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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.
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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.
My company contracts with Florida Blue for all our employees in many areas of the United States. Their provider search delivers ZERO results for all the locations where my family and I reside - Southern California, Northern California, and New Jersey. So, we cannot access our care at all. They don't answer their phones. They are closed on Fridays and weekends, so only get sick Monday through Thursday! Basically, this product is useless because they have made it impossible to access. But their CEO makes over $6 million dollars a year. Perhaps collecting everyone’s premiums and then making it impossible to access their service is how he can afford to pay himself so much. Does anyone else think it is immoral for the CEO of a non-profit to earn this much?
BCBS has tried to deny my child therapy to prevent deformity and tried to deny my wife life-saving medication. Lawyers don't have enough money to fight them and they have purchased the state of Florida politicians. They are the same as the rest of the lawless cartel and there is no doubt in my mind they have an unwritten "deny until they die policy". So here is what always works for me. Never deal with customer service. Call the CEO's office. Get the number from Bloomberg. Write a press release with a title like, BCBS denies Mother of 3 life-saving medication or BCBS drops insurance on child without notice. Make sure you are speaking to a representative from corporate headquarters. They will put you on hold for a minute and come back with those words, "Your claim has been approved." Good luck.
The company denied claims in July 2017 due to their explanation that their system changed my primary care physician in April 2017. After months of fighting they paid the doctor, then months later charged back the physician with no communication with me. They don't know why any of this happened and are refusing to pay the claims. I have demanded my premiums refunded to me in full or the claims to be paid with no response. They commit insurance fraud and need to be banned from doing business in the state of Florida.
They automatically deduct their payment off our checking account. They increased our payment without notification and when I called they said, "We mailed it." Well they didn't mail it to us so I cancelled our insurance. I was one day short of them deducting it so they are making me pay for another month before they will cancel. That is how insurance companies make their money stealing from the elderly.
I'm not going to speak about the fact that they almost tripled our insurance from Dec to Jan because "Trump MIGHT take away govt subsidies for Insurance companies". I'm not going to mention that when I signed up I was given a list of doctors none of which ended up taking the insurance. I'm going to say that they are just plain evil! They took off my 5 year old daughter off the insurance without any notice, no email, nothing, She is the ONLY reason I pay for this insane insurance that doesn't care about anything except getting money.
She keeps throwing up even water for 3 days, we go to the doctor and they tell me we have no insurance. HOW?! I go online, and see that she was removed. Just gone. And you would think that a company that is charging so much money would have a customer service line... Tough luck, In their view people ONLY get sick on Monday through Friday. I truly wish the management and the owners had to go through what all of us have to go through. But they won't, they're making too much money off our families to care! Last time I walked in the entire office was empty!!!
I signed up for temporary health insurance. The salesperson told me that after 90 day enrollment period, I would be eligible to apply for "regular" insurance. First, they processed my 90 days policy as 30 day policy even though in the contract it stated it's 90 days. After multiple transfers through multiple dept for two days and 5 hr phone time it was sorted out. Blue Cross accepted they were wrong and made a mistake and made necessary corrections. At the end of my 90 day policy I called to switch to new policy and I was told I am not able to do that. I have to continue with my temporary.
I listened to the customer service individual as I thought she knows more than me as she works for Blue Cross and Blue Shield of Florida and provided her payment information. To my surprise, I received letter to my home stating that I overpaid and that I will get my money back and that my insurance lapsed. People that work at Blue Cross and Blue Shield of Florida Health Insurance are not knowledgeable and are beyond incompetent and they are messing up with people lives and taking advantage of their position in State of Florida. They should be ashamed.
I have been using AvMed health insurance for 7 years very little problem with my medication. My wife change to Florida Blue this year 2018 and it's been a disaster to get any medication for both of us. Life THREATENING SITUATION. In fact, I might have to go to the E.R. TO SEEK HELP.
I have waited 34 days, and have spent hours on the phone speaking with multiple representatives to get a single prescription filled. Just to give you an idea, I've spoken to my doctor multiple times, FloridaBlue multiple times, Alliance (a mail order division of Walgreens) multiple times, Prime Therapeutics (I'm not sure who they are, but I was sent to them by FloridaBlue) multiple times, and Walgreens multiple times, yet my script has still not been filled. If you have a choice of health insurers, I would suggest you pick someone else. My coverage was provided by United Healthcare for over eight years, and I never had these types of problems. If my employer provided a choice, I would insure with someone else.
Had Florida Blue through state employment. Had a good experience. Changed jobs and purchased under their individual and family plans. In short, it costs me thousands of dollars and almost nothing is covered. They send you so much paperwork, even after I told them only electronic. A silly issue I had that created so much headache was around auto pay. I kept trying to set up auto pay and though I had confirmations online, it wouldn't go through to them in the coming months. I would get them on the phone and be shuffled around to departments, it was always a 45 minute or more ordeal.
I had put my newborn on pediatric dental because of the federal laws and I couldn't access that information online so I always had to call in when trying to make sure the auto pay was correct. They would never call me about payment not being in on time, or even email mail. They send a letter, and then the next letter would cancel coverage. When I got customer service on the phone, they were often helpful and pleasant, but then I would find the next month that the issue was not resolved. I ultimately decided to not do business with Florida Blue. I cancelled. 8 days later they billed me again, and I felt compelled to let others know about my awful experience over the last 6 months.
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.
If there was a “ZERO” to give I will not hesitate. The worst customer service and agents ever. In Dec 2017 I was out of state on vacation. On Jan 1st 2018 I was hurt, I called and I was told to go to an urgent care and send them the bill. I told the agent I am not familiar with the area, she asked for my zip code where I was, I provided that, then she said go this urgent care and you will be cover. I walked in gave my insurance card, when it came to pay I was told that I have to pay out of pocket $249. I called FL Blue, I was told, "Oh you need to pay it then send us the bill."
A week later I was back in FL when I faxed all the paperwork including the bill I paid. About 3 weeks later I check the website, claim was received and then by the 4th week it was gone!! I called FL Blue they said some code was missing that I need to provide, I had to call the urgent care and get those code, which delayed the process by another 2 weeks, then in April I was told that it is not covered because it’s out of my network. UNPROFESSIONAL, LIARS and DON’T GIVE A ** ABOUT CONSUMERS!!! Today I called them because my coverage has been cancelled. I was told because of non-payment which is BS... UNPROFESSIONAL, LIARS and DON’T GIVE A ** ABOUT CONSUMERS!!!
I would give zero stars if I could. I signed up for Florida Blue Select, a platinum plan on the marketplace based upon my prescriptions being covered my providers working within the plan and I could afford the co-pays and deductibles. At the time I signed up there were over 300 ob-gyn providers available to choose from within a 10 mile radius, when I went to use the plan after finally getting pregnant as planned the amount of doctors available to choose from within a 10 mile radius was down to 75. All 75 of those doctors work for one company which is rated one star.
I called Florida Blue Select to get to the bottom of this, and was transferred too many times to count. Was told they would call me back and never did. No one knew any answers work and let me speak to someone who didn’t know the answers. Member service representative at Florida Blue Select were rude, spoke over me, did not listen to what I have to say, were not willing to seek the answers of the questions I was asking. After speaking with several managers, they were no help either. Florida Blue Select has chosen to not pay their providers enough money causing over 200 providers that were available originally to drop out of the plan.
Per law there is no regulations, and doctors can drop out any time. However, this does not make it right that an insurance company can offer you a huge array of doctors, and then when it comes time to use the plan hardly any of those Dr. still except the plan. The only doctors that are left are rated one star, Florida blue told me to give them a chance. So I did, but these doctors and staff are rude, incompetent, don’t care about me or my care.
Have been to the office twice now and the level of care is practically something you would see in a foreign country. It is unacceptable. Because I don’t qualify for a special enrollment period, I am now stuck with hoping these 1 star rated doctors and staff can keep me alive, and deliver my baby safely. I specifically chose the plan based on the doctors available, and the prescriptions it covered. So disappointed, but yet I have no other options. Never again Florida Blue Select, will I ever give you my business. I’m paying for a platinum plan but being provided with welfare doctors who could care less about their patients.
Blue Cross of Florida Company Information
- Company Name:
- Blue Cross of Florida