Blue Shield of California Reviews

Blue Shield of California is hands-down the most predatory, soul-crushing, slow-walking denial machine I've ever had the misfortune of paying thousands of dollars to every year. They approved my specialist, then denied the exact same visit after it happened because the doctor's office "didn't submit the correct form"… that they never told anyone existed. When I called to ask what form, three different reps gave me three different form numbers. None of them existed on their website. Their "expedited appeal" process took 47 days—longer than their own advertised 30-day maximum—and ended with a one-sentence denial that basically read: "We decided we don't feel like paying. Regards, the void."I had to pay $3,800 out of pocket for scans that every other Blue Cross/Blue Shield plan in the country covers without question. Their excuse? "Not medically necessary."

My husband and myself been trying to get health insurance with Blue Shield since December of 2025. Finally today January 21th 2026 our policy is activated and they took our payment $2430.09. We ask them to please make our policy effective in February 1 2026, due to Blue Shield errors. Unfortunately they can’t, talking about a scam. They didn’t insure us due to their lack of knowledge. We gave them everything they needed in December 2025 and now we are paying for the whole month of January when we were not even insured till today January 21th 2026. ** this, I’m so sick and tired of this shit! ** scam!!!! Staff members are all garbage!

Worst customer service ever. I put a claim in for hearing aids which I purchased back in September of 2025. It was denied. They claimed missing information was omitted. I gave them that information and we are still waiting. Every time I call them (which is every 2 weeks) there is always a new excuse and I can’t tell you how many times this claim has been put in for processing. There is never a supervisor to speak with. The way customers are treated is unacceptable.

Horrible experience with Blue Shield. I took it for the year of 2025, thinking it will give me greater flexibility (than Keiser) and help me save more money, even though their premiums are much higher than Kaiser. The whole year was a disaster, they would refuse EVERYTHING, and the doctors and hospitals would TRIPLE charge me just because I have their insurance. I will rather pay cash prices if I have to go outside of Kaiser than have to have to deal with Blue Shield of California again. I never came close to my deductibles, nor for in-network, nor out-of-network, not for facility fees. Spent hours of my life on the phone trying to deal with them. It all seems like a big scam and completely inhumane.

My review is going to be along very similar lines to other reviews here, but I'll still write it. Wait times are ridiculously long even at odd hours. When you finally get to an agent, there is a high chance you will be provided inaccurate/wrong information. Not only do the phone agents not know what they're doing, they are highly incompetent and unprofessional. My review is not based off of one or two interactions. I've been led astray every time I've spoken to a Blue Shield representative. There is a reason these guys have the reviews they do.

Customer service representatives don't know enough to do their job. Hold times are ridiculously long. There is no online chat that I could find. Why, oh why, did I pick this insurance company? Choose wisely, friends!

If I could give them a negative I would. The worst insurance I’ve ever had!!! It took 6 months to get a test approved while I kept getting sicker. The funniest part is after they denied the first two test my doctor asked for they recommended another. Then after they recommended it they denied it. When I finally got something approved it was actually a procedure and more invasive. Then I paid my deductible and am getting bills for more than the 20% I should be paying for the rest. They’re so bad my company is switching Insurance.

This company does not care about diabetics or diabetes prevention. They waste everyone's time on pre authorization and appeals. Unless you are on insulin 3x a day you can't get coverage for a CGM, which is covered by other PPOs and helps prevent people from needing insulin. They also do so much pre auth it means you will have significant delays in care, prolonged periods of pain and suffering while waiting for them to approve doctors orders. Totally interfering in medical advice and harmful to patient care.

I am so angry and upset, I could cry at the fact that I still try to believe BCBS is any type of good. The amount of claims that have been denied due to my chronic pain leaves me in agony. The money I have spent just to hit my out of pocket maximum will leave me in debt and at the verge of homelessness. It has come to point where I have to suck it up and deal with my chronic pain so I don't end up living with my parents and selling my house. I think BCBS wants me sicker and more desperate so I can give them more money. It's the only way...How could you DENY me medication that HELPS me live a better quality of LIFE? I have never seen evil and greed at this level... I don't believe the devil exists but I think I found it here.

Blue Shield of California appears to make the review and resolution of claims intentionally difficult, seemingly to avoid making necessary adjustments. In my experience, the claims department consistently demonstrates poor customer service and an inability to handle even basic tasks related to claim review and troubleshooting. The only option they provide is escalation to the grievance department, which does not engage directly with the customer. Instead, they issue a generic response based on their own interpretation of the claim. If an issue falls outside designated time frames—which is often unavoidable given the systemic barriers to resolution—the automated response is simply that the appeal window has closed.

Red Time Experience with Mike ** & Covered California – A Year of Chaos, Charges, and Cancellations. I’ve never felt more frustrated, confused, and frankly taken advantage of than I have over the past year of dealing with Mike ** and the Covered California system. What was supposed to be a way to access affordable healthcare turned into a nightmare of random charges, canceled policies, and a complete lack of support or accountability. It started with Mike ** constantly enrolling and canceling my plans without clear communication. I would think I was covered, only to find out later that the plan had been canceled — usually without warning, and sometimes without even an explanation. Then I’d get re-enrolled, and it would start all over again. This went on for months, and every time I reached out to ask questions or get clarity, I was met with generic answers, delays, or no response at all.

Worst insurance experience I have ever had. Their policy is to delay. They ask for 30 days to review any treatment request. I have lung cancer. When the doctor asked to have the radiation treatment request marked as urgent, which changes the response time from 30 days to 72 hours, they downgraded it back to 30 days. They ask to have appeals in writing (not email, but snail mail) so they can delay the response time further. They denied my radiation treatment after 2 1/2 weeks of waiting. Blue Shield now says to expect a response in late September, so I will be waiting nearly 2 months for lung cancer treatment. And no guarantee they will even say yes. It could spread, but they don’t care. Customer service is unbelievably awful. I have to wait on the phone for an hour to an hour and a half. I have called them at least 10 times now with no result. I'm scared radiation will not be an option any longer by the time they approve, if they even do.

Dignity is TRULY in chaos. First of all, they don't have sufficient doctors, specialist, etc. As big as Sacramento city, they ONLY have 1 or 2 specialist or doctors..i.e., ophthalmologists. They had to send me to Folsom office instead. Other times, had to go Citrus Heights for another specialist. Another incident, Dignity scheduled a neurologist into year into future, but did not verify whether that neurologist handles certain symptoms, until 6 months later after I call back.

Truly the absolute worst experience I've had with an insurance company and I have chronic illness so that's saying something. I confirmed that my doctor was in network using their doctor search. Then they switched it to a different dr without telling me. Then I spent FOUR hours on calls with completely incompetent reps that just said they weren't seeing her even though my dr kept reassuring me she was in network. Finally found an agent who claimed they knew what was going on and she spoke with my dr and said she got it all sorted out. Next thing I knew they changed my pcp again. I spoke with them today and they were horrible. I truly don't know how this is a "business" or how California feels okay partnering with them.

I have been very disappointed by the covered California HMO silver plan. I came from a blue shield PPO through work plan and the drop off in service is disturbing. The pharmacy coverage is dismal, inefficient and often just wrong. You cannot get 90 day refills at your pharmacy only 30. You must get 90 day fills through Amazon, the only option! But the system is so bad it will state that you received a 90 day fill when you haven’t and then block a 30 day refill at your pharmacy. This has happened 3 times now to me in 6 weeks on this plan. I will change as soon as open enrollment allows it. It was bad enough to be laid off but this horrible experience had just added insult to injury.

I have been sick for months. My doctor requested an MRI to find out why I am so sick, and they deemed it medically not necessary. Why does a con doctor whose job it is to deny as many claims as necessary, have the ability to say a doctor who studied in his field does not know what he is talking about. The health care system is disgusting and these people are CROOKS. My test was cancelled without anyone contacting me regarding any issue. They lies about trying to contact my Doctor. They are terrible and I would give them a negative review if I could. Oh and did I mention I work in the health care industry.

I have had Blue Shield/Blue Cross for the better part of 60 years. I’ve had two kids all under their coverage, 4 surgeries, mental health care and I’ve never had an issue. I’ve had an issue with their billing department sometimes because they would send me a check back for my premium and then send me a notice that I was on a 30 day warning to be terminated. Then I’d find the check in my mailbox and call them and tell them they sent my payment back and would have to sort through that. That happened like 3 times in a 5 year period. So not that surprising issues do happen. As far as the doctors available though and the healthcare literally anywhere in the world I found that if I had their card in my wallet, someone was willing to see me and take care of me and that is very important to me. Unfortunately this last year they just got too expensive for me to afford and I had to switch to an HMO and it’s weird. I can’t say I’m particularly happy with it.

I won't recommend Blue Shield to anyone. This company is a joke, I've had several other providers like Aetna and Kaiser, and they were great, billing was good. This company hasn't notified me before cancelling my plan due to the autopay. I've used my same account for years. Never had a problem until this year. Now every month they take my autopay off after I've set up online. I've checked with my bank and they say there's nothing wrong on their side. But the last 5 months blue shield has gotten me frustrated with this billing issue that doesn't seem to ever fix.

Worst ever Healthcare Insurance company in the West Coast. They delay care like they are champions in this game. They injected multiple third party companies for denying coverages, dealing with customer issues and grievances, and flat out refuse to cover the most basic health concerns common in the area. Worst of all, they do this especially in a medically underserved community so people, healthcare providers and common public are worn down and discouraged from seeking care or investigative care.

Just had to find a place to let people know my experience with Blue Shield of California. I have had stage 4 cancer for the last two years and so have a lot of knowledge about health plans, chemo groups talk. I can so that I am so thankful that I had Blue Shield through this process. I have heard horror stories of other providers constantly denying life saving treatments. Where I have received nothing but teamwork from Blue Shield. I'm pretty sure I'd be in a different place if I hadn't been lucky enough to have them. I'm sure every provider has their issues, this is just my experience.

What absolute garbage customer service. They forced me to fill out this detailed form which took hours to collect all of the information to request reimbursement of urgent services received out of state. I followed all the instructions and they claim they never received the form. They claim they denied it months before I ever submitted the form, which made it too late for me to appeal the denial. Free Luigi.

Blue Shield is absolutely the worst insurance I've ever had. I signed up for the best coverage available and have a high premium, and I'm still charged ridiculous high co-pays for basic medical care and prescriptions. Their customer service is horrible and they don't answer questions in a clear, direct manner. Good luck with their app, because you just get stuck in these endless loops leading nowhere. I'm going to go broke with this insurance and am going to switch as soon as I can, but I'm stuck for now. Grade: F-

If I could leave -10 stars, I would. I am paying $500 per month and was told I can only schedule an appointment with my PCP in 2 months. Other doctors in my group don't accept new patients. Transferring to a new group takes time, and customer service is unable to tell me which doctors accept new patients. I regret BIG time switching from Kaiser. Wasted 8 hours this week on useless phone calls and still don't have an appointment. Worst app (inaccurate data), worst customer care. AVOID. How can a company be so reckless with healthcare I have no idea. Have some shame. I pay you $500 a month and cant get a basic doctors appointment, do you want your clients to die?

Starting January 2025 City and County of San Francisco changed Medicare plan from United Healthcare to Blue Shield Medicare PPO. BIG MISTAKE. For all the bad press about United healthcare, l had all my specialty treatments authorized no problem. Since having blue shield Medicare ppo inflicted on me, l have had nothing but denials spending precious time speaking with customer care representatives who are uniquely able to keep polite and sympathetic replies to upset client BUT no further along to getting the care l need. Simply put they suck. You just get nowhere and eventually you give up. If l had any choice this would be the LAST plan l would have.

I have 494.99 left to meet my deductible. Received a bill from a provider for 2375.70. Called and asked if I paid the 494.99 and then had the claims resubmitted, then I would not owe anything else. Nope - sucks to me according to them. I have to pay over my deductible by 1880.71 to meet my 494.99 remaining deductible. Only in America could math like this be legal.

I have repeatedly tried to get in touch with Blue Cross in order to correct a serious coverage error in their records of my account. It could not be done through their web site nor their text message number. In both cases I have been denied to speak to a live agent.

I switched from Healthnet to Blueshield Platinum 90 HMO to keep my Doctor. Blueshield has denied every single prescription I was on from the first of the year. After multiple phone calls and waiting two hours on hold I finaly got through. Was told everything is denied and they are looking into it. I checked the Blueshield website and researched my RX online. They say they covered all. I also tried to leave an message in their portal and have and no response. Regretting making the change. Deny, Deny, Deny seems to be the new norm.

Automatic reply after automatic answer, when asking to speak to a person, it says your wait time is 1 minute, I'm past an hour hold. I don't know why they have a customer number. I don't know why I switched to this insurance, but it is the only few options available through work.

The providers don't get back to you with mammogram, imaging, lab, or blood results. Do people have to wait 10-14 days for mammogram, imaging, or blood results? That is crazy! What if something was wrong and those 14 days were imperative for treatment? And the customer service they provide is abhorrent! Emails are not replied to and the live chat and phone options are ridiculous. They provide information you don't ask for and avoid answering what you do ask because they do not understand or know how to research and find the information. The issues are not addressed and now I am worried I have lost all the funds that I wanted to reimburse to my hacking account in my spending account. They are awful -- are not empathetic, do not ask clarifying questions, assume they are giving you the information you requested or just guess at the answers.

Blue Cross DETESTS their customers. The entire executive team are corporate wonks who couldn't care less about the consumer, and are incapable of running any semblance of a customer service business. CEO Kim Keck was clearly hired for reasons other than merit or competency. There cannot be one intelligent person on their entire exec or tech team. I would absolutely NOT recommend using their insurance, and I would also never hire anyone who has ever worked there - big red flag on any resume to have been a part of this sham of an organization.