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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.
After numerous contacts with Anthem, by phone, email, filing grievances, they have not fixed this. Anthem is ripping off Seniors on their Medicare Advantage Plan benefits, by charging more than double the copay for Urgent Care. Ever since this company appointed Gail K Boudreaux CEO in 2017 their member services has gotten worse with each year. Their member services reps don't know what they are doing. They don't have enough of them, you can hang on the phone for hours. Their website is antiquated, you can't conduct all your business on it, and are forced to call member services, hang on the phone forever, and get reps that don't know anything, and solve nothing.
Anthem is ripping off Seniors! This used to be a good health insurance provider. Since 2017 Anthem has gotten so bad. If they do not fix this issue with their urgent care copay which all documents state is $30.00, not $80.00. We will no longer have Anthem as our Medicare Advantage Plan. Anthem is a Senior Citizen Ripoff insurance provider.
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.
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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.
Now the fifth person is saying it's covered but there's a copay. I didn't say anything about a copay and neither did the pharmacies, the pharmacies were straight to the point that my insurance will not cover the tests and I need to pay out of pocket. The Biden-Harris administration issued an order in January 2022 that all insurance companies must cover covid testing. It's been half the day, I'm sicker than can be and I still can't get a test or any answers from anyone at Anthem. Worst coverage, worst service.
"SCAM" --- Anthem Health Insurance is a Bait and Switch SCAM... TV commercials are Hollywood designed to be attractive rather than helpful to those looking for a Quality Healthcare... If you Value your Health…Stay away, FAR WAY, from “Anthem” Health Insurance…BEWARE of the SCAMS..!!
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.
When I myself experienced issues I got involved with looking into things and of course by my own account did I do this. And anthem really went to bat and helped me greatly. You couldn't ask for a nicer more helpful team of people and group of very intelligent people I might add. Thank you anthem and all who are on your team, I owe a sincere debt of gratitude to you. Sincerely yours Rob..
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....
Anthem author 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.
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