Blue Cross of California
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Blue Cross of California

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Last updated: Jan. 16, 2018

199 Blue Cross of California Consumer Reviews and Complaints

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Verified Reviewer
Original review: Jan. 16, 2018

I don't know how many times I have called this company, and my enrollment issues are STILL unresolved! They have enrolled me with the wrong Drs., clinics and coverage, and when I requested that they send me another card with the corrected information, they sent me a card with an arbitrarily assigned doctor and clinic instead of the one I chose and had already seen! I really like my Dr., and I DON'T want another one.

I've worked in customer service in the past; companies rate their employees by how many calls they take each hour. If they can't get call queue down within a reasonable number, their performance ratings goes down and they can be fired. So there's no real incentive for providing quality service for the customers. There's only enough time to give people affirmative responses, promise to take care of the issue, get them OFF the line within 2 -3 minutes (sometimes more), and move to the next call. How much quality service can a representative give within that short time span, especially if there are complicated issues that involve inputting information on multiple screens?

Based on my own experiences doing that kind of work, it isn't easy trying balance speed with quality, especially when the employers' focus is on speed. One of my supervisors once said, "I feel it IS a service to take the customers' call quickly so they don't have to long wait times in the queue." That's true, but not at the expense of resolving that customers' issues!

I suspect that's what is going on with Anthem Blue Cross customer service. I hope I'm wrong, but I doubt it. I'm a former Kaiser Permanente member, and I switched to Anthem Blue Cross because I was very dissatisfied with their fast food industry approach to medical care. However, I never had any problems with their customer service. Now, I'm dealing with the exact opposite situation: great care from my medical providers, and ROTTEN customer service from my health insurance plan!

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Verified Reviewer
Original review: Jan. 10, 2018

Due to lay-off from work in 2017 I obtained insurance with Blue Shield through Covered CA. So far nothing but problems and unfortunately when calling in to customer service I reach non-US based help desk who are very difficult to understand especially with loud environment they apparently work in. I've asked multiple times for US-based rep to call me back. Each time they indicate call-back within 24 hours but is now a week later and I'm still waiting. Called again and was told call-back within 24 hours but I'm not holding my breath. Such a disappointment after 5 years at United Healthcare where all their support is US-based. Shame on you Blue Shield.

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Verified Reviewer
Original review: Oct. 26, 2017

I switched from Covered California with Blue Shield to a regular policy with Blue Shield in March of this year. It's been one nightmare after another with them and it just keeps getting worse. Blue Shield deposits my premium checks every month but stopped crediting them to my account three months ago. I have spent an inordinate amount of time on the phone with them about this issue. The last supervisor I spoke with told me that they had recently changed their billing system and that's why my payments weren't showing up. He told me that everything was alright and I should just put a different code on my next check rather than using my account number. Well, tonight I get a message saying that my insurance was CANCELLED and that I had 48 hours to pay them $1700 or my account would never be reinstated! This includes a $548.17 "reinstatement fee".

I have a complete paper trail of every premium check I've sent which they have deposited (I send them 10 days early too just to make sure). I have lost sleep and time from work as a result of Blue Shield's negligence and ineptitude. They outsource their calls to a call center overseas and the people are not trained. I very much look forward to finding a different healthcare provider once this is resolved. Shame on Blue Shield! I have filed a complaint with the Insurance Commissioner as this has gone much too far.

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Verified Reviewer
Original review: Oct. 5, 2017

I have been trying to get a response from Blue Cross as far as my payments are concerned. I hit my deductible in January 2017, and to date Blue Cross has not rectified my account. I've spoken to numerous people at Blue Cross in regards to this, and have been trying to get in touch with Holly to no avail. To date, October 5, 2017, has not returned my calls. The bills keep coming and of course, the doctors and hospitals want payment. I don't know what to do at this point. I have EOB's that indicate I have hit my deductible, but no one will call me back to get this taken care of.

Verified Reviewer
Original review: May 27, 2017

They terminated insurance with no cause, reinstated after a month with apology, reimbursed for the missing month of coverage for the family. 1 year later, (not near an open enrollment period), extortioned me for their missing month of coverage. I had to pay, as no way to change providers due to the Obama-Care requirements. Dropped them at my first opportunity. I would love to see this company go out of business for how I was treated. Never again with these crooks!

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Verified Reviewer Verified Buyer
Original review: May 6, 2017

I was out of the country and ran into financial troubles and did not pay my premium for two months. They sent me my new card and a statement which I was prepared to pay upon my return. I called them and they told me they would return my call in 7-10 days. After 12 days I called and they said I received the wrong information and would receive a call in 30 days. After 33 days I called again and they told me it would be after 40-45 days. I asked if this is because of the new legislation and they confirmed that it was. I own multiple properties and need to be covered in case of a catastrophic accident. Out of the country it doesn't matter because there I can easily afford health care. I told this company they were lying to me and they had another term for it. I'm seeking a new provider.

The government should either stay out of health care or simply provide a universal plan to all its citizens. I've come to find out that I can get an excellent plan in Asia for $60 a month that includes almost everything. You get excellent care beyond what you get here. I'm moving probably at the end of this year. ** this place and ** Blue Shield. Their coverage is garbage along with their customer service.

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Verified Reviewer
Original review: April 4, 2017

My bank sent me a new credit card. I'm enrolled in Blue Shield's auto payment option. I logged into my account on the Blue Shield website and tried to add a new credit card for my payment. The website said all my info was already on file, which it was NOT because it was a brand new credit card. Called. Had to waste time wading through the phone tree only to be told the office was closed. Then they hung up on me. They make everything so difficult and waste so much of my time they should be paying ME.

Verified Reviewer
Original review: March 4, 2017

Blue Shield of CA arbitrarily denies you a vital medication/treatment which has been proven and documented to shield (excuse the pun) you from pain and improve your overall quality of life by improving your mobility - this has to do with gel injections into your knee which is, for all practical purposes, bone on bone. I believe this to be inhumane and cruel, especially considering that I pay $733 a month to Blue Shield each and every month which they have no problem with taking. Also, claims processing is at a snail's pace (took about one month to process my claim - still waiting for the money!). The only thing that Blue Shield of CA is great at is taking your money monthly!

Verified Reviewer Verified Buyer
Original review: Feb. 12, 2017

Blue Cross/Blue Shield business is appalling and if it was not such a large conglomerate it surely would have gone bankrupt because of their business practice. My story... For the past 2 years my prescription cost was $0 out of pocket. Come January 2017 my out of pocket rose to $535. Called BC/BS and waited on the phone for 35 mins on two occasions. Ok, I understand everyone is busy but really 35 mins!!! Third time was a charm as I got thru within 5 mins.

Went thru the menu and spoke with someone that deals with prescriptions. Told him since my conversation is being recorded I first I need to complain and it's nothing personal against him but rather for the company he works for. I said, "please let me know what kind of company is BC/BS that changes the conditions (I see it as a contract because a premium is being paid for service rendered) without notifying the customer first? I was paying nothing and now all of a sudden I'm paying over $500 a month. This is terrible customer service and because it is cost prohibitive, when I become ill (or die) for not taking my meds, I'll see BC/BS in court."

Enough said and as protocol dictates I started asking him what are the alternative meds I can take. I started with the 3 that cost the most; $394, $89 and $27. He gave me some alternative meds I could take and then I stopped him to ask a few more question. "How do you know what alternative meds to recommend? There is a chart that cross references to similar medications. So, for one of my pills the only alternative medication you are recommending is 10 mg; 20 mg is not available. Since I am taking 20 mg does that mean I double up on the medication or is it formulated to meet the 20 mg strength?" He could not answer and said he could transfer me to a pharmacist. I said "OK but I have one more question for you. Are you a Dr?" No. "If you are not a doctor how can you safely recommend an alternative medication?"

I am allergic to sulfur and how does he know any of these alternative medications do not contain sulfur. He said I should speak to their pharmacist and will transfer my call. As the call was being transferred it was dropped. I think they tried to call back within a minute but I was so pissed off with the answers I was getting I really did not want to speak with anyone.

So, I spoke with one of my doctors and he gave me enough samples of the $394 meds until there is a fix; whatever that may be. For the $89 meds, I am still waiting to hear from my other doctor and according to BC/BS there is no alternative medication. This experience is almost as bad as the EpiPen and my heart goes out to everyone that is experiencing similar medical cost problems.

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Verified Reviewer Verified Buyer
Original review: Feb. 1, 2017

Since I enrolled with Blue Shield CA in 2016, I have had ongoing repeated problems with the billing system. I am told that there is a 2 month delay in updates to the premiums due. This resulted in me being overcharged for my January coverage - the system continued to bill me for the 2016 plan, rather than the 2017 plan that I changed to effective Jan 1. I cannot believe that this level of service is considered acceptable by the California insurance bureau. Blue Shield CA should be required to upgrade their systems so that consumers are not routinely overcharged. I spent another hour on the phone with a rep who basically told me that I just needed to be patient and wait the 2 months for the system to catch up. I have taken the initiative to calculate and update my payments, so I am fine for moment... until the next Blue Shield SNAFU.

Verified Reviewer
Original review: Dec. 25, 2016

Blue Shield of California deceived me as to the terms of my dental plan. As a matter of fact, they did not disclose to me the complete terms of my plan either upon the enrollment or renewal. My plan had one year waiting period and when I wanted to use my insurance for the first time (after paying them for a year and half) they denied me practically everything.

It took me additional several months to get from them at least some explanation for their denial. Only then they sent me the evidence of coverage with some weird restrictions that had never been sent/disclosed to me before. When I complained to them that they failed to make proper disclosures, they prepared a false account of my complaint and just canceled my insurance, falsely alleging that the cancellation was requested by me. In such way, they managed to pocket all my premiums without having any expense. Since I had a deductible, I even had to pay for the full mouth X-rays they requested from my dentist without any legitimate reason (they did not need the full mouth X-rays to invoke the restrictions they had been concealing from me).

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Verified Reviewer
Original review: Dec. 12, 2016

I am both a provider and a patient with Blue Cross PPO coverage, like many people, I also received a notice from this company indicating a 30% increase in my premiums, they also increased my deductible. I would like to share that as a healthcare provider, Blue Cross has slashed their reimbursement to providers by a whopping 60%. I will no longer will be accepting Anthem Blue Cross of CA. I understand this company wants to turn a profit; but increasing premiums by 30%, raising deductibles and co-insurances, and cutting back provider payments by such a huge percentage, one wonders how much profit is enough for this company. Unethical practice by this company.

Verified Reviewer
Original review: Nov. 16, 2016

My employer changed our company insurance plan to Anthem Blue Cross from AETNA, effective 8/1/2016. I provided all the necessary information so that deductibles would carry over from AETNA. In mid-September, I went to an in-network lab for lab work that my doctor had scheduled. The billed total was a little over $1400. In October, I received a bill from the lab stating that the claim had been denied. I went online to look at the EOB and found that the claim was denied pending my answers to a questionnaire about Medicare coverage that Anthem claimed to have sent me. When I still hadn't received that questionnaire 2 weeks later, I called Anthem, waited through the interminable delays, and explained my problem. The rep said they'd send another copy.

A week later, no questionnaire, I called again. I explained that I do have Medicare pt A, but I haven't signed up for the rest since I am employed full time and I have insurance through my employer. This second rep was polite and helpful. She took the time to call Medicare, got the proper information, and said she would submit it to Anthem. She assured me this would take care of things. A week later, no progress, the website said the claim was still denied, and now there was a second denied claim for the doctor's appointment that followed the lab work. Same explanation, they were awaiting the answers to the questionnaire. The one I still have never received.

The rep I spoke to on the third call somewhat rudely advised me that I needed to be patient because it would take 30 days to make the change (30 days to make a simple change as to whether I was covered under Medicare? What the heck?) Since then, I have been monitoring the EOB online. Until this past weekend, there was no change. Then, suddenly, the lab EOB disappeared and only the doctor visit EOB was visible.

A few minutes ago, I checked again, and I found an "adjusted EOB" which now states that they have denied the entire $1400 charge and that I am responsible for that charge. There is no reason given for the denial. I am flabbergasted. I have no other insurance that will cover this claim. I have paid my Anthem insurance premiums through my employer on each paycheck. I went to an in network provider. What is their problem? Can't wait for them to deny the doctor visit as well. I used to have good credit scores. Wonder what they'll be when Anthem is through with me. And my employer made this change because the Anthem premiums were a better deal for the employees. I was never thrilled with AETNA, but I never had problems like this with them. No wonder Anthem is cheaper. They keep premiums low by denying legitimate claims. I've emailed them this evening. I'm lodging a complaint with my HR department tomorrow.

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Original review: Nov. 4, 2016

Blue Shield of California increased my monthly from $815 to $1200 as of 2017. I called them and increased my yearly deductible from 6000 to 10,000. My monthly went up to $950 per month, an increase of $135 per month and worse coverage. I called to complain and got nowhere. They called me today on a robo call to tell me how good they are. That's it!!! All I can stand. I called them and told them that they are as bad as the government. They lie!!! They are complicit. Why did other company's opt out. I'll tell you why --- because they are honest. This company prefers to deceive their customers instead of standing up and telling the truth. NEVER BUY FROM THEM!!!

Verified Reviewer
Original review: Oct. 15, 2016

We lost our insurance last year and it was 2 months before I figured out what happened. I think it is deceptive practices how many notices Anthem sends out. After a while it's like the boy calling wolf. We always paid our premium on the 5th or 6th of the month. If you didn't pay by the 1st, notices about losing your plan start going out... and they keep going out. After a while we were kind of numb to them. We always paid... until something happened with our card and we didn't... problem is we didn't know it.

We eventually got other coverage (I was 9 months pregnant), but we just had to pay the penalty for not having insurance for 2 months. $1,100 people... If it was my fault then I would have no problem paying the penalty. But the fact that we had no idea we had even lost our insurance should be an exemption. Also I think Anthem needs to revisit how the issue notices and let you know about the status of your account. I think their current practices are intentionally confusing and it is wrong.

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Verified Reviewer
Original review: Oct. 11, 2016

My husband carries me and our children on his Blue Cross/Blue Shield Federal Employee insurance through his job. On September 20, 2016, my husband, whom I am legally married to and have been for 17 years, called and told the representative that we were divorced and I was then terminated from the insurance plan as of September 30, 2016. We are not divorced. I was not notified and found out about the cancellation by accident. I am scheduled to have major surgery on October 31, 2016. On October 7, 2016, I called the hospital to verify my co-pay and register for surgery. At that time the assistant attempted to access my insurance information and it said I was inactive. I was informed to call BCBS to inquire about the issue. When I called BCBS, I was told that I had been removed from the policy because my husband called and said we were divorced. Again, we are NOT divorced.

I asked if he needed to show some type of legal documentation like a divorce decree and was told that "Your policy does not require that and that no notification goes out to the cancelled party." However, I was told that I had a 30 grace period. Today, I called BCBS back because the pharmacy said I have no insurance. BCBS now says that there is no 30 day grace period because the cancellation is due to a divorce that never happened. The representative told me that if I can prove that I'm still married then maybe you can fix this. So now I have to prove that I'm married, but he does not have to prove that we are divorced. This is just wrong!

So here I sit with no insurance, no asthma medication, no blood pressure medication and no very necessary major surgery that has been planned for 6 weeks. All of this because my husband is angry that his child support increased and BCBS does not care enough about its clients to at the very least verify the information that is being told to them, especially when benefits are being terminated. That's not just a minor thing. And why isn't the terminated party notified? If I had gone to my pre-op appointment tomorrow I would have unnecessarily been billed hundreds of dollars because I wasn't informed. I'm fortunate that I have a job that offers medical insurance. However, it won't be effective until November 1, 2016 because I was originally told that I had a 30 day grace period. Thanks for treating me like the number and cash cow that I and all of your subscribers obviously are to you. Shame on you Blue Cross Blue Shield!

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Verified Reviewer
Original review: Sept. 30, 2016

I transferred my medicare plan over to Blue Shield 65 plus HMO plan several years ago. I just received a letter from them on September 29, 2016 in the mail but the letter was dated October 2, 2016. It stated that Blue Shield 65 Plus HMO won't offer our Medicare plan in 2017. It also stated that this means our coverage through Blue Shield 65 plus will end December 31, 2016 and that we should make a decision to take action about Medicare coverage by before December 31, 2016 or prescription drug plans will not be covered. In addition we should look into choosing a plan before February 28th 2017. There was no other explanation for why this was happening. I called the customer service line and they told me I should be receiving another letter stated that if I want to continue Blue Shield 65 plus I must fill out another application and pay a $29 premium monthly.

So I asked the customer service rep "I thought they were no longer handling medicare or taking over medicare". The representative told me they would still be an HMO with medicare but I have to pay a $29 a month premium in addition to what I pay each month for Part B Medicare out of my social security check. I said this is extortion of senior citizens who are on HMO because they can't afford supplemental medical insurance on fixed or low incomes. There was no explanation for the increase or what it would improve.

Blue Cross 65 plus has hoodwinked seniors into this plan knowing that they would be increasing. Also I am under Hills medical group which takes Blue Shield 65 plus but does not take straight medicare. I may have to find a new doctor which I am very upset about. Something needs to be done about Medicare, and these HMO plans that they sell out to. The newly elected Vice President Margaret Anderson of Senior Marketing is obviously stupid and not very good at her job, otherwise she would not have to send out two letters confusing people.

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Original review: Sept. 12, 2016

My husband and I have been paying for our Blue Cross policy for over four years now and the first time we are in dire need of it, we are denied. My husband is a severe alcoholic. We checked him into a rehabilitation facility after he ended up in the hospital on a breathing machine unable to breathe on his own. My husband is near close to death and this insurance company is only willing to pay for 5 days of treatment with complete disregard for all recommendations that he needs to be in house rehab for at least a month and then on to a sober living house.

Through group therapy I have learned he is not the only one with this problem and in fact it is common for Blue Cross to do this. They know his drinking has landed him on life support, many other hospital stays and that his addiction has been with him for the past 10 years. Going into the facility they ask many questions to submit to the insurance company to determine how dire a need the treatment is. It is clear to all doctors, myself, counselors and my husband himself that if he does not get help he will most certainly die. We have submitted all documentation that is required.

By law all insurance companies are now required to treat chemical dependency as they would any other disease. Blue Cross is blatantly ignoring the dire life-threatening situation and has made it clear they will only consider this medically necessary once he is no longer around to need it. Like I said, they're required by law to treat him as any other life threatening patient. They are ignoring that law and my husband may pay the price with his life. Another couple went through this with them and they lost their son to a drug overdose. It's up to my husband to do the work but it is up to Blue Cross to provide the service we pay for.

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Verified Reviewer
Original review: Aug. 12, 2016

Their accounting is screwed up and they take too much money, then not enough... I was notified by Blue Shield that they were going to terminate my account for non-payment. However, I had overpaid last year and they were supposed to start taking automatic payments which I signed up for when they had it figured out. Long story short, they never sent me any bills or took any automatic payments from my account. I tried to pay online and it said that I had no payment due. I called and the automated system said no payment is due. Then I called one day after the date they were threatening to terminate me (only communication I received in over 6 months) and I was no longer in their system and when I got a hold of a Rep to make my payment, I was told I was terminated and there was nothing they could do.

That was my first case and grievance and I have spent countless hours on the phone getting a different person with a different story each and every time. "Yes, you are correct, it was our fault and you are being re-instated. I have escalated your case and you will get a call in 24 hours." It has been 8 weeks now and still they can't seem to get it corrected, even though they say someone is working on it. I call every day now, hoping that the squeaky wheel approach works, but it hasn't. I have filed grievances online and still nothing happens. I am getting threatening letters from medical billers that are not getting paid. This is not fair!!

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Original review: July 25, 2016

Don't do it!!! BUY ANYTHING ELSE but coverage from this company!! We have the most expensive Platinum coverage available but it's next to worthless!!! Wife has been trying to find a in-home PT, prescribed and authorized, for two weeks. NO ONE WILL TAKE THIS INSURANCE!!! I don't write reviews, check, but this has been a nightmare of no responsibly, no availability, and no accountability, never mind just no help. Our lives are forever changed as a result of her injury. This company added insult to our misfortune at the most stressful time of our lives. Buy their horrible coverage and you too can learn this lesson.

Verified Reviewer
Original review: July 7, 2016

I am an ILWU-Marine Clerk. It all started in 2013, after my employer (Pacific Maritime Association), dropped a notice that we would be using Blue Shield of Ca. It was all done by the Trustees. Anyway, my daughter had knee surgery and because most of the people at my job are out of network, I guess Blue Shield decided they would not be responsible for our bills, one the most horrific incidents in history. It was all in the newspaper, destroyed our credit. I did everything to fix it and to no avail. Here it is again 2016 and I guess I have to try again to fix my credit. I refuse to pay because it was their responsibility. Most of us were out of network, so why would they take us on and then not pay our bills. Pathetic! If I could afford my own insurance I would DEFINITELY stop using Blue Shield. That way I can go to whoever I want. I find this to be the best rather than be stuck in a network whose job is to not pay claims and destroy lives. Very upsetting!

I had gone to the provider and at that time they said they were paying it slowly, then all of a sudden, I started getting collection notices and then I found out they stopped paying altogether. I had sent every document following every instruction. It has been over 3 years and I have not received another collection notice in over a year, but my credit is destroyed. I refuse to pay them. I heard Blue Shield was one of the worst and unfortunately, my job as stupid as those persons who decided to take them put us all in jeopardy.

Let me tell you, if the other people from the surgery center had not known what to do, I would have a bill exceeding over $100,000. What they stopped paying was the therapy which comes along with the doctor's orders. Everyone's experiences are different, but this happened with my job. They were told to clear it and fix it, and if they didn't my job would drop them, but I guess I got lost in the mix so I need to find out what to do! I have everything documented, I never got help even with all of that! Weird! I understand they don't pay out of network, but why would you take 3-5000 employees on knowing all of our medical expenses are out of network if you knew you would not pay?

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Original review: June 10, 2016

Went to Blue Cross, Dr refused one refill, changed another. First time there, spoke 5 minutes, forgot insulin. Also called Blue Cross, told a supervisor would call in 24 hours, didn't happen. I called twice today, waited to be put at beginning of phone waiting process, never got called or got through. Need my meds taking 4 years now. Customer service non existent. I need help before I lose it. Didn't sleep last night, leg cramps, back pain, sweating, greetings, holding. Dr. have specific reason for withholding meds, blood test, medical records. Before denying meds shouldn't Blue Cross be concerned and call me back? Not happy Blue Cross UG.

Verified Reviewer
Original review: May 19, 2016

I signed up for paperless billing and made my first payment. Anthem never sent me a bill in mail or email. It is of course very easy to verify this with a quick mail search. I DID get emails about confirmation of my first payment and other wellness living emails. However no bill and they then terminated me. It is rather amazing to me. I'm still trying to get reinstated and then plan to hit small claims court.

Verified Reviewer
Original review: May 19, 2016

I have been trying to get my refund from Blue Shield since last May 2015. Here is just my 2016 contact with them. I call, I get references, I get the whole 7-10 days processing and just excuses. I asked if they were going to refund the interest. 1-888-319-5999. Previously called in Jan. 4, 2016. At that time I was to receive a check back for $638.16. Called today 03-09-2016. Called Blue Shield regarding refund still due from May 1, 2015 - $659.54 Minus 1 Day ($21.38) = $638.16. Covered California plan ** Jan 1, 2015-April 30, 2015. Current Plan **. Effective May 1, 2015-April 30, 2016.

Blue Shield rep got Covered California on the line to get them to check on status. Blue Shield says they only show payment through Jan 31, 2015. Katnis asked me to call back in 7-10 days to check to see if they received notice from Covered California, so they can issue a refund to me. Called on May 2, 2016 to find out where my refund is. Spoke with Mark and he reviewed the ref# **. Prior agent (Katnis) worked on the incorrect member number which is why I haven't received the refund. Mark spoke with Tina in the back office and she is putting in for my refund. Mark said I would receive the refund the same way that I paid for it (i.e. my savings account). He also said it would take 7-10 days again to receive the refund.

Called on May 18, 2016 @ 4:16 pm to find out where my refund is. Spoke with Riza and she reviewed the ref# **. Riza is checked all the notes. Connected me to another department and I spoke with Christine. (Their direct number is 1-855-836-9705.) Christine was checking the status on the refund. She came back on the line and said they were still processing it. I argued that it has been over the 10 business days (today is the 12th day). I asked her to go find out WHY and that I needed the refund NOW.

She put me on hold to go check after trying to tell me it had not be 10 business days which I counted for her (from May 4th to today May 12th 12 days). She came back and said there were delays. I told her I needed my $638.16 now and there was no reason for this to be delayed. It is a simple refund not a claim or anything difficult. The rep keeps telling me she is calling the "back office" and they have "so many" claims that they need another 4 days. I told her that this is unacceptable and I wanted the refund tomorrow May 19, 2016. I let her know that I really need the money desperately. I will post again when I find out the results. They are a horrible company.

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Verified Reviewer Verified Buyer
Original review: May 15, 2016

I was on a Blue Shield plan with Covered California until I began Medicare when I turned 65 and enrolled in another Blue Shield plan to supplement Medicare. Blue Shield refuses to acknowledge that I should not be covered by overlapping policies even though its overlapping coverage is impossible with Medicare regulations. Blue Shield is billing me for the overlap and is refusing to correct the situation. I will take the company and all the employees I have spoken so many, many times with about this to SMALL CLAIMS COURT if they cannot resolve this. They knew my date of birth and when I would enroll in Medicare but refuse to resolve this issue. They want me to pay hundreds of dollars for coverage that was invalid once Medicare and the supplemental plan began.

Their excuse so far is that Covered California has an incorrect date entered somewhere but it is Blue Shield that keep trying to make me pay! I have also called Covered California several times but all I get is promises that someone will look into it and get back to me. Both Covered California and Blue Shield were VERY AWARE OF MY DATE OF BIRTH AND WHEN I WOULD BEGIN MEDICARE! Each call to Blue Shield about this has resulted in explaining the whole situation to each individual even though they had the reference number from the previous call. Their complaint system seems to be structured so that a person will just give up and pay even though no product was provided! I will NOT GIVE UP!

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Verified Buyer
Original review: May 5, 2016

I am a new insurer and have been trying to get a prescription authorization for over a month that is medically necessary. I keep getting the runaround and they denied the medication. I never had a problem with Kaiser or Anthem Blue Cross.

Original review: May 4, 2016

I signed up for dental insurance last year, and after checking with my dentist to make sure everything is covered, my dentist claims that Blue Shield suddenly changed their policies and only covered a minimal portion. At the end of the year, I decided to go with another insurance that actually covers SOMETHING. I kept getting charged after I'm pretty sure I called to cancel. After 4 months of charges, I called in to request cancellation, and they said I need to FAX in proof of insurance with the other company for me to be issued a refund.

Basically, the customer service representative I originally spoke to sounded like a high school girl on her first day of work. She just sounded like an idiot, which added to the frustration of having to go through all these horrible automated systems. She provided me two FAX numbers. I asked her if there's anything specific I need to include because I want to make sure I have the correct instructions before I get off the phone with her. She said "Nope, just fax the proof in..." I asked if there was a direct line I can call to skip the automated systems and she said no.

I drove out to a UPS and faxed my proof to both FAX numbers. I waited a few hours, and called back in. Waited through the HORRIBLE automated systems and the representative this time said they did not have access to the fax and she does not know that they've received it yet and to call back in a few days. I called back in a week and the gentlemen that helped me said he received nothing, no note, and from the notes that the previous rep left, I was given the wrong FAX numbers... He proceeded to give me the CORRECT FAX number and again, I had to go out and fax because they don't have a direct e-mail for customer service issues such as this.

2 weeks later, I noticed my account has been billed AGAIN. I called in and they said they have received the note, and they had only just proceeded with terminating my membership because I called in, but billing is completely separate? BASICALLY, just avoid Blue Shield. I don't understand how a company this big can be so disorganized and have such unprofessional, idiots on their front lines of customer service. They need to do something about their ways of communication and update their technology, etc. They also need to have a direct customer service line for those who have already opened a claim and need immediate assistance.

Also, it's one of my biggest pet peeves when it sounds like foreigners are in charge of customer service. I am a minority as well and have nothing against foreigners, but it only makes the situation worse when the person who is suppose to be helping you on the phone has an extremely THICK accent that's very difficult to decipher in an already frustrating ordeal. Either offer online chat support, or don't allow those that can't speak clear enough English to be on the phone. It's not only for my sake, but for their sake as well.

They show absolutely no understanding when I ask them to repeat what they had just said. They give attitude as if I'M the idiot that can't understand perfect English. They then proceed to just speak slower and louder, and add "okay" after every sentence. What would be OKAY is if they didn't speak like a foreign robot. My blood pressure spikes every time I have to be on the phone with them. Just avoid it. Life is too short to be this unhappy in unnecessary situations.

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Verified Reviewer
Original review: April 30, 2016

This insurance company has made me hate anything medical. Has caused so much stress, more than Ive ever had. My fiancee has Crohns Disease and its more of a nightmare because we have an insurance that sucks. They mess up all the time, we're on hold for 30+ plus every time, our prescriptions are always never approved for no reason, and to top it off we pay 500$$+ each month. WTF?!

What made me write this complaint was because my fiancée has been on HUMIRA for about 2 months now. IF you don't know, HUMIRA is a medicine for Crohn's disease that helps him stay in remission. If he doesn't take it on time he is screwed. SO...the insurance company said it will be at the pharmacy for pick up. He goes...and they're saying they couldn't approve it being picked up. OF course we call and get bounced back and forth from person to person with NO ANSWER. Oh by the way, this is not the first time. They compromise his health and I'm 100% more people than just this forum will agree.

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Original review: April 29, 2016

I hate that I even have to give a star. This is by far the worst insurance I have ever had. Thank god my husband and I switched over to Oscar (which is AMAZING) - as we are now trying to conceive and I couldn't imagine having Anthem Blue Cross in our current situation. My story- I FRACTURED my ankle about 8 months ago. I went to the clinic that ANTHEM instructed me to go to. When I got there they said we were not up to date on payments (which we were as our payments were automatically deducted every month and we always checked to make sure it was operating correctly). So they said they couldn't see me. We called Blue Cross and since it was a Saturday there was NOBODY there to help us.

Long story short (some yelling ensued at the clinic - which was out of character for us), we ended up leaving WITHOUT BEING SEEN. At this point I didn't know my ankle was fractured since I didn't have x-rays. I stayed off of it until Monday. Monday morning I called Blue Cross (since there was NOT ONE PERSON there to help me over the weekend - because people don't get sick on weekends, right?). Again, they instructed me to go to the same clinic that had turned me away on Saturday. We told them what happened. They said they would make sure it wouldn't happen again - as we were up to date on payments. SO, we go back to the clinic. Not kidding... They said the same thing. They couldn't see me because we were not up to date on payments. SO we bring up our payment log and show them. We also have Blue Cross talk to them. They say "sorry - we can't see you, go to a hospital." We leave.

We don't go to a hospital because we can't afford it and because we PAY $680/month FOR INSURANCE. Back on the phone w/ Blue Cross. They tell us we can go to a clinic that is 33 miles from our house and they're sure there will be no problem (no joke). For anyone who lives in LA, you know that 33 miles is about 2 hours or more of a drive. We tell them that doesn't work. So they make some calls and send us to a closer clinic assuring us that we will be covered.

We hobble over to that clinic and guess what? THEY WON'T SEE US BECAUSE THEY DON'T TAKE OUR INSURANCE. I wish I was kidding. My husband said ** it and we ended up paying OUT OF POCKET for my x-rays. The staff was so accommodating and they felt so bad that they ended up only charging us half of what we had to pay (which is unusual and we were SO grateful). I found out that I had a fractured ankle and with no thanks to this AWFUL insurance company. EVERY SINGLE PERSON we spoke to had NO idea of what they are doing. It was honestly scary. What if we had a real emergency?? What if I was pregnant?? Thank god we got new insurance at the beginning of this year. This was a scary experience and I don't know how this company intends to stay afloat and keep customers. Dangerous, scary, uninformed and irresponsible - how I would describe Anthem Blue Cross.

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Verified Reviewer
Original review: April 29, 2016

This medical insurance company is the antithesis of "health". They have screwed up my billing so many times I have lost count and wasted at least 40 hours trying to straighten things out on the phone, only to have them bill me incorrectly again and again. It baffles my mind how these crooks are allowed to do business. My wife has hot flashes and they denied the doctors order for hormone therapy saying it was "medically not necessary". How does the insurance company get to tell the doctors what is medically necessary? I am diabetic and whenever my doctor prescribes the most effective drug they deny coverage. It like they want us to be sick. The stress of trying to follow up with the incorrect billing is bad enough, but to be constantly contradicting the doctors recommendations and denying coverage left and right after we pay over $1400 a month in premiums is just plain evil.

They are more than happy to keep cashing my checks and screwing me on the back end. I will be cancelling my insurance with them ASAP. Another scam that ALL of these companies get to use is called open enrollment. Why should healthcare be locked in for an entire year? People should be able to choose who they like, so when horrible evil companies like Blue Shield of California take your money and then don't provide service, you can cancel. Let the open market decide who is best. I bet the rates would drop then too. We will be cancelling and telling as many people as possible to never use Blue Shield of California PPO. The absolute worst of the worst. I had Kaiser before... HMO... wishing I still had it. They never screwed up the billing.

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