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We purchased this insurance via the Marketplace based on the providers that “appeared” to be in their network. Once we enrolled, we discovered that none of the providers that they had listed in their network were actually in their network. This includes hospital facilities. We have yet to find any providers in our area that are in their network. It doesn’t appear that there really is a network. They also sent a notice to us that they are now requiring a referral for a specialist. It doesn’t really matter if they change that rule. That is actually illegal to do, because there aren’t any providers anyway. We are now stuck with this joke of insurance until next enrollment. Buying beware!
I renewed my health insurance plan with Anthem for 2019. Never had problems over years of being a member in the past. However, this year is different. I had canceled my credit card that was on auto-pay file with them due to other fraud charges. I forgot to update the auto-pay card on file with my new credit card. I then receive mail saying my plan with them has been canceled due to the card not working.
When I called them to update the card on file and make my previous month and current month payment, they said they have to send a letter in mail stating whether they are accepting to re-instate my plan or not. I never received the mail. I called back three weeks later and speak with a supervisor who tells me their policy is to not let me re-instate. I explained the situation and told them I've been trying to give them my updated card number on the phone for weeks but they would not allow me to update my card so I can continue my plan. They made zero effort to let me update my card on file.
I spent hours on the phone with multiple customer service and member representatives, none of which would let me simply update my card on file for auto-pay and said all they can do is make an appeal which can take another month to hear an answer from. It appears that Anthem Blue Cross Blue Shield no longer offers any real action or customer service. It is not difficult to let a member update their credit card and maintain their health insurance for the year. They are proving to be very unprofessional and showing zero care to help a member of multiple years.
The Rep: Barbara was horrible. Had a terribly rude attitude. You could hear the unhappiness with her job in her voice. She was annoyed by having to give me the eligibility over the phone. Also gave too much eligibility info. other than what I was asking. Made the conversation extremely confusing. Feels as though she was trying to make the call complicated to please herself. Then was upset when having to repeat herself and accomplished her goal of trying to confuse me over the phone. Please let her know she accomplished that much. Overall horrible experience!
Anthem hasn’t been working on any of the items I mentioned to you back in September. Instead they are just taking back more money. We needed a Level 4 reimbursement for ** because her medication was above the contracted rate for Level 3. We asked for Level 4 but instead Anthem decided they want to reduce our score to a Level 3 without giving any reason or even reviewing any medical records and ignoring my 3 requests with the UM department, the recovery department, and with your department.
So now our reimbursement is $6,000.00 for 15 days of skilled care after we spent $2,048.86 on medications, spent $3,3340.87 on therapy and spent $129.68 on Labs totaling $5,519.41 and that doesn’t even pay us for the basic room and board meaning this patient stayed in our facility basically for FREE costing us the provider money. This continues to happen with your Anthem members and it is unethical that we can’t get the reimbursement we deserve with our contract and that your Recovery department is ignoring all our requests to dispute them. We no longer want to take any of your members because it costs us too much money to take care of them. This is absolutely ridiculous and a terrible way to treat seniors and their healthcare. I am disgusted.
I’ve had no problems when my Anthem Medicare Advantage plan itself. My problem is the difficulty in getting info from the customer service department. The people I talk to are almost always very nice and seem like they’re trying to help. Unfortunately, they apparently know less about my plan than I do. All they do is read to me the same things I’ve already read. And what I’ve asked is pretty basic. When I asked whether an authorization was required for a specific service, I was told yes, no, and maybe. So far I’ve made 6 calls to find out what the coverage is for glasses following cataract surgery and no one knows other than that there is some coverage.
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I need a two epidural steroid injections. To make a long story short, I have an L-3 herniated disc. The doctor I went to, who I would have bypassed had I known that he DID not do epidurals, referred me to another doctor. Spine clinic, in Dublin, Ohio. I go to the doctor on Monday, he says come back on Thursday for the shots to relieve the back pain. I was informed when I arrived that I had to wait for Anthem medicare approval. My back is screaming and so is my quad. I told
the help to put the bill on my credit card and withdraw the claim. They flat out refused. I tried three times on the phone. So, I do not have control over my medical treatment.
Anthem obviously strings out the claims to cut the cash outflow - even when it is clear cut. Get ready to wait 2 weeks for your claim to be approved or denied - unless it is a life threatening emergency. Anthem Medicare insurance is horrendous. That is why there is a two tier health care system - pay cash, like I begged the provider to take, or languish at the mercy of the reviewers at Anthem, who have an automatic 2 week stall.
This is the worst insurance in the world. They never ever take this insurance. They find reasons not to cover. Their customer service is the worst. God save you if you go with Anthem. I was hit a bill of $9000 when the provider is in network and they kept rubbishing my appeal. Beware of this scam company. I am filing a consumer reports rt with the state to ban them in the state.
I have been fighting with Anthem since August 2018! In 2012 I had to have my 6th rib removed due to a mass. The doctor had to place a Gore-Tex mesh and anchor it to the 5th and 7th rib. After the removal I had so much back pain and then after a while neck pain, HA and shoulder pain. I was also diagnosed with TOS this year. I have spent a lot of days with physical therapist, massage and acupuncture and pain meds. I have had 4 of my doctors. Ortho Doctor, cardiovascular surgeon, the Breast surgeon and primary care doctor all write letters to the doctor denying the surgery!
The breast surgeon also did a peer to peer with him to plead my case. The reduction will help with the back neck and shoulder pain by taking the weight off! This procedure will cost $10,000 out of pocket, and I don’t have that kind of money lying around. I would like a better quality of life than what I have now! These people have way too much power over your life and something has to give! I’m a large breasted woman that would like to give this male doctor a bra with weights in and have him wear it for a year and see how he feel!
I am a Type 1 diabetic that has been using Omnipod pumps for well over a year. Omnipod sent my pump request for approval well over 2 weeks ago and Anthem keeps telling me they can take up to 15 days to review and approve. Tell me what's to review if I've been using it for a length of time. Omnipod has been great. If I had a choice I would not be using Anthem. I will be sending the insurance commissioner a certified letter about this.
With no notice, Anthem stopped processing claims for the chiropractor that I have been seeing for 17 years - with all claims for 17 years processed and paid by Anthem. They have said that they have not received the required documentation from the chiropractor, however I know they have sent detailed information for each visit for myself and my 2 children via certified mail to the claims department. I have been in communication with Anthem through their claims department for more than 4 months now and the only explanation they have given is "they have not received the required documentation". This is untrue.
Chiropractic care is covered under my plan, and has been for 17 years. Now I am stuck with paying out of pocket for 2 months of visits because Anthem refuses to process the claims I am entitled to. I received NO notice from Anthem that they would stop paying the claims and have continued to receive NO information from them as to what exactly they are not receiving from the doctor. I viewed the documents sent to Anthem and they are full and detailed. I need a lawyer.
I have an HSA that contains over $8,000 of my money, not employer contributions, my money. I left my employer and when I tried to use the funds, I was told I can't - it has to be transferred to a personal account. I have called 4 times and I still can't use the funds that I put away for medical expenses. I have had over $400 in out of pocket expenses that I've had to pay while I wait for Anthem to take the time to "process" my funds, so that I can use them. Absolutely unacceptable. I have been on hold for over 10 minutes on what is my fifth call following up on this. DO NOT USE THE ANTHEM HSA if you want to actually access the funds you have earmarked for medical expenses.
I have used Anthem Health Insurance for 18 years. Always make my payments. In 2016 I was forced into the marketplace due to high cost. For 2 yrs 2016 and 2017, no problems. In 2018 I paid January premium online. In February 2018 at a doctor visit I am told I have no Insurance. But wait, I have a card in my hand that says I do. Hmmm So I call Anthem, Pay double for January and February. Seems they lost my payment for January. I found out in 2017 they misapplied my payment. All went to dental. I spent countless hours on the phone to be told they can’t figure it out. I just owe. So I provided information showing 2017 paid in full. So I had insurance for 2018. Now in 2019 I had signed up before Dec 15, 2018 and was enrolled. Anthem did not bill me for January 2019. I called and they say they can’t accept my payment. They say I owe for 2018 still. Here we go again.
I provide all documents showing 2018 was paid in full. All through the process no one at Anthem is calling me to give me updates. I call and I'm told the mistake is in 2017. So I round up paperwork once again for 2017 proving I paid in full for the year. For the month Of January 2019 none of our insurance cards have been accepted for doctors or Prescriptions. When I call Anthem says I have Insurance, But the doctors and pharmacist say different. Account resolution specialist, PFFFT, can’t figure it out. What a joke. I'm a High school Flunky and I figured it out. Not sure how to handle this. Lawyer maybe that I can’t afford. Unfortunately Anthem is the only Health care provider on the exchange in my area. Thanks Obama.
For two years in a row, timely responses to info requested by the audit of dependent coverage was NOT handled properly by the agency. This is a second year in a row that responded with ALL requested info and still got a notice that my dependent's claims were no longer being processed because I did not respond. I kept details on photocopies sent the first year and time/date of phone calls the second year. The only way to properly resolve the audits were to call the number on the back of the card and update dependent info that way. But that is NOT what the audit instructions say.
Since the information I mailed to the designated address on the audit form last year (which I mailed TWICE) was not processed, I decided to call this year. I called the number in bold letters in the audit letter as instructed. The agent who answered the phone (Cody) seemed completely unsure about how to handle the information. There appeared to be one other person there who was on break. Cody took the information and said I would get a call back if they needed anything more. I did not get a call, but once again, I got a letter from Anthem later that my dependent claims would no longer be processed because I had not responded to the audit - which I had. This letter suggested I call the number on the back of my card. This seems to be the only number capable of handling updated dependent coverage. So why the audit letters instruct you to do otherwise is completely baffling. If I do, apparently, nothing gets done and my dependents' claims get denied.
In previous years, I would get a simple form. I would note dependent coverage on and mail back and all worked well. The new audit process clearly DOES NOT WORK if you follow the instructions in audit letter to either mail (as I did in 2017 -- twice) or by phone (as I did this year). Last year was a nightmare, as it took months to get dependent medical claims reprocessed and payments issued to providers. I'm expecting similar problems this year. A total an unnecessary headache simply because the audit instructions are not accurate and do not get handled properly. Anthem needs to straighten this out!!
I just turned 40 and with that for women comes all sorts of lovely things that need to be done including a Mammogram. Anthem will pay for the Mammogram, but they are in a dispute with the Radiology of Indiana and WON'T cover the radiologist fee. When you don't have much money and you need a Mammogram done and you have to pay for something that should be covered it makes you really regret having Anthem as an insurance provider. Do they not realize that this is something that needs to be done!
Breast Cancer runs in my family and I need to have this done (not that I want one), but it needs to be done. Can you guys (Anthem) please pull your heads out of you know where and start covering stuff, come to an agreement, because you're messing with the health of your customers. I mean, after 17 years of covering everything you all up and decide you don't want to pay for it now?!? I hope you don't start losing a lot of companies after this year.
They keep denying claims for services that are In Network, in my local area and listed as covered providers. When I contact them via their message service to review the claims, they say out of area (it's 10 miles from my home, and in the same state and a listed covered provider). These are simple blood tests for annual physical. Unfortunately the provider has "Massachusetts" in their name, guessing this is the issue. So many other issues that I have to repeatedly follow-up on with them. Most get resolved eventually, but just so frustrated. Today I went to reorder my 1 and only medication, and the new cost is $154 for a 90 day supply, was $30 a month ago...on and on it goes. Crappy health insurance, crappy government oversight.
As a new employee, I called the call center to sign up for a medical plan. Keep in mind all phone calls are recorded for training purposes and I clearly stated I wanted to be signed up for a Plan B as in BOY which included a $1,000 deductible. I was mistakenly placed on a Plan D (I can understand the mix-up, they sound alike) which has a $3,000 deductible. As I started going to my OB, Maternal doctor, labs and other such places required for a newly pregnant woman I quickly realized there was an error. I called Anthem BCBS attempting to get the correct plan switched over and it took more than 3 months. The new card they mailed me had the same member ID # and group # but they assured me when a doctors office ran it they would be able to tell on their end of the deductible changes.
This was a lie. I had paid my $1,000 deductible and am getting billed for $3,695.84 from offices and labs and Anthem BCBS says my plan never changed until 1/1/2019 and they will not be back paying for any of the medical expenses accrued for 2018. Well I've filed a complaint with the insurance commission of the state Anthem is based out of, and am considering hiring an attorney, but Anthem is still collecting money from me every pay period so really I am still getting screwed over and my kid is due in 3 more months. Hands are tied, and my credit score is about to get ripped a new one thanks to the medical bills stacking against me.
I newly moved from NY to CT and I needed a new health insurance policy. I followed the guidance and submitted my enrollment application on the first day of enrollment period, 11/1. I filled out eh auto payment forms and got confirmation mails about successfully of first payment. Everything seems in place. On 1/4, I received a mail dated 12/27 saying that they were able to deduct fund from my bank. But somehow the bank requested to get the fund back. Since I am unable to fund my premium, they wanted me to contact them immediately. Upon receiving the mail, I contacted them immediately, and realized that they cancelled my plan on 1/2 and were unable to reactivate my policy.
If they send out a mail dated 12/27, during the continuous year end holidays, there is no chance I can respond to them on time. Now I need to rush through the hassle to get another health insurance, and I lose one month of insurance (hopefully I will get injured by anything), and I will get fined when I report tax. I did nothing wrong in this case and I am suffering from all the consequences. I will definitely stay away from them.
Absolutely horrible insurance!!! We pay $1,475 per month for a family of 4 for the crappiest plan. Very high deductible so we consider it emergency coverage. Under the NOT affordable care act the middle class is forced to pay for everyone else’s insurance! I don’t mind paying a little extra if it isn’t exponential and if we had good coverage. When you call you get what sounds like someone they pulled off the street and gave headset to. These reps know NOTHING! Husband needs knee replacement, called and after about four incompetent people and several hang ups was told the clinic of our choice was in network. Great! Made non-refundable hotel rooms and scheduled the consult.
Today received call from clinic that Anthem will not cover because of the county we live in. Called and spent an hour with reps who can’t answer any of the most basic questions such as “is this provider in our network?” Today I was told with our crap plan we do not have coverage past 100 miles of our home!!! How I missed this important fact I do not know. I cannot believe we are paying $1,475 for $10,000 deductible and coverage only within 100 mile radius, not to mention we live way up in a Northern California, 100 Miles is nothing. For two years we chose not to be robbed by insurance companies and paid the $3,000 penalty, we will be going back to that, at least the penalty has been done away with. This health care debacle is in need of some major help! If we all opt out there will be no funding and it will fail.
I am a domestic violence victim and I’m trying to get documents from them of my doctor and hospital visits (explanation of benefits) for my court case. They raised their voice at me multiple times, told me they couldn’t help me, and said “it’s not their problem.”
Had ongoing issues. Pay way too much monthly, plus coinsurance and copay costs! Oh not to mention everything my family needs seems to be out of network so majority still paid out of pocket. Called to search new plan options hoping to find a better fit. On hold and transferred to one person and another. After 45min of this, a lady picks up and I explain I want to figure out plan options that may work better for my family and have more providers in the network. Said she’s got people waiting to enroll and she’s gonna place me back on hold! And I explained I’ve also been waiting on hold a realllyyy long time and I’m rightfully next in line so why can’t she go over it with me now? She hung up! Ugh???
$13,875 Individual PPO Premium + $3,000.00 Deduct = 1/2 my yearly take home wages. In Southern California. One Half. And not including copays. And I need insurance. Sixteen. Thousand. Eight. Hundred. Seventy. Five. Dollars. One half my wages. One. Half. I don't live above my means because I can't. Anthem lets me keep $1400 a month to pay for rent, utilities, food, auto insurance, gasoline, wi-fi, taxes and copayments. In Southern California. I've worked since I was 15 years old and always paid my own way. I have two roommates and I don't go to movies, out for dinner or travel. I never thought it would come to this. Using all my earnings to simply exist. I wonder how Joe Swedish used his $18.6 million? And what Gail K. Boudreaux spends her $2.2 million on?
I have spent hours upon hours on phone calls trying to have my claims paid to providers! I have followed ALL of my due diligence prior to seeing any physician and each time I have never had a claim that has not been a problem. I’m receive different responses each and every time I’ve contacted them — to no avail in getting my medical bills paid as expected! I would never choose this coverage and is certainly not worth the $586 per month I’m paying for my PPO Gold? They need to be reported for total incompetence along with American Specialty!
I am a heart transplant patient that takes anti rejection medication to stay alive. Anthem Blue Cross has on multiple occasions has blocked me from getting the medications I need because it's not their preferred pharmacy. As I write this it's a Sunday and the specialty pharmacies are closed and the Walgreens by my house has the medications but Blue Cross will not allow them to get it to me because they do not want to. They are making me go and get admitted to the hospital and waste the room and nurses from people who actually need it just so I can get my medication. If people have a choice for their insurance, I HIGHLY RECOMMEND NOT USING ANTHEM BLUE CROSS!!!
We have been trying to get a case settle for almost a year because someone at Anthem cancelled our insurance a month early and we were paid in full from having a baby and I had surgery still in December. We have been emailing, calling and mailing for 9 months and they still can't get it fixed??? I have been hounded by collections. This is ridiculous! We paid in $25,000 last year for coverage! No one will call us back and get it figured out!
Good luck getting real answers to needs. I recently tried to find out about my plans mail-order pharmacy benefits after reading about them in a Fall 2018 newsletter sent to me. A call to the provided Clinical Pharmacy Call Center initially was blown off by the first phone rep. That's right. Just blown off by placing me on hold and back into the call center queue. The 2nd rep was great but ultimately provided inaccurate details about the benefits and didn't even communicate my concerns properly to her supervisors.
The CEO of the parent company (Anthem) has an inadequate process in place since her office never even saw fit to respond directly to an email and pawned me off to Pharmacy Benefits when in fact the issues were deeper than that and deserved a more nuanced response. All told internally they don't communicate well so don't expect any member of their multitude of plans to receive outstanding communications and in the end it is all about communications.
DO NOT BUY THIS INSURANCE!!! I had Anthem Blue Cross. I went to the ER for a bad case of hives. I paid the $150 copay. THEN I get a bill for over $1,700. Anthem said that is because I have a $2000 deductable for the year. I MUST pay all of the $2000 before insurance will pay even a part of it. ARE YOU KIDDING ME... On top of the $450 we paid every month for premiums, FOR NOTHING!!! I have to pay for insurance I can't even use!!! SEVENTEEN HUNDRED DOLLARS I have to pay for a ** pill and some **... I suggest you all check your policies to be sure before this happens to you too, and you are blindsided by this. They aren't there to help you, just rob you blind.
I have tried for 3 days to get to tech support regarding Anthem's pharmacy tab and the listed medications that are 'ready to refill'. Anthem changed their website earlier in 2018 and since then I have been led to order prescriptions that say 'Ready for refill' and I don't get them and run out. I am not notified that there is a delay. THIS IS DANGEROUS. There is a HUGE disconnect between Anthem and the home delivery service which is Express Scripts. I am finding other ways to order my medications not using Anthem. Anthem's customer service is poorly spoken in English, I can't understand a word these people are saying. Taking Anthem out of the loop... they simply don't care.
At least with the browsers that I use (MS Edge and Firefox), Anthem's website fails to provide the basic service that I need: the Explanations of Benefits. So when they denied my large claim, I could not find out why. It has been 2 weeks since I notified them in writing, about this bug. With something this important, why haven't they fixed it quickly?!
My coverage with Anthem ended on 9/1/18. Since as of this date I was now on Medicare, yet on 9/5/18 Anthem took out another premium payment of $918.00. I called them on 9/7/18 to ask for a refund and they asked me if I had cancelled my coverage (it should have been automatically cancelled). I did call them in July to make sure that August 1 would be my last payment, so in essence I did call to be sure it would be ending in as of 9/1. Anyway, two weeks later I still have not received my refund. I have been told that they are saying no to refunding my money. I guess my next step is going to an attorney. DO NOT USE BCBS... THEY ARE HORRIBLE TO DEAL WITH, AND THEY LIKE TO STEAL MONEY FROM YOU.
I actually think it'd be better to deal with the cost of medical bills out of pocket than pay for insurance with this company. Oh wait, that's what I'm doing anyway despite having paid them thousands of dollars over the past year in case, you know, I have a medical emergency and have to go to the doctor? TL;DR - Had a medical emergency while out of state. Filed a claim with under my PPO plan. Claim was denied due to it being "an out-of-network, non-emergency" despite my having documentation to prove that it should be covered under their Explanation of Benefits.
I've literally had to file an appeal with the State of Colorado Department of Regulatory Agencies to even get them to consider paying. My only real comfort in this situation is knowing that somewhere, some underpaid, disengaged, twenty-something is monitoring these reviews at whatever terrible social media marketing agency BlueCross BlueShield hired to try and bury this sort of press and hopefully picking a different insurance company for their own health benefits.
Anthem expert review by Joseph Burns
Anthem is one of the better-known national insurance companies. It operates under different names, depending on what state a patient is from, but covers patients throughout the United States.
It’s easy to add other types of insurance: Anthem customers can easily add dental, vision and life insurance to their policies.
Offers benefits to people who become incapacitated by illness: Unlike many health insurance providers, Anthem offers disability benefits.
Fairly low-price plans: Consumers can get insurance for less than $100/month, although they also may have to pay high deductibles.
Plan options: Heads of families have fewer health insurance options than other consumers.
Best for: Students, senior citizens
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