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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.”
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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.
Called about a billing discrepancy where I paid the full amount on a bill with proof but they only marked it as partially paid. Waited on the phone for over 30 minutes trying to resolve the problem only to have the woman hang up on me because she couldn't figure out what was going on.
I cannot stress to people enough, DO NOT USE BCBS. I was in a very serious car accident and my back is fractured in two places. I was taking narcotics along with many other medications, and was accused by BCBS for being a drug addict and refused to pay for medicine. I thought the woman was kidding when she told me she could put me in touch with an addiction clinic! I now pretend to be self pay just so I can see doctors that are always conveniently out of network with my plan. Being uninsured is better than being insured with BCBS and that's a sad sad fact!
I have been sending my inquiry for a week now but, I still do not get any response to from them. Aren't they a big company already? Why not have enough customer service to help customers? Also, their website is too slow!
We are a small business who was on the Anthem Small Group Healthkeepers Bronze plan, which had a $6,550 deductible. The deductible had to be met by the employee before any coverages for office visits, prescription drugs, hospitalization or treatments were paid. In March, 2018, due to reduction in workforce and employee turnover, only 2 employees were enrolled in the plan. We decided in our fiscal year budget that due to economic reasons that we would stop offering health insurance. We issued a letter to each employee, along with Anthem Blue Cross and Blue Shield stating that effective April 1, 2018, coverage on the group plan would be terminated.
We received a letter from Anthem Blue Cross and Blue Shield stating that claims were paid throughout the month of April, 2018, therefore, we owed them $784 for coverage for that month. Employees and Anthem were notified in writing that their coverage would be terminated as of April 1, 2018. The two employees covered have said that they did not use their coverage in the month of April, 2018. Both employees stated that they did not even come close to meeting their high deductibles of $6,550. Since the deductibles applied to all coverage, it would have been impossible for Anthem Blue Cross and Blue Shield to have paid any claims.
Today, I was notified that Anthem Blue Cross and Blue Shield has handed the account off to a collection agency. The $784 that Anthem Blue Cross and Blue Shield is requesting from us is for services not rendered. We requested a termination of the policy. We did not pay the policy premium. We notified 2 employees of termination of the policy. The employees did not use the coverage. The request for $784 from Anthem Blue Cross and Blue Shield is not justified. I have mailed Anthem Blue Cross and Blue Shield a written request to submit a report or some type of proof that claims were paid for the month. We requested a termination of the policy, so there should have been no claims, no bills, no amount owed, no services and no collection agency.
Called Anthem from their solicitation for a Medicare supplement plan. I asked not to be recorded and they told me it has to be recorded (Violation of Code of Va. 19.2-69). Then asked for information to be sent out...15 minutes of questions (don't forget they solicited me by mail) about address, etc. they want to continue on phone...asked again for information packet to be sent out...more talking but no packet. Two weeks later I have yet to receive any information by mail, interestingly enough I did get another mail solicitation. BE CAREFUL.
Called Anthem Health Keepers (AHK) customer service regarding issue with discrepancy notice of only 1 allowed visit to a referred chiropractor between notice from AHK insurance and American Specialty Health (ASH); who notified of 30 allowed visits. I was told to call my primary care physician office. I did and found the issue was not on their end as they had noted "unlimited visits" on the referral. Called AHK back. Rep could not answer why Anthem listed only 1 allowed visit despite different information on the referral sent from the doctor's office. The rep told me that I had to speak with a representative from the 3rd party ASH medical mgt dept. I called them and had to spend even more time on the phone getting an answer.
What I found out after 40min: ASH informed Anthem always lists only 1 allowed visit despite the doctor referral indication. Rationale - This for the initial visit. Any additional allowed visits are left to American Specialty Health to determine and approve once they are in communication with the specialist office. My concern is 2-fold: 1) It took me 4 phone calls, conversations with 4 different people in a span of 40min to address a concern that was finally explained in less than 5min. 2) I don't want to be charged full price for additional visits to my referred chiropractor because Anthem listed only "1 visit allowed".
My questions to AHK: Why in the heck couldn't your first customer service rep have really looked and read my Dr office's noted referral to them (indicating unlimited visits; saw the discrepancy and referred me directly to ASH? Why don't you clearly explain the process regarding # of allowed visits in the referral notice? Why did you (AHK) mail a misleading and erroneous notice to me? The written notice informed that my PCP only approved 1 visit. This was NOT TRUE. I have been with you (AHK) for 12+ years through my employer. Several years ago, I was referred to the same chiropractor from my PCP. I never had to go through this.
My hip replacement surgery was denied as not medically necessary and my surgery was canceled, last minute. I have severe arthritis. My doctor appealed, but was denied. I also appealed, and was also denied. I made sure I answered every excuse to the letter, for example, I tried non-surgical treatments for at least three months. They say I didn’t state “for at least three months”, but I did. I was also denied in 2017, but for a different reason. It is inhumane to put someone through the pain, inconvenience and expense of preparing for surgery, and then have it cancelled. I believe discrimination is occurring, but I’m not sure why. My family has had this same insurance policy since 1992, through my husband’s union, Metal Trades Local 638. I believe BCBS has violated their contract.
My mom was complaining about pain in her abdomen since 2015. Every time the pain was excruciating she went to the hospital. The doctors did what they could for her but they needed to see deeper into her abdomen. So they filed for an MRI with Anthem and she was denied. This went on and on until May of 2018. The doctors say MRI and Anthem continues to deny her. When she was finally approved for MRI the doctors found a massive tumor on her pancreas that started to attach to her surrounding organs. The doctor that performed the surgery said that she was lucky. Any longer and her life would have ended. It's been a month since her surgery. Now they are denying her rehabilitation. The doctors and nurses at Toledo Hospital found out what the insurance company did and was furious about the whole ordeal. Anthem is terrible coverage when it comes to the seriousness of someone's life.
I'm writing a negative review on the pages of each of the companies: CVS Caremark, Walgreens, and Anthem for their mishandling of prescription claims. My Anthem insurance plan switched to CVS Caremark for handling prescriptions in January 2018. I went to Walgreens, my usual pharmacy, to refill my prescriptions during my coverage period. On several occasions, the prescriptions I had filled went through without a hitch at Walgreens, with my normal co-pay. Several months later, I received a $500 bill from Anthem saying I owed them for those prescriptions. They stated that since I went to Walgreens and not CVS to get my prescriptions filled, I owed them the full price of the prescriptions. However, there was never a flag at the Walgreens counter telling me I could not fill my prescriptions there. They went through and allowed them to be filled, not ever informing me they were not covered by my insurance.
Normally when a prescription is not covered, the pharmacy will not be able to process it through your insurance and you will have to pay full price. This did not happen - it went through as usual and with my usual co-pay. Anthem, CVS Caremark, and Walgreens are each passing the blame off to each other when I call them to try to get the issue resolved. I'm stuck with a $500 bill because none of them can own up to their error.
Anthem is the worst insurance I have ever had. Just got it a few months ago. They will not pay for prescription medicine I need because it’s not on their list? Even though we were told all medically necessary “preventative” RX’s will be covered with a small copay. Apparently, Depression, Anxiety and ADHD are not medically necessary, and medicine is not considered preventative. I am so upset I want to make a case about someone attempting to harm themselves due to being denied the proper medication for a mental illness that was completely under control with prescription medicine for 25 years.
Terrible. Every month have to fight and be declined for medication necessary for health. This is in a top tier plan. Never renewed Dental, Cancelled Dental, and they have continued to charge me, will not allow me into my online account and the member services advises that cancellation must be in writing but they provide no address. This is an obscene abuse of patient welfare and finances.
Every time I submit a claim at the message center, it logs me out continuously. When I mail it in, the claim goes into the black hole, you can't even call them up to reference the claim you submitted and ultimately and no one can help. There is no one to email regarding technical support. Call them is virtually impossible with hours and hours of waiting.
I have re-submitted numerous claims over and over again by mail, to the point where I have completely run out time to submit my claims, and ultimately end up paying out of pocket, On top of that, nothing goes towards my deductible. The system, on so many levels is inept and some sort of scam. Everything goes into the circular bin it seems. Online system must be set up to log members out deliberately so that claims CANNOT be submitted and paid. Ultimately, the member runs out of time.
I have been working with my dental provider since March to get my complaint filed. Several times we have been told they have everything they need to review the claim, only to find out later that the claim cannot be processed until they get something else or something different. It has been resubmitted so many times it has gone to appeal. I was assured they had everything they needed. Guess what? Today I found out they don't. When I insisted that we had sent in everything that exists, the rep said maybe something just wasn't good enough. On top of that, they have my old mailing address on file. Both my HR department and I have attempted to change it. The rep told me it 'takes time' to get through to other departments, maybe a week--and he had no answer when I advised it has been about 3 weeks since our requests.
They will not pay for prescription medicine I need. They will not pay for dental treatment I need. I'm a childhood mass murder survivor, have a moderate to severe traumatic brain injury, other sequela, such as PTSD. ** in large amounts, 60 - 80 mgs per day, is capable of quelling the worst of my symptoms, which are terrible, indeed. Anthem tells my neurologist's nurse that my "plan" allows for only 30 mgs per day. This astonished and bewildered my pastor, who commented, "Plan?! How can anyone 'plan' for something like that?!"
Anthem makes appeals instructions as abstruse to understand as possible; you almost need a legal background to understand them. Oh yes, about my neurologist's nurse: she told me that she cannot get over her shock that Anthem turned down a request for coverage for generic **, the drug which slows Alzheimer's, for another patient. This is shocking, the inhumanity of it is shocking. I want very much to leave Anthem. My only regret will be losing my primary care physician, who is excellent.
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
Anthem Company Information
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