Blue Shield of California Reviews

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.