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Insurance and Gen needs to be revamped. I had a hospital stay for five days - the bill was $57,000. My insurance cover the majority of it. My portion of the bill was 2500 but honestly, if I didn’t have insurance I don’t know what I would’ve done.
The coverage of my health plan is very good. It helps me pay very little when it comes to prescriptions for drugs that I take and also when I had to receive procedures like stent implants to save my life from further heart problems. They came through with flying colors. That is why I shall continue to have Blue Cross as my secondary health plan.
This is a benefit that I retired from work with, fortunately. Good prescription coverage too. It's my secondary health care provider. As far as options, my options are I take what the union negotiated for us.
I am able to use my Doctor, no problems getting an appointment. I have no deductible. Most of my prescription medications are very low cost. I have always been able to get the care that I need: specialists, tests, physical therapy. Going to the hospital was easy and not stressful. Low co-pays.
I had Coventry through Obamacare and they stopped all insurance policies so I had to switch. Florida Blue was the only big name brand offering service on the Exchange. It is hard to find a good doctor there, very limited choice, mainly doctors who just accept Medicaid. I was lucky and found a good primary care doctor. They were good at paying my primary care doctor and my prescriptions. I know going to a specialist is a hassle, you need a referral. Luckily I never needed a specialist, so I can't say much about that. I really had no big problems with MyBlue. It all revolves around who you have for Primary Care Provider.
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Insurance is not like it was in the old days (80's and 90's). I guess doctors back then weren't getting sued enough. Premiums are ridiculous and so is the deductible. I am not impressed with the prescription options. I can get some of my prescriptions cheaper without using the insurance and with FAR less hassle. I do like the online web interface though. It is easy to use and somewhat helpful.
I recently had a colonoscopy. After the procedure I was in a great deal of pain, I was bleeding and I could not pass the gas use during the colonoscopy. Borland Groover Clinic where the procedure was performed sent me home claim I would be fine. Twelve hours later I was close to death. My wife rushed me to the emergency room at Mayo Hospital in Jacksonville Fl. and they performed emergency surgery that saved my life. I spent 8 days in the hospital where there were times I didn't think I was going to make it. I now have a colostomy bag, a huge foot long scar wound from my groin to the bottom of my chest and hospital bills approaching $100,000. I will need further surgery and that means more bills.
Florida Blue has agreed to pay $10,000 and says I am responsible for the rest. They are claiming that since Mayo is not in their network they will not pay. Florida Blue representatives are telling me that I should have gone to an in network hospital. I was in no postilion to shop around for hospitals, I was dying. Regardless my policy claims in writing that if I go to an in network hospital my maxim out of pocket is my deductible $7900. If I go to an out of network hospital my maxim out of pocket is $15800.
Florida Blue is not honoring that clearly written claim and standing by their $10,000 payment. I am trying to recover from this life changing medical event and now shouldering what will be a long tiresome battle to make Florida Blue pay my hospital bills. I have always had health insurance Coverage to protect me in case something like this happens. I am 62 years old and have never had a claim. What an eye opener this has been. I never dreamed Blue Cross Blue Shield could be so unethical. I don't know how they live with themselves.
BC and BC PPO is accepted everywhere by all providers. There is never a question about coverage. Provider and insurance company resolve issues if any without input from the client. Hassle free and reliable.
The high deductible is just too much for someone to meet. I no longer go to the doctor unless I am really sick. It just way too high. You need to lower it. My deductible is $7500, that is totally outrageous.
Florida BCBS use to be a reputable health insurance until they started hiring third party companies like ASH to micromanage the benefits you pay premiums on which makes them crooks. I would highly recommend you find a true PPO that doesn't scam their clients to make them think they have PPO when they only pay to have it but dont really.
The deductible is high, the cost is high, and you do not get many benefits for this Affordable Health Care plan. I would not recommend it to others. They offer different levels of plans, Bronze, Silver, and Gold, but I think there must be better coverage out there. I have not found it though.
I received health care in Hialeah hospital (ER) for head trauma, what was my concern. Dr Jorge ** in charge to review the claim determined that the insurance will not covered the diagnose and treatment. Horrible.
Around December 2018 BCBSFL processed my outstanding covered in network medical claim of $500 as medicare instead of my blue select of florida ppo policy. In result, claim was not paid and rejected to bill issuer and now bill is over 30 days due and will be sent to collection agency. I have called BCBSFL over a dozen times and spoken to two supervisors who assured me that the claim would be reprocessed. However as of today the claim shows that no department is handling it and is sitting stagnant. In the meantime, I am a cancer survivor and need to followup with several doctors but am reluctant to visit because I was told all claims will be sent to medicare and denied because of BCBSFL system glitch. In the meantime, I am making monthly payments for health insurance since October 2018 until present and have been been unable to use services.
I Signed up for coverage ACA end Dec. 2018 to start Jan. 1st, 2019 paid premium stated online same day, also set up autopay for remainder of monthly premiums. Thought I was all set for Jan. 2019, now comes a letter dated Feb. 3rd, "we have closed your coverage because we have not received your first full monthly payment?" When I initially signed up I was stated one amount which they (Florida Blue) immediately withdrew from my account, now they say that was approximately $11 dollars less than the full amount??? Why would I pay an arbitrary amount of $10.79 less than the quoted premium, and why would they withdraw less than the full amount??
So I call the customer service office today, there is nothing they can do, their autopay system is not working in the month of February either - but that’s not their problem - you should have paid the full amount - and they don’t know where that amount came from??? And here’s the CLOSER for all this FLORIDA BLUE - Florida Blue sends out an email to me dated 1-29-2019. Your Scheduled payment is coming up on 2/1/2019. Autopay: *Your total amount due will be drafted. If your account is past due or changes were made to your plan, your draft for this month will be different from the normal amount... Nothing about cancelling your coverage. THIS IS OUTRAGEOUS - HOW ONE COMPANY HAS SO MUCH POWER OVER ONE'S LIFE/HEALTH... This is why you flip the switch in people and there's road rage, why people go postal...
I was hospitalized in May of 2017 for 7 days and was told by the hospital that my insurance (BCBS of FL) would not cover my bill because of an exclusionary waiver. After looking at my BCBS agreement, it was evident that they should cover the claim. I then hired an attorney (for several thousand dollars) and BCBS finally decided to make a one-time business decision to cover the total cost. Over the last year-and-a-half, I've been receiving bills and collections letters and when investigating they keep pushing the claim around or not covering it.
Now the billing agency let me know that BCBS have changed their mind and do not want to cover the claim. I have tried calling several numbers and get nothing but automated responses with purposeful confusing and frustrating disorganization. Any person I talk to is a customer service rep with no power or answers and they often try to transfer me to someone who is not around. I have no choice but to keep my policy because it is affordable when compared to other companies. Remember, insurance companies are not around to provide healthcare...they are around to make money!
I'm already paying $210/month for my policy. It's the cheapest one with a very high deductible. I am stuck on a medication for the rest of my life and with the insurance deductible it costs me $200/month. I decided instead to use GoodRx coupons which I searched for on Google (only took me a couple of minutes). No membership fee, no signing up, it was just there. My meds were reduced to $100/month. Why am I paying for health insurance when my medicine is cheaper through free online coupons? Customer Service is terrible too. There's a reason why Blue Cross of Florida has 1 star. I hope too they lose business. I'm glad the government canceled the tax for those who don't buy a policy. I'm canceling mine.
I initiated my Florida Blue PPO health insurance on November 1, 2018 after coming off of Cobra from my last job. In preparation for the search for new private market coverage my new policy I got many quotes from health insurance companies within a Florida including Florida Blue Cross Blue Shield. After several weeks of research and firm quotes, I finally decided to go with Florida Blue Select PPO based on a quoted monthly premium of $1522.59. I was charged this amount for November and December, 2018. Beginning on January 1, 2019, Florida Blue without any notice increased my premium basically $140 a month for a new monthly premium of $1663.26. This was done without any notification by mail or e-mail.
My complaint is that after two months under an agreed to premium of $1522.59 per month, Florida Blue without any notice significantly increased my premium. In the initial negotiations in September 2018 with Florida Blue Sales Representatives they clearly made it seem as if my premium would be $1522.59 for at least a year but to my surprise, after only two months, I get this $140 increase per month which I cannot afford. The simple fact that Florida Blue May have misrepresented my monthly premium as a yearly guarantee in order to get my business to unfairly compete with other Insurance providers is totally unprofessional and is a clear misrepresentation.
No prior communication shows total lack of transparency. I made four attempts to get this resolved with the Florida Blue Billing and Complaint Departments but was either disconnected in transfers to Supervisors or told there is nothing that can be done. I find this business practice by the Florida Blue organization to be an absolute case of misrepresentation and I have already filed formal complaints with the Florida Health Insurance Commissioner and the Better Business Bureau. Stay far away from the company. Total scam...
Tried to pay my premium for my 2018 Marketplace plan in December 2018. Florida Blue would not confirm my plan or accept payment. They said they were waiting for finalization from Healathcare.gov. Healthcare.gov said everything was A ok. This explanation plays like a broken record. Dozens of calls to FLblue, many with a Marketplace Rep, on the line/3/way. At least 15 case and reference numbers generated by FLblue, these bogus case numbers would change overnight unannounced to me, so when I called to check on the status of my case, FLblue would have no record of the reference number for my case.
After 2 and a half months of NO confirmed health insurance and over $1800 in tax credits harvested by FLblue, I received a bill for over $600 from FLblue. They informed me I was covered since the 1st of the year. When I said I had proof their office they denied to confirm coverage and denied to generate a bill for this coverage and denied to accept payment, FLblue said, I have no further information for you. They are breaking the law!!!
How about we enact a new federal law: Any corporation that puts a "This call may be recorded for quality or training purposes" recording at the opening of their customer service helpline, automatically agrees, by LAW, that they are allowing themselves to be recorded as well. This review is not about warning innocent people about being yo-yo-ed around by insurance companies. This report is about exposing those responsible for stealing money from the US government and its upstanding citizens. Time to put some of these CEOs and upper management in prison. Oh ya, same thing is happening to me again right now in 2019.
Paid full premium for 6 months, (nearly $1400 per month), after losing subsidy, didn't hear anything from them till going to our pharmacy, was told we didn't have insurance, they told me after calling I had not made a payment when I did... If you're shopping around, I would suggest going elsewhere - this was not a good way to do business after being with them quite awhile - going elsewhere...
Aug. 13, 2018, my ACA premium tax credit for Sept. changed based on income documentation I submitted for 2017. However, my income drastically changed between 2017 and 2018. I appealed the decision in early September. Oct. 26th I got notice that that the August decision was overturned and, as instructed, requested that the reversal be retroactive to Sept. 1, 2018. I had also asked for it to be retroactive in my initial appeal. Until my insurance company (BCBS) gets word from American Health Marketplace that the tax credit is retroactive to September 1, there's an additional $600+ showing as owed for my September BCBS payment. BCBS has stopped my health coverage until the $600 is paid. If I had $600, I wouldn't be on food stamps and need the ACA tax credit.
Based on lab analysis done for a dermatology visit in Oct., my doctor has said that I have an aggressive squamous cancer lesion on my leg that needs surgery ASAP. I can't afford the surgery until my insurance is operable. American Health Marketplace told me today that they have 90 business days to respond to the retroactive request. That date is February 26, 2019. I'M HAVING TO WAIT 4 MONTHS FOR CORRECTION OF A MISTAKE THAT THEY MADE! As I wait, the cancer continues to spread and eat thru my leg!
Florida Blue has been denying claims with medical records and also pretends they do not receive claims. Also, if a patient has a high deductible, they will process it no problem because the patient will have to pay. If Florida Blue denies claim even with notes and the patient has a PPO plan, the patient will be responsible for the full amount as well.
We try to accommodate our patients when Blue Cross denies claims. After 10 years in this field, I can see that their plan is to pay on a few claims for a patient, then they begin to deny claims hoping providers will bill the patient because the insurance company knows they will create friction between the office and patients and the patients will feel they should go elsewhere because they don't want to pay for medical costs when they pay a fortune on their insurance. I have been battling the claims department on complete nonsense denials and it is completely frustrating because we are complying with what they request and they are not doing their part. Since 2009, this company has been denying and rejecting claims more and more and they are doing anything possible to not pay.
I called on September 29 to have BCBS stop my auto payment for October. I was told a bill would be mailed to me and if I didn't pay before November 15 my policy would automatically cancel which I wanted because I have new insurance. However on November the 2nd BCBS withdrew October and November premiums for a total of 1,900 dollars. I have gotten zero help from them to have this issue resolved.
Even though I checked for doctors on my plan during enrollment, they all dropped my insurance come January effective date. Then after seeing 1 option for Pediatric orthopedics for my son 3X for the same issue with no benefit I tried to get a second opinion. Guess what? After calling 10 specialists in my area, no one accepts my insurance. My prescriptions are often a battle to get covered and I’m over it. Why is there only 1 option in FL? All the doctor offices say FL Blue is the worst for reimbursement. I don’t want them anymore!!!
Under our Fl Blue policy my husband and I, both diabetics, are entitled to certain lab tests 4 times a year and one diabetic retinal exam, at no cost to us with $0 co-pay. The eye doctor says we owe a $75 co-pay and the lab makes us pay a co-pay (it goes on our credit card they made us give them at the lab) for the A1c test, lipid panel and urinalysis. Those 3 tests and eye exam are $0 co-pay under the Value Based Diabetic Program. Fl Blue keeps denying our reimbursement for services we had to pay after 3 bills and a debt collector calling, saying the eye doctor and lab aren't using the right codes for them to be the $0 co-pay to us.
Last I checked, both places have not gotten this cleared up, even after they called Fl Blue. We are entitled to these benefits and Fl Blue won't help the eye doctor or lab with the correct codes, what do we do? Now they want to raise our $1,500 a month policy $243 more! This has been going on for 6 months with me calling every month to get my labs etc. paid back to us.
I had no idea when I signed up for BCBS that I would be limited to the experience of Sanitas, the medical facility you must use if you sign up with BCBS in Miami. You cannot call your doctor’s office, all calls go through a call center (the primary language is not English), appointments must be made months in advance and last 10 minutes. You have to go to the doctor to get a referral and referrals take weeks (sometimes months), you cannot use CVS or any other drugstore - just Walgreens. You have to use their urgent care center which is poorly run and not at all convenient.
If you have any questions for your doctor or their office, you have to call the call center and no one knows what you’re talking about. They have to get in touch with the doctor’s office which can take days. Appointments are cancelled by phone days before when you have been waiting for a month to get in. So inexcusable. If you told people this before they signed up, they would and should go elsewhere.
On a weekly basis now I am getting calls from my Primary care Dr. stating my insurance company says I am not compliant and not doing their required test. Today I got a call that I had not picked up one of my medicines. That was a lie. I ordered it on a Monday and did not pick it up until Saturday. HELLO! Maybe I didn't need it Dumb buts. Where are all the attorneys who like to sue places. When insurance companies start controlling your life and what you have to take and test to do then that is not a good thing. Florida Blue is good but not the best. They do not offer anything when it comes to Vision or dental. Time to move on to another insurance company.
Florida Blue is an insurance company I would NEVER recommend. First, they think they know better than specialist doctors, without doing any exams or reviews of records. They continually deny needed procedures, even when multiple doctors say they are necessary. Secondly, they tell you that if you are out-of-state, just go onto the national website to find in-network doctors. But if your Florida doctor orders a test, they deny coverage for being out-of-network because it's out of state. And even their reps don't know about this, but the lab says it happens all the time.
They denied a claim from my hospital back in May saying they needed the medical records from my surgeon. My surgeon's office sent them 3 times to the fax numbers provided! I’ve called BC/BS FIVE times about this claim. Two of those times, they said they received the records and they were with the Medical Review department. Today, they tell me they have never received the records and there are no notes in the system from my last two calls where the agents said they were still in review. This agent said she’ll call me back after she speaks with medical records. I’m not holding my breath – and I told her that. EVERY agent has said they will call me back and they never do. This is so frustrating - it's been going on for over FOUR months! And this was a pre-authorized procedure in the first place!
I'm tired of the completely incompetent customer service agents who have clearly been lying to me every time I call. I was also billed for my estimated portion by the hospital, which I finally paid because they were threatening sending the account to collections, but that amount would have been based on not having met the deductible yet and at this point, most of it has been met, so if/when this claim ever gets paid by BC/BC, I’ll have to fight with the hospital to get money back most likely. I can only hope that my husband's company changes providers this year because I can't fathom dealing with BC/BS much longer. In 20+ years, I've never had such problems with an insurance company!
I was dropped by Aetna because Aetna pulled out of the Central Florida market. When I compared replacement plans, none of my providers accepted my insurance except Florida Blue PPO at $867 month plan. The coverage I now have is exactly the same coverage I had previous to OBAMACARE, which I don’t qualify for any subsidies, but my premium prior to the HORRIBLE OBAMACARE HEALTHCARE DISASTER THAT IT IS, was $267.00. I may just self insure and get a catastrophic plan.
I am being discriminated against because I am a ** woman who chose to work and be self supportive and self employed. By the way, I have worked in the healthcare field for years, I am not a Dr or a nurse, but I spend my days in hospitals for my job. Often ICU and critical patients. I can GUARANTEE YOU THAT THE DOCTORS YOU GET ON THE LESSER PLANS are not equally qualified as the doctors I can only access through self pay via MD VIP practices or plans that are $867/month like I am forced to pay. I am a single mother putting two daughters through college and I can’t afford to save for retirement with ins. coverage like this, but I also can’t afford to have poor healthcare coverage because I have personal first hand knowledge of how quality medical delivery is vastly different based on each individual physician.
BEFORE OBAMACARE we could at least afford healthcare and the truly needy could not legally be turned away from the hospitals, so we formerly subsidized their care with our tax dollars just as we are now being asked to do today. The difference is now those who are paying the taxes to insure those who rely on the Govt. can no longer afford to pay health insurance themselves. In addition every Doctor I know is trying to leave their practice or retire early and are definitely leaning heavily on their own children NOT to go to Med School themselves.
Blue Cross of Florida Company Information
- Company Name:
- Blue Cross of Florida