Blue Cross / Blue Shield Health Insurance Consumer Reviews - Page 2

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.

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.

Here is a copy of the complaint my wife registered with the State Insurance Commissioner. It is accurate and happened just yesterday. I have been paying for family insurance from Blue Cross Blue Shield through my employer (Catholic Health Initiatives) for around two years. On three occasions, I have tried to pick up prescriptions for either of my two sons, only to have to call BCBS and fight with them to acknowledge the children on our plan. Today, ** (my 3-year old) was diagnosed with Bronchitis and an ear infection.

When I went to pick up his prescriptions, once again, I was denied. Upon calling BCBS, they told me the problem was with Medco (apparently, that's who they farm prescription coverage out to). I called Medco, they told me they have NOTHING under my name, Social Security number, date of birth, children's names, NOTHING. They told me they get their information from BCBS and that the problem lies with them. I called BCBS again. They told me that they have nothing to do with Medco, it's their problem, and that I must call them again. I REPEATEDLY asked to speak to a supervisor and was denied.

I called Medco AGAIN. I realized that I've been paying for coverage that I have NOT been getting, so I asked to be reimbursed and that the problem be taken care of immediately as my son does not have the medicine he needs because I can't afford it, because I've been paying over 300 dollars a month for fake insurance. At this point, the representative began playing dumb and said that BCBS is responsible as they get their information from them.

I AGAIN called BCBS, they said that they've been sending updates every Friday to Medco as recently as December 2009 and that they would have to play fax tag with their membership department to get my son covered and it could take 72 hours. I understand that these things can take some time, but I've been paying for coverage that doesn't exist and asked to be reimbursed. They also began playing dumb, eventually denying any involvement with Medco, and saying that they were a completely different entity.

It's now 6 PM, I've been back and forth between BCBS and Medco several times since. Medco is now saying that the last update they received from BCBS concerning me was March 9, 2009. Again, I called BCBS. A BCBS supervisor named ** has been lying to me, providing me with fake numbers to call, and being completely rude to me since I finally was transferred to her. She is now blaming my employer.

I would like to be reimbursed for all premiums since March 9, 2009. I also would like to ENSURE that this will not happen again. My 3 year old is sick on the couch and I cannot tend to him as I've been on the phone for 3 hours and counting. He does not have the medicine he NEEDS. They have been lying to me, stealing from me, and they should receive some sort punishment along with paying me back.

They were actually giving her numbers to call that were not even numbers to Blue Cross Blue Shield. She repeated one back TWICE to the "supervisor" (who was actually just another CSR that she'd reached in an earlier call) which was some random guy's home phone number. I'm shouting this from the rooftops until they resolve the problem.

DETROIT, MICHIGAN -- My husband signed up for BCBSM insurance in March 2009. We enrolled in Auto-Pay so we would have one less bill to worry about keeping track of each month (we used an account that we only keep money for bills in, so there is rarely more than $10-$20 more than our bills in this account). Since then, BCBSM has decided to take money whenever they feel like it, however much they feel like taking and if it causes you to either overdraft or if you don't have as much as they want, they won't pay the NSF fees.

This started in July. Our usual date is the 9th of the month for them to take their $81.38 premium out. This month they took it on the 9th, then again on the 30th. My mother had passed away on the 14th so we were helping my dad out with funeral costs and didn't have the extra money to spare (not to mention they tried to take $162.76 out, which is 2 months of premiums). It caused an NSF, which our bank charged us $25 for.

When I called to ask why this charge was made, I was told it was an error and the money would be refunded, pending me faxing a copy of the NSF detail from the bank. No problem, I faxed it over. In the meantime, they tried to take it out AGAIN on the 3rd of August, which caused another payment to bounce, which we had enough to cover prior to them trying to take their money (2 more NSF fees). I called again, was told the same thing and that I should expect to be reimbursed for all 3 NSF fees.

August and September's payments came out on the correct date, but still no word regarding our reimbursement from July/August. Come October they tried to take $245.14 out on the 7th (not our due date, not the correct amount). I called and asked what was going on. I was told the other case is still "pending" and that they had recently increased their premiums, thus the new amount. I get a copy of our bill each month, it showed that the new premium was $82.40. There is no way it was this amount (no matter how many ways you figure it).

The attempted withdrawal cost us another $25, plus they tried to do it again on the 8th and the 9th, costing us $50 more for them and $50 for other payments being NSF. The woman denied any wrongdoing on their part and said my husband needed to call, since he is the account holder. My husband calls, they tell him it will be taken care of. My husband also advised them to un-enroll us in auto-pay as they can't seem to keep their record straight. He is told it will be done, not to worry and our open cases that are "pending" will be resolved shortly and we should expect a refund any day.

November 2, BCBSM cashed our check for our premium. November 4, they take $180.16 out of our account. That money was there to pay 3 other bills, which consequently bounced over the next 2 days, costing us $75 more. I called BCBSM and was told that they didn't take that money, they needed to talk to my husband and wouldn't discuss it with me, except to tell me "their accounting department decided that we wouldn't be reimbursed for July, August and October" (which the total for those month's NSF fees are $200).

My husband calls them on his lunch break to cancel, to figure out what they are thinking denying any wrongdoing and why they tried to take money AFTER they cashed our premium check and AFTER he had un-enrolled the month before in auto-pay. He is told he has to write a letter to appeal the decision to deny those cases and that he has to fax a letter canceling his coverage. They said they didn't have a record of him canceling auto-pay and that the money they took was to cover "past premiums that were unpaid".

He told them that they took them out automatically, the bill showed what we owed (which had already been paid by check) and that they needed to unenroll him NOW. He faxed the letter to cancel coverage and also included them to cancel auto-pay (just in case). We thought it was taken care of, until yesterday, they tried to take another month's premium out of the account. I called to ask why, was on hold for an hour. Hung up, called again.

After being on hold for 20 minutes, was told to have husband call. He used his entire lunch hour waiting on hold. Called back last night and was told they would review it and call back. They never called. So, today, he used his lunch hour again to be told that they would review the case and have a supervisor call back. I advise anyone who is looking at BCBSM for insurance to run the other way. It has cost us $480.16 extra in NSF charges and unauthorized withdrawals to have him insured, with no refunds on the money in sight.

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.

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.

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🤬🤬🤬.

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.

DECATUR, GEORGIA -- I was approved for IUD (merina) at the doctor's office, which I go ahead getting done. 2 months later, received a bill of $1300 that am supposed to pay, BCBS didn't pay a penny. Am still figuring out what to do, if I call them they say "Give us a week, we'll call you back." The procedure I did is preventive which should be cover by BCBS.

SANTA FE, NEW MEXICO -- When Blue Cross Blue Shield bought out Lovelace, we were promised that the coverage would not change for 2014. Lovelace in 2013 paid for the entire yearly physical. In spite of promises, Blue Cross Blue Shield refused to pay, and I had to pay $160. Sign up with Humana Medicare advantage... Much better coverage!