Blue Shield of California Reviews

We have a high deductible of $7000 for both of us. We met that deductible in June plus the co-pay max. of $2000. So the $9000 per year out of pocket has been met. I was diagnosed with cervical cancer and had to undergo a hysterectomy plus radiation and chemo. The hysterectomy procedure was preapproved and so were the radiation treatments. When they submitted the bills, Blue Shield of CA kicked them and did not pay almost $40,000. They will screw these health care providers any way they can. My advice is go somewhere else for insurance.

My daughter has knee injury so the orthopedic doctor wants an MRI, which needs to be pre-approved by Blue Cross. Here we are 3 days later and nothing. My husband was on hold for an hour already today and I have been on hold for nearly 30 minutes. We pay approximately $1,500 per month for their premiums. Something needs to be done. This is unacceptable.

I am a neuropsychologist in Northern California, who has been burned every single time I've seen a patient with Blue Shield insurance. I was a hospital-based consultant and had to stay on the panel to be compliant with my job. Now that that job is over, I am off that panel and couldn't be happier. Blue Shield routinely gives authorization for services that are (or should be) covered under a patient's plan. The clinician (such as myself) provides the services in good faith and then once the claim has been submitted, eventually receives a letter from BS denying payment for one reason or another! Over and over and over again. They also violate their own contract with clinicians by sending partial payments (20% of the claim or less) directly to the patient. I have never once had a patient pay me after BS has sent them the check.

Blue Cross sends all claims and phone calls out of country. These people do not understand medical at all. They only give responses they read from a computer and they never write the correct comments. I had a bilateral procedure and it took a year to get the outsourced company to process the claim as bilateral not unilateral. It cost me time and money. Society needs to wake up and stop outsourcing the American jobs. If my claim was processed here in the States, they would have paid the first time because they know what bilateral means. Stop paying premiums to BC because they pay little to their employees and do not forward that savings to the member who have to pay full price.

I called Blue Shields number and I provided my name, DOB and address to the screener and then she transferred me to an agent. The woman at first was polite when explaining the first option with limit doctors' visits. But when I started to ask about different plans including unlimited doctors' visits, she changed the tone of her voice and says, "health insurance is like car insurance, it's for emergencies only," and other very condescending statements she used. I told the way I felt and hang up the phone.

I am trying to figure out if I can afford a surgery on my shoulder. I was given the CPT code for the procedure by my doctor's office and called BC to determine just how much my insurance would cover. Blue Cross said they can't give me the information because they don't know what the surgery center will charge. How is one supposed to know if they can afford a procedure if they can't get an idea of how much it will cost prior to doing the procedure. I made this analogy for them and it didn't even faze them.

Non-member status since 2009 - Stop sending explanation of Benefits Summaries to previous address, **, Sunnyvale, CA, 94088 and to current mailing address, Cathie ** Santa Clara, CA. 95054. Now, the Dept. that handles crossover/cancellation request to Medicare parts A&B was supposed to process the notification of cancellation of Plan C Pre-65 in December of 2011.

Co-pay increase. I picked up my prescription that is normally $20. It has gone up to $50. How on earth can a 110% increase be justified?

We have reason to believe that Anthem Blue Cross and their network providers are engaging in fraudulent billing during office visits. My office PPO copay is $35, but it is very unclear what this covers during the visit. On several network doctor visits for various minor health care issues such the flu, colds, minor sprays, allergy tests, and such, I have received large bills from the visits that itemize procedures that were not disclosed to me at the time of visit.

I pay $155 per month for my insurance, which basically doesn't do squat except pay for most of my medications. Today, they let me know they were raising my rate by $40/month. Why? I'd love to be given an actual valid reason because I've yet to hear one. What did I do? The coverage is bad enough as it is! Why did you raise my rate by $40/month?! Is it because I passed a kidney stone two months ago, which you guys didn't cover anyways?

Received okay by insurance at dental office and a month later, Blue Shield changed their mind, they were charging me $721. I have been disabled since 2008. It can't even function right anymore and I used to be smart.

I had gone in for my annual pap, which is covered by my insurance. I have barebones insurance which I paid $340/month out of my own pocket since I am self-employed. While at the doctor’s, after the procedure, she asked if there was anything else she could do. I showed her a small wart on my thumb. She said she could easily take care of that. Within 5 minutes, she had used liquid nitrogen to "burn" off the wart (which eventually didn't work).

Since I became eligible for Medicare, I have been enrolled in Anthem Blue Cross Senior Classic F plan. When attempting to review information online, to prepare for the current open enrollment period, I discovered Anthem was showing a different lower current premium for Plan F, for my age 70 and area 6, than I have been paying. I am paying $240.70 a month (paid bi-weekly $481.40), and the current premium Sold for Effective Dates On or After June 1, 2010 is $158.36 a month. A difference of $82.34.

I just called to confirm that my premium plus deductible totals over $300 per year, yet the maximum benefit total is $500 per year. More than half of my "insurance" is already covered by my premium. This is disturbing and should not be legal. If my auto insurance was as expensive as my dental insurance, I would have a $5000 premium every month.

Blue Shield of CA is the biggest rip off there is in America. I have been insured with Blue Shield of CA through my employer for 13 of the past 15 years. I have insured myself and daughter.

Hi, Levi of Hesperia. Desert Valley Hospital is a privately owned, for-profit hospital. Dr. Prem ** dropped his contract status with BCBS years ago. Like you, I have learned it the hard way. The same situation occurred to me in November 2010.If you dig deep enough, you will read and find that ** strategically operates this way in order to gain multi-millions of dollars. Another Dr. ** admitted me! They are probably related to each other.

We have an account just for health care payments which Anthem Blue Cross Senior Classic F and the Rx plan was a automatic monthly withdrawal. The problem is with only the Senior Classic F payment and not the Rx. Our bank was PFF and there was no problem for years until PFF was taken over by U.S. Bank around the first of 2010. The bank sent out to our health provider the new account number. We thought this was taken care of. In reconciling the U.S. Bank statement, I spotted no withdrawal of the Senior Classic F since April, 2010.

August 22, 2007, I went to Desert Regional Medical Center, located at 1150 N. Palm Canyon Dr. Palm Springs, Ca 92262, to have a tumor removed from my stomach. Everything was pre-approved by my medical insurance (Anthem Blue Cross) prior to the operation. The sergeant was five hours late. I had to go back to my home for several hours. The Doctor, Hospital or Insurance company did not give me a choice, they did not say because the doctor is late there is going to be different anesthetist or would you like to reschedule.

Anthem delays sending member ID cards. I've been insured and paying for the past two months and even after two phone calls to request an ID card, they haven't been able to provide one. I payed $615 per month and they can't seem to send a ten-cent ID card. It's very difficult to obtain health care using insurance if you don't have an insurance ID card.

On July 5, 2008, I experienced acute pain in my lower left abdomen and went to the ER. I looked online to ensure that the ER was a Preferred Provider under my PPO plan. My wife and I decided on Desert Valley Medical Center/Hospital since it was listed as a Preferred Provider for emergency room services. After spending the night at the ER, I was admitted as the pain did not subside and the doctors could not properly diagnose the cause of my pain. After I was admitted, I was told that I had a kidney stone that was obstructing my left ureter and surgery was required to treat this condition. Additionally, I was told that the doctors were worried about my heart beat, which was very low. The cardiologist recommended further tests for my heart.

After just 6 months on new policy, premiums have been increased by 23.5%. Calls to a phone number ended with a message that the call cannot be completed. I have had an HSA with Blue Shield for about 10 years, and I have this constant struggle to keep it affordable by increasing the deductible. The recently passed Health Care Bill is a joke. My income hasn't increase at all over the past 3 years and can't afford these double digit increases that the insurers use to pay their selves fat salaries.

My wife was in need of allergy shots which were going to be very expensive. We were told to check with our insurance company to see if the services were covered. We called and got confirmation that the services were 100% covered. My wife decided to get the shots. About a month and half after the 1st shot, we received a statement from the Health Care Provider that the insurance company was not going to cover all services.

My wife passed away from cancer on 10-19-07. She was treated there for the final days of her life. I had to pay BC Health Services over $20,000, then later, I filled out the Claim Form for Anthem Blue Cross of Ca., which I sent in around Nov. 2007. I called numerous times to find out the status of the claim, with no results, always talking with different people. On approximately Jan. 11, 2008, I was notified by mail that the claim was denied stating additional information. I asked what was this about, but they did not tell me that I had to pursue the additional info.

My wife and I are members of Blue-Cross BlueShield of California. In December 2009, while on vacation in Brazil, Lora was hit by a bicycle rider. As a result, we incurred several medical bills for emergency surgery etc. which came to over $19,000 Brazilian Reals which comes to over $12,000. These bills were originally mailed to Anthem on February 8th 2010 and I have yet to receive a reply. I called Anthem several times and spoke to Quava who indicated that they were having difficulties with my claim because they needed more information about the surgery.

My daughter has had inserts since the age of five because of her flat/bad feet. The reason I am writing this letter is to get my insurance to pay for new inserts for Krista because she had grown out of them. In 2001 or 2002, our insurance paid for the orthotic inserts for her shoes. Around 2008, there was a change in insurance policy at Blue Cross and Krista was denied for new inserts. Because Blue Cross denied her claim, we had to pay to go get the inserts for Krista. Krista often says the inserts help with the pain in her feet.

I was released from a hospital and the doctors gave me a prescription, for two bleeding stomach ulcers, which Blue Cross refused to allow filled. How can a clerk override the findings of an MD?

The County of Fresno changed health plan providers on December 15th, 2009 from Blue Shield to Anthem Blue Cross. They (the County of Fresno or Anthem Blue Cross) have not provided the ID cards necessary to get medical coverage. The county did send out emails saying we could print temporary ID cards from the Anthem website. The website is defective and puts the user in an endless loop of logging in and starting over and does not offer the option to print an ID card! My wife needs to see a doctor and we cannot because we do not have an ID card for Blue Shield. I just want to confirm that we do indeed have the healthcare coverage and would like to know why we do not have ID cards even though we have been charged by payroll deduction since December 15th 2009.

My name is Vinhloc ** and I am writing this letter to appeal the claim (**), which the Chino Valley Medical Center billed to the Blue Cross on July of 2008. The total of my claim is $4,678.64 plus interest of $599.78, equal to $5,278.02. On July 17, 2008, I was taken to the Chino Valley Medical Center from my workplace (by Ontario Airport, CA) by an ambulance due to sudden faint. After a few hours in the emergency room of the Chino Valley Medical Center, I was admitted to the hospital there for 3 days. I received a bill from the Chino Valley Medical Center stating $4,678.64 is my responsibility of the total amount billed to the Blue Cross ($14,895.58). I immediately contacted the billing office of the hospital for more information.

I was insured with Anthem through Cal-COBRA and never received a notice in the mail that my coverage was stopping. I am now without health insurance and not by my choice. Today, I received a notice from them that is back dated August 9, 2009. I never received this notice. I called several days ago to find out why I had not received my monthly bill and that is when I found out I was no longer insured. I believe that is why they sent this notice to me today.

I overpaid my insurance premium by paying $1,233.26 for the month of July 2009. Check #**, dated May 29, 2009 and cashed by BS on 7/2/09. My insurance coverage ended on June 30, 2009. I have still not received a refund after three communications. The first response was on August 12, 2009: "Thank you for your question about medical benefits. Our records show a refund was set up on July 17, 2009 to send to you. You should hear from us shortly." I have heard nothing. After two more contacts from me, I have still heard nothing. It is now Oct. 13, 2009 (3.5 months after the check was cashed) and I have still not heard nor received anything. I now expect a refund of $1,233.26 + $50, totaling $1,283.26. The $50 represents the late or reinstatement charge Blue Shield would charge if I did the same thing to them. I will also ask for interest.

It is impossible to connect with someone who can explain my coverage. The first person I spoke with had such a strong Filipino accent that I had to ask him to repeat everything. I speak several languages, so this isn't xenophobia! Then, when I tried to get a supervisor, he put me through to a mail-order pharmacy, which had nothing to do with my call. I tried to file a complaint at Blue Cross's website, and it kept rejecting it!

I was laid off of work on July 24, 2009 and my health insurance ended on July 31, 2009, at which time I opted for COBRA. I mailed two months' worth of payments on August 1, 2009 and was received by the third party administrator. They processed the activation back onto Blue Cross Blue Shield and it was sent to them on the 9th of August. On the 14th of August, we still did not show as covered. Consequently, the third party administrator "CONEXIS" sent an urgent email to reinstate my wife and I. I called again on the 26th of August 2009 and we are still not showing as covered. I have made calls with no results. I was passed onto the special services group and that can take up to 10 days for a response. All this time, my wife is awaiting coverage for test to be scheduled for neck pain.

They raised my monthly rate by $492.

My wife had an emergency visit to the hospital. We have coverage through her medical plan, Blue Shield, who initially paid the bill. We also have coverage on another plan through my retirement, Kaiser. Blue Shield asked for a refund after they paid the bill because they are saying my wife is covered primarily through my coverage. I am the primary coverage through Kaiser and she has primary coverage through Blue Shield. Now Blue Shield is saying our claim is denied because the time to make a claim has expired. We are getting billed from the hospital for $729.00 because of Blue Shield's refusal to handle this claim.

I received my Anthem Blue Cross Health Insurance billing statement (due 3/1/09). My insurance plan is a $5,000 deductible plan. My insurance premium went up 38% (from $267 per month to $368 per month). That represents a $1,200 a year increase. I was told by Amber at 800 333-0912 that the Department of Managed Care approved the increase for all their policy holders. I called the Department of Managed Care at 800 400-0815. They told me they do not have any jurisdiction over the insurance companies. They only require the insurance companies to inform them 30 days prior to a rate increase. MY COMPLAINT IS: My rate went up 38% on a $5,000 deductible health plan. I can't believe this is a reasonable increase. Is there any investigation arm of the government protecting us from unfair rate increases by Health Care insurance companies.

Blue Cross raised health insurance premiums on March 1, 2008 by 40%. Now on March 1, 2009, I have been informed the premium is being raised again by 34%. I think something is wrong here. Are Blue Cross executives thieves without any conscience or just plain incompetent individuals that do not know how to manage a company for the benefit of its members?

I was denied coverage after having my parents group coverage and school coverage end. This is the same company that has been my health care provider since birth. I am overweight, but apparently I'm supposed to weigh 102 lbs and that was one reason I was denied. I was denied for taking oral contraceptives for an irregular period and for taking some medication for social anxiety. Apparently I'm a high risk for taking some medication, even though I'm almost never sick and almost never go to the doctor except to renew my prescriptions. Logically, since when covered by them I came to have all these conditions it's both ridiculous, stupid and should be illegal that they won't cover me any longer.

Anthem Blue Cross lately has had a bad reputation and one of the reasons is stated below. I had an Anthem Blue Cross Dental 100 PPO in effect and went in to my dentists office, Premier Dental in Aliso Viejo, California in pain for a dental procedure on 2/4/2008. We (my husband and I) have now paid the entire bill of $521.00 to keep our reputation and credit secure, after Anthem three times by phone said they would pay this claim, now delaying payment by asking for more and more information which we and the dentist consistently sent, including a X-rays a narrative from the dentist relating to the pain I was in.

I had Blue Shield for 3 months, went in for my regular check up, found a cyclist, had it remove. $18,000.00 surgery. Blue Shield will not cover it saying it was a pre existing condition. My doctor wrote a letter stating it was Not a pre-existing condition. They refuse to revise this bill.

My daughter was covered under her dad's policy through Cobra after she turned 22. (At 22 the policy kicks you out even though she was still a college student). In May 2008 she was approved by Blue Cross for major knee surgery - reconstruction of the medial patella femoral ligament with a cadaver ligament - following a college cheerleading accident. On June 22 she had the surgery. When the surgery center submitted the bills she was suddenly no longer covered. She was cleared by Blue Cross for both the surgery and the cadaver ligament. We have evidence of this from the transcript notes at the surgery center.

Tonik Health, a subdivision of Blue Cross mailed out a notice on 6/20/2008 that a plan benefit would be dropped as of 3/1/2008. The implication of this is that if any member had gone to an emergency room, their cost for service would increase from $100 copay to $5000 deductible, yet would be unaware that their policy had changed because Tonik did not send out notice until over 3 months after the service change.

Blue Cross mis-entered the procedure/diagnosis code for an annual exam. Blue Cross put down that I had a missed abortion and refused to pay. Called and told them they looked at the wrong column, that the diagonis code was for the far right column. The BC rep insisted that I was wrong and I told her that I never had been pregnant and never had an abortion.

Blue Cross of California is charging $2 dollars to every person who doesn't sign up for their Automatic Payment Plan. They are saying the costs of paper mail is taking a toll. I said that I'm paying automatically through my own online banking, but I'm still being charged the $2 dollars. When I pointed out that it's very sneaky to add the fees into my premium instead of itemizing it so I can see the charge, they responsed, "Yeah, it is..." Don't they make enough from my high premiums?

Rec'd my bill. As I was reviewing it, it stated that a $2.00 Admin Fee has been added to my bill. I can waive this fee by enrolling in their automatic premium payment program. I called the # and asked what the admin fee is for. Customer Service (Tamika) said that I will get charged $2 any time I mail in a check or do a one time payment through the automated phone system... and the only way to get this waived is to enroll online for a monthly recurring deduction from my checking or credit card....I would rather go online and make a payment on the date I want to, and I usually pay for two months at a time, but that is not a possibility...I have to have a specific recurring date every month...I do not have a specific date for when the money will be in my account...I think this admin fee is unfair, especially if I'm paying for two months before hand and on time....Is it even legal to do charge such a fee for choosing conventional payment methods..i.e. US mail or automated phone service.

My wife spoke to CHRIS JOHNSON on june 25 2007 at 7:00am and advice her she needed to fax the HIPPAA form again since it was lost for a cost of 6.00 total again.

We her parents went ahead and paid the physician costs--the radiologist and the physician that did the breast biopsy--but want to force Blue Cross to pay for at least something.