Blue Shield of California Reviews

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.

Each time that I have needed to find a doctor, there has been an issue with the website. This is so irritating! It takes me a while to want to do the research, and when I do, the website has an issue loading information.

Compared to our earlier insurance, Cigna, the current insurance, that is Anthem Blue Cross, truly has been a nightmare! Every single medical bill from the start of insurance was denied the first time, but all of them got approved upon reappeal. All providers were deemed out of service the first time and then confirmed over phone that they're indeed within network. Any lab bills, any consent form, any vacation waiver approval doesn't get approved first time and has to be explained in multiple calls, some explaining the minutae of the English language or the fine print already mentioned in the Anthem form.

Horrible! They don’t care about people, they care about money and money only. They only want to cover the lowest cheapest and worse medications for you, not the really good high price medications that will do more good than bad to you, this because they have to fork out more money. They will give you a million excuses to decline the medications you need. STAY AWAY FROM THEM, AVOID THEM IF POSSIBLE, FIND OTHER INSURANCE.

If I could I would give them zero stars. They're terrible, their customer service is terrible, their protocols for adding or removing members from policies are terrible. Their systems are as broken as Blockbuster back in the day. My only hope is they go the way of Blockbuster and all the bloodsucking ticks at the top end up squeezed until they pop.

I got my vision and dental insurance here through Covered California. When I got insurance through work, I called Covered California to cancel my policies. I was told it was no problem, and was even congratulated on getting insurance through my employer. Six months later I found out that while my dental insurance was canceled my vision insurance was still being charged. It was $6.90 per month, so it had slipped through the cracks for months. I called Blue Cross to ask why my policy had not been canceled and was told that they had no notes of it being asked to be canceled. So, after over an hour on the phone I was told that since there was no proof that I had tried to cancel all they could do would be to cancel now, but I would not receive a refund. Do not go to these people! They do not care and will leave you high and dry without a second thought.

I wish I could rate BCBS of CA -1 stars. As a chronically ill, disabled person who worked in healthcare for 20 years before medical retirement, I have worked with and seen a lot of insurance companies in action. This company is by far the worst; it has the worst website, the worst app, and the most unprofessional and untrained/uneducated customer service representatives in the industry. Shop elsewhere if at all possible. This company should be investigated.

Anthem Blue Cross PPO acts like an HMO. You need prior-authorization for EVERYTHING. Need an MRI? Guess what? You can’t have an MRI until you get an X-Ray and a CT scan first. Can’t get a CT scan due to allergic reaction to Iodine? You get to take massive doses of steroids before the CT but you’re still getting the CT scan. We pay cash for a lot of specialty tests that the doctor recommends simply because of the red tape or the tests is just not covered.

Several times I was told by my doctor that "my insurance told them that it is ending" mysteriously in the middle of the month. When I call my insurance they have no idea what that is about. My claims were all initially denied. All appealed. All denied "in error." There is a strategy here. They are trying to ensure that you do not use the insurance you have paid for. They need to be fined and heavily. I couldn't even get the medicine I needed the first month because the insurance moved so slow and caused so many problems that I failed to get the services I was entitled to use.

I placed a grievance with the grievance department. I get a letter indicating that my grievance was submitted to a medical director, however the letter indicated that the grievance was with the incorrect physician. WHAT? What a waste of my time. They spend more time getting in the way of patient care than they do providing patient care. The entire system is in violation of patient's right to care. It's time for the elderly to demand that these health care plans adhere to the contract patient's rights. They are killing us by tortuously denying health care.

My mother has this PPO insurance. They do not approve needed services that are recommended by the doctors. They will find the cheapest alternative, with no concern for the member’s best interest. You are most vulnerable when you have the greatest health needs. There is a rehab center that helped my mother in the past regain her strength after she had an infection with sepsis. We had to fight and appeal to get her there. My mom had the same infection after a biopsy done at the hospital. We again are having to fight with this insurance. They have denied it and any decent rehab facility.

This is absolutely the worst insurance company in the world, scam is more like it. They charge a lot for PPO insurance, but they don't pay for anything, everything is denied or not covered. when we call them they give us the run-around, we will never deal with this scam of company again. No wonder they lost a federal case for 2 billion.

February 2023. I'm making this review in the hopes that anyone reading this during open enrollment will be able to make a better decision. No one expects to have a positive experience with an insurance company. But this one is far below average. The company is trying to boost profits by denying micro claims and it's just causing me way too much frustration. There is no reason for this but to squeeze every dime out of subscribers. I know our family's medical expenses are not covered. I know that this disease is too "new" and too "expensive" to treat. I get that and I pay for the insurance for emergencies only and for them to cover anything in the off chance that it falls under the "normal" treatment umbrella. So when my doctor prescribed an antibiotic, I assumed it would be covered. Well I assumed wrong. It needed prior authorization. Okay, I assumed it would be straight forward. Well I assumed wrong.

Nice insurance. Covers maximum regular lab tests and visits. Rare lab tests which are not covered. Annual physical covers all lab tests. Apart from this provide less out of network cost. Easy billing from insurance

Worst insurance company I had to deal with in my entire life. The coverage is pretty good when things are going well, but it is rarely the case, and the stress of dealing with them is not worth it. They deactivated my coverage twice in 3 month due to a billing error, which happened as a result of their poor billing system, not because we didn't pay. We called them to fix the issue, the latest update was basically "we are aware of the issue and working on it", I heard this message 2 weeks ago. They are obviously not doing a good job working on things because I am without health insurance for over 2 weeks now, while pregnant, I must add.

When searching for a supplemental plan for my mother's Medicare A and B plan, I decided to select Blue Cross. I noticed that most of the benefits included were already perks in her regular Medicare plan but since I was bombarded with letters and tv commercials regarding the great additional benefits I figured we would give it a try. This “additional coverage” only prolonged doctors' appointments because of the excessive requirements for referrals. I think these plans exist to represent the political power of organizations proving limited coverage for the elderly and proving political strength of programmatic structure forces against expansion

I am a PCP and have been trying to get behavioral health services for a patient of mine since 2019. No luck. I have provided counseling for free in the interim because her HMO does not provide MH services. Today my assistant and I spent > 2 hours on the phone with provider services and then patient services. We were transferred 5 times and they then they just abandoned the call. They obviously just don't care. I will encourage the patient to file a complaint. I will file a complaint with the department of managed care services and her HMO.

BlueShield is ridiculously expensive and almost every time my doctor needs to get approval for something, it is denied as Medically not necessary. My doctor and I always discuss treatment options and then proceed. How can a "doctor" who has NOT seen me, make a judgement as to what is necessary or not!? This is ridiculous. I have been in serious pain and this is the plan that the doctor and I decided upon (chose to try and avoid surgery). I pay extremely high amount per month for a PPO, plus I have to pay a copay, PLUS PLUS PLUS... I am getting NO care from Blue Shield! I have to appeal everything and in most cases appeal to the state board. Blue Shield is the WORST! If you can avoid this company, I absolutely recommend looking elsewhere!

Blue Shield did not cover their portion of a bill from an IN NETWORK provider that I was referred to and received prior authorization. I submitted an appeal/grievance, Crystal H was the coordinator, and she denied the grievance, stating the doctor was out of network. I was asked to re-appeal with my "new information." However it is not new information, all this information is readily available on their own Blue Shield website and within their own system. They apologize for being "so busy" but if they just do their job correctly the first time, they wouldn't be so busy. Ridiculous, and the cause of expensive health insurance fees - administrators who cannot do their job correctly the first time and get "so busy."

My experience with Blue Shield has been the worst. I will recommend or renew with this insurance provider. In July of 2018, I was taken to the ER in Nevada to Sunrise Hospital for immediate treatment. I had given all the proper documentation with correct Blue Shield insurance information - to the Sunrise Hospital. I ensured I paid the ambulance bill, which blue shield covered.

I changed policy type for myself and 2 daughters in January to save money. They told my broker to start new applications for each of my daughters and they would keep me on the same policy number. That was the start of my problem. I paid my premiums on time for each policy separately. Come January I log on to my account and it says I owe over $1900! Their system has all 3 of us on the policy still and for the old higher premium from 2019. I call to get it fixed. I was patient and was told it was fixed.

I work in the UR department for Mental Health for adolescents. This company puts children's lives at risk by providing them with the less than minimal service. I have watched them for years get away with denying VERY sick children the mental health services they need. For perspective, other mainstream insurance companies provide up to 20 days of service for the children to get treatment. They give 6-8 days. If you have children, STAY AWAY FROM THIS INSURANCE COMPANY!

It took me hours to get a couple of questions answered. I was hung up on once, the second time the person went silent and they were from another country. Just now as I type this again I was sent to the wrong department and the guy went to transfer me because I was transferred to the wrong dept, and he hung up on me... I have lost my patients.. BCBS and anyone who has anything to do with insurance, medical, or any other life issues needs to hire people with competence... These people don't know how to listen to a simple question, they can't even transfer a call to the correct place or transfer a call at all!!! Real INCOMPETENCE BCBS. Disgusting

My husband and I are going through infertility treatments. We have Blue Cross Blue Shield of CA. First they told the fertility clinic that my procedure was covered. Now all of a sudden they are saying it isn't covered. My explanation of benefits show it is covered. The clinic has been fighting with them to cover it. While going through fertility treatment, it's best to minimize stress. This whole situation has been nothing but stressful. They are awful. I filed an appeal and the lady at my husband's district office is going to try to get it sorted out. If they stick with the denial, we are switching ASAP. Shame on them.