stat Same Day MRI, the results of which, they sent me to a Neurosurgeon for consult due to the issues found on the MRI as well as my symptoms (MRI showed a bulging/herniated disc at L4/L5). I couldn't do PT after 6 additional weeks of trying to hopefully get better, nothing was working.

They scheduled a discogram to examine the Disc structure. The discogram confirmed the suspicions. Not only was the disc herniated but I had a Grade IV tear in the disc with significant leakage into the canal. The MD who did the discogram agreed with my neurosurgeon that due to the damage and the DDD in the disc that fusion was the only sensible option due to likelihood of reinjury or disc space collapse resulting in major issue potentially. I was 2 weeks from having surgery and then the BCBS of NC brick wall came up. They denied my surgery. My Surgeon put in an immediate appeal and he was denied... all because they said it "wasn't medically necessary."

I went through 1st level internal appeal at BCBS which was a bloody joke. Their supposed internal review physician was a bloody family practice MD, they don't know anything remotely about spinal surgery or surgery in general for that matter so WTF... DENIED again!!! This was July... I had a setback and major pain issues that nearly had me admitted due to exacerbation of pain issues and my pain meds were increased... OK filed 2nd appeal. Hearing was Aug 26 (same day as Irene is about to come barreling through our fine town). Thought it went well... Got letter this past Saturday, DENIED again.

Neurosurgeon on appeal says I don't need fusion, I need disc resection (oh the moron also asked about disc replacement but I find it funny because bloody BCBS of NC still think disc replacement is experimental despite the fact that several other BCBS affiliates DO cover it). My neurosurgeon will not do the disc resection because he doesn't think it'll solve the problem long term and is concerned about I'm sure legitimately being held liable if the surgery fails and I end up worse. I think he's dead on on what needs to be done, but once again BCBS thinks they know better.

The sad truth is BCBS of NC only cares about one damn thing. Getting my money and not paying out theirs despite their responsibility to their members. The less they pay out the bigger the higher up douchebags bonuses are (don't lie, we know the truth). I'm sick and tired of my life being ruined by these **. If I could pay for my surgery myself I would and then sue the hell outta them for the cost plus bad faith actions on their part leaving them WIDE OPEN to punitive damages in the millions potentially. I can't be the only person fighting with them over this. If you are in my same situation feel free to contact me please.

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Very Bad Experience With Handling of My Premium Payment
By -

DETROIT, MICHIGAN -- BCBS of Michigan is in receipt of 3 premium payments for my fathers health insurance. The first 2 payments, sent electronically, were not applied to his account and I was forced to pay a third time to keep the insurance from being canceled. The total amount I have provided to them is nearly $1000.00. BCBS of Mich advised me last week, that they found the payments and had refunded them back in a check payable to me. This was strange because the policy is my fathers, not mine.

I did not receive any check and called after a couple of weeks to inquire. They then advised that the refunds were sent to an address in Saginaw MI - where I have never lived. I live in Kansas. Undeterred, they asked if I "knew" someone at this address. I do not. They required my SS# to prove this person was not me. I provided it, although I am neither the member nor the payor.

They finally admitted that this was an error and they had sent the refund to someone with my same name by mistake. They said my bank was at fault for this error. This other person cashed the check. Yesterday, BCBS indicated they will not refund this money back to me, since they feel they are not at fault.

As bad as this sounds, the money in this case, is not the worst part of this problem. The conference call set up between my bank, BCBS and me took place yesterday. I was told by the BCBS supervisor that I could not speak on the call. I asked if she would please allow me to speak. She said and I quote - "no, you cannot speak." She talked over me and indicated that I had "blamed BCBS 100 times for this mistake and it is not our fault."

After being chastised, I had no choice but to be silent for the rest of the call. When she finally paused, I responded "Since I am not able to participate in this discussion, I will hang up now, and would ask that my bank representative brief me on the outcome." I have not heard back from either BCBS or my bank.

Since this was an electronic payment, the bank likely has a role in this error and I am not indicating otherwise, but the real issue is the way I was treated. I am considering filing a complaint and getting legal advice on this situation. Treating people the way I was treated must only add to the problems BCBS has with their members. Issues that could be resolved with a fair and balanced discussion end up escalated. This costs all BCBS members because rework and lawsuits drive up premiums. Bottom line - the BCBS of Michigan customer experience is horrible. I feel sorry for customers that do not have the means to defend against such abuse.

This supervisor was rude and abrupt to me - made even worse, considering that I had cooperated to help them identify the mistake, cooperated to be on conference calls with no notice and worked with them to rectify this situation and provide my SS# even though I am not their customer. I was insulted and degraded by the BCBS representative. They require regulation and oversight for a reason.

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Widowed, Screwed, and Scammed!
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

TN -- My husband went to the hospital (on a Wed.) to get 2 bags of blood because he was malnourished and his levels were EXTREMELY low. He was eventually admitted b/c 2 bags turned into 8 with no improvement. BCBSTN (Marketplace insurance) denied his first claim for admittance saying it was unnecessary. Friday morning around 1:30 a.m. he was transferred to a bigger, better, trauma-level hospital to be evaluated b/c they didn't know what was wrong. After testing/x-raying/scanning all day, it was determined around 5 p.m that he had a bowel obstruction which needed immediate surgery but there were two other cases that went before him.

He didn't get into surgery until Saturday morning. His bowel obstruction turned into a perforation and all but 100 cm of intestine had to be removed to get necrotic tissue out. He was left open and kept in a medically induced coma until surgeons could decide how best to put it back together. Two weeks of a coma (even after medication for sleep was discontinued) and four surgeries later, his kidneys had shut down requiring dialysis (which I had to fight for) and all of intestine eventually necrotized and he was left with no way to connect his pancreas to his colon requiring him to be fed intravenously for the remainder of his life.

I found out he coded and was basically was being kept alive by medications and a ventilator. I allowed him to go peacefully after discontinuing all medications that were keeping his heart beating -- truthfully he had been dead for 12 days but his body was going through the motions.

After he died in August I called the insurance company to report his death and have him removed from my policy. I was told just to let it ride until the end of the year and he would drop off automatically. After losing his income I was no longer eligible for a tax premium credit (which was my concern in the first phone call to BCBS) and my premium jumped $110/month.

In November we were informed that my employer would offer affordable insurance the following year so I called to cancel my policy for January and the rest of the year. I was advised NOT to pay the premium and it would cancel on its own (2nd bad advice) at the end of December. My employer's insurance (also BCBS) was over $100 less/month so I switched as of Jan. 1, 2015 (so I thought). Fast forward one year (I switched to a Cigna policy) and I file my income tax in Feb. 2016.

At the end of Feb. I get a letter from the IRS stating that the HealthCare Marketplace/BCBSTN had "informed them" that I had been given a tax premium credit for the month of January 2015 that I "Failed to file" on my return so they were reviewing it and would hold it until after I filled out an amended return to pay back the $316 that had been paid "on my behalf" which included my husband who had been dead for FOUR months!!!

After placing blame on each other (HC Marketplace vs. BCBS/TN), at least 3 one hour plus phone calls, and giving me the run around for two months, I get a call yesterday from BCBS big-wig saying basically this: because my pharmacy had incorrectly billed two prescriptions the wrong BCBS policy and they paid a whopping $23.29 my policy would/could not be retro-terminated for Dec. 31, 2014. IF they changed the date of my termination from Jan '15 to Dec '14 they would be "forced" to (a veiled threat) also retro-terminate my dead husband as of Aug '14.

The reason this upset me is that without husband's income I lost the tax premium credit and would OWE BCBS $150/month for the higher premium I SHOULD have paid in 2014. OR I could keep quiet and leave things the way they were and owe the IRS for the unreported tax credit in 2015. Blackmail so either way I get screwed because of THEIR mistake. I will NEVER AGAIN have BCBS insurance even if it means paying a penalty for no insurance!!!

In the midst of all this, I also fax proof of my employer insurance date of enrollment and explained the situation and the IRS approved my refund and sent it to me. NOW I have to figure out what to do with an amended return and pay more money and probably a huge penalty to the IRS. BCBS not only kicked me while I was down but they ruined me for life. The year I lost my husband I had to PAY IN thousands of dollars to the IRS for taxes on his 401K. Now this -- the IRS will audit me every year for life.

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Blue Cross Blue Shield Of Georgia Involving Labor Law Discrimination In New York State
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

I am survivor OF a severe labor Law discrimination retaliation (LLDR) & personal permanent injuries to me resulted from the retaliation. My husband and I were going to law enforcement reporting the LLDR deadly death threats, property damage, ethnic acts of hate resulted from my New York State Workers Compensation claims (NYS WC) ref. ** The retaliation from my NYS WC claims & complaints rolled over on to my husband & breach of his employee elected benefits that were contracts for medical that covered him and myself. I received Social Security Disability (SSD) after **, I had Medicare Part-A & Part-B.

Blue Cross Blue Shield of The State of Georgia (BCBS of GA) were the Administrators of my husband's employee elected contracts for "the medical" for him and myself. Empire BCBS Butternut Dr. Syracuse, NY were the Medicare Secondary Payer Recovery Contractor (MSPRC) involved for recovery billing/HIPPA with Excellus Blue Cross Blue Shield, (former address) South Salina St. Syracuse, NY now located @ Butternut Dr. Syracuse, NY. They denied me medical treatment.

A former friend of mine **, RN, was employed with Excellus BCBS, South Salina St, Syracuse, NY said she worked & reported to Excellus BCBS Director, who is a physician in the Syracuse, NY area who was involved. BCBS of GA stated Empire BCBS/Excellus BCBS were responsible for the PPO in-network physicians in the contract & denied me physicians who were “IN-NETWORK.” I could not find a PRIMARY CARE PHYSICIAN (PCP) from 9/2005 until 3/2010.

My husband employer "General Electric Polymershapes" continued deducting premiums from his paychecks @ work for him & myself after the contract was breached (he wrote to General Electric CEO, Fairfield. CT & contacted CT Insurance Department). He never recovered the loss.

BCBS of GA stated it was Empire BCBS/Excellus BCBS that denied me the in-network physicians stating they were not in the PPO network, when in fact, they were in the PPO network. (Question of Empire/Excellus BCBS Director, who was the physician that **, RN reported to @ Excellus BCBS involving the HIPPA Law violations, Ref. US Postal Service Office of Inspector General file 01IH029I011.)

Empire/Excellus BCBS cancelled Dr. **, GYN the only physician I had in the PPO network that **, RN has set me up with. I went to Dr. **, GYN for my yearly healthy woman's exams. BCBS of Ga, Warm Springs Rd. Columbus, GA guaranteed us in a letter issues with (Empire BCBS) "Excellus BCBS" would NOT affect us. BCBS of GA then CANCELLED DR. ** GYN (after we received the letter from them).

I had gone from September 2005 to March 2010 without a PCP & no preventative care. I had to go to Emergency Rooms/Urgent Care Facility when I got sick and never had follow up care. Medicare WOULD NOT AUTHORIZE.
preventative care for me because my husband was an active working employee with employee elected medical benefit contracts for him and me.

Finally, a Health Advocate Group in the State of Pennsylvania got involved and authorized a PCP for me (the PCP could not get involved with my NYS WC claims). I was approved on 3/2010 with the PCP & requested a gyn exam from him also due to having my GYN cancelled. By then, I had stage 3 ovarian cancer involved in major surgery & 6 month of chemotherapy treatments.

When I was in the hospital after the surgery for ovarian cancer, BCBS of GA cancelled our health insurance & a certificate of cancellation was issued for me. We have filed tons of letters with BCBS Warm Springs Rd Columbus, GA Corporate Attorneys & also with supervisors and tape recordings etc, etc. so their Legal Corporate Team are well briefed on the situation & what was going on.

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Denial
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

CANTON, MICHIGAN -- My husband was denied a CT scan, then denied an MRI. Has been having serious abdominal issues for over a month. Doctor's order tests and insurance DENIES them every single time. I know. Let's wait until it gets so bad that he needs surgery, probably will DENY that too. Had HAP before he retired and that insurance was the best. BC/BS is the WORST insurance we have ever had🤬🤬🤬.

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Insurance Doesn't Help
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

ARIZONA -- This insurance really doesn't help. I wish I would have never signed up through my work. I pay three hundred a month with $1,000 deductible and I'm getting no help for chronic insomnia which is ruining my body, my mind, and my social life.

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Impossible to Cancel Dependent and Absurdly BCBS Wants Me to Keep Paying
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

RALEIGH, NORTH CAROLINA -- My wife got a new job at the university and the employer will pay for health insurance, which by the way is also BCBS. I called BCBS on Monday asking how I can terminate her policy (she is in my policy as dependent). The attendant told me fill a termination form, put my wife's name, and send back to them. I did.

Today (Wednesday) I was checking for bills and found out that myself and my child will be terminated from the policy as well. I called BCBS and the attendant told me I cannot terminate just one dependent. It is either everyone or no one. I explained that my wife is going to get a new BCBS policy through her employer but the attendant just repeated the same. I ask her if I could make a new policy for my child and myself after the current one is terminated but the attendant told I have to wait for the next enrollment time, which is in July 1st. I asked to talk to her supervisor who told me the same story.

After I complained that this makes no sense, that BSBC is pushing me to keep her in my plan, and BSBC will be absurdly receiving two payments to cover the same person, the attendant told me to ask her employer to postpone her coverage until July 1st and I keep paying for her. I asked them to suspend the termination form and the supervisor told me she is not sure whether they can do that either. She is going to call me back whenever to give their decision. What kind of unreasonable people work for BCBS? What silly rule is that? It makes no sense. They would keep the same number of subscribers as none of us is leaving BSBC anyway.

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Upfront Denial and Delays in Claims Handling
StarEmpty StarEmpty StarEmpty StarEmpty StarBy -
Rating: 1/51

ATLANTA, GEORGIA -- On December 19th of 2012, I went in for a preventative doctor's appointment. Today, March 22nd, two of those bills are still unpaid and the providers are telling me that they will send these to collections if payment is not made in the near future.

BCBS initially denied my claim because of "other coverage." When I called to address this issue, I was told that their system had not been updated and I had to have the Customer Service Rep contact my prior carrier to verify that there was no overlap in coverage. Now mind you, I have had the BCBS policy since Jan 01, 2012 and a claim had already been paid without this issue arising nor is it customary for individuals to carry more than one health coverage.

Why they would assume that their coverage which I pay them for would not be primary is beyond me. They didn't have any prior carrier info on me, just that someone might be out there. Regardless, I did as I was supposed to do, promptly addressed the issue and my claims were marked to be paid on January 09. Between that period and today, I have made quite a few calls and was told basically to be patient, their claims office is taking up to 30 days to process things. It's been close to 90 at this point.

The CSR that I spoke with could not connect me with anyone in claims nor did she appear to know how to even reach claims. I don't doubt this, none of the prior reps ever offered it as an option. I have spent 15 years in auto and injury claims with two major carriers, 5 of that in management. If a CSR could not address the issue, they got the call to me and I addressed it.

I ended today's call requesting a callback and payment of these claims by end of day March 30th. If I get no response, I will simply pay these bills out of pocket and file a Department of Insurance Complaint. With my experience in claims, I understand that volume increases or staffing issues can throw a kink into even the best run organization but that is not the customer's problem and I have been more than patient. Unfortunately, based on their past performance, I don't look for this to be resolved without that formal complaint. For the record, this is my first ever negative review regarding any company, I am just that ticked over this.

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Blue Cross / Blue Shield Health Insurance Rating:
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1.1 out of 5, based on 32 ratings and
72 reviews & complaints.
Contact Information:
Blue Cross / Blue Shield
225 N. Michigan Avenue
Chicago, IL 60601
312-297-6149 (ph)
312-297-6609 (fax)
www.bluecross.com
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