Anthem

My husband has been with Anthem MediBlue Plus (HMO) since 10/2017. I have been with them since 2/2021. This is a Medicare Advantage Plan that we both signed up for on the Medicare.gov website. The EOC, SOB, and benefit plan information on Medicare.gov all state Urgent Care is a $30.00 copay. On 5/2/22 my husband, and I, went to an in network urgent care provider, 17 miles from our home for his plugged ears. He was told it looked like he had a slight infection, possible fluid buildup in his ears. Was prescribed 2 medications to clear it up. Anthem sent us the EOB around 7/1/22. They paid nothing toward this urgent care visit. They are saying our share is $80.80, more than double what is stated in the EOC, SOB, and benefit info for this plan on Medicare.gov. This was a walk in urgent care clinic, not a hospital emergency room. The location was 17 miles from our home.

With open enrollment right around the corner, my recommendation is to stay away from Anthem. They sell you a contract and then look for little loopholes to deny your claims. I have been fighting with them over a 35.00 claim for months. I have sent at least 2 appeals and they keep changing their stand on every appeal. Thankfully, I am very versed in reading a contract. Their EOB contract has them dead to rights, but they continue to deny the claim. Medicare doesn't seem to care what they do. The State of Ohio has filed a complaint against them, but they continue to deny the claim. In my opinion, they are a scam artist organization that needs to be dealt with by the government.

I went to 3 different pharmacies that told me my insurance won't cover antigen covid tests. Most insured people in the US can received up to 8 antigen tests per month. I have been on the phone with Anthem for over an hour trying to figured it out, they keep giving me the runaround, have made me speak to 5 different people. So far, no one has answers. One person told me the pharmacy I went to should cover it, I ask her to call that pharmacy and she told me she can't get through. All lies.

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I spent hours on the phone without getting anyone to address enrollment issues. I can understand why our dentist dropped this plan. It is horrible, and I cannot imagine what providers have to go through to get claims paid.

I have called in many times to get help with my claims. I have been given the run-around many times. I have insurance every 2 weeks and I shouldn't be denied or delayed treatments. I have been waiting for weeks for someone to call me back. That never happened. When you can you got to explain yourself over and over. Should there not be notes for every call. I live with knee pain daily. It is excruciating and all I want is some relief.

I have intestinal surgery three weeks ago where over 1/3 of intestines were removed. My pain doctor increased medication temporarily for a limited time and this insurance company denied his prescription because of the increase.

I have nothing but good things to say about Anthem, and the staff is truly there for their patients. There are some who may not be pleased with them, but I would like to ask you this question.? Have you really looked into where a hang-up up might have occurred, because I had similar issues that maybe you might have experienced, and I can say This much in all honesty truly try to research where a hang-up might be occurring, it could be The referral from your provider's medical group, it might be a lot of things that are simple miscommunication or honest error in the chain of things.

The list of providers on Anthem’s website is YEARS out of date. The list provided by Psychology Today was more accurate and had more options for providers that accept Anthem. The representative at Anthem said that they have to rely on providers to keep the list up to date, which is ridiculous. It is appalling that the insurance company cannot provide an accurate list of its own providers.

I went to Anthem's website to change my primary care physician as I had moved. I selected a doctor and found that not only had he relocated to another state, the phone number listed didn't even belong to a doctor's office. The second doctor I added as my PCP, no longer worked at the office listed on Anthem's website. I did a live chat on Anthem's website for help on this issue. Someone named Kyle emailed me a list that had the same names as before. What a waste of time....