About Blue Cross Blue Shield of Florida
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There is a fraud going on with company CareCentrix, subcontractor of Florida Blue. They use Phillips recall of CPAP machines to prevent eligible people from getting replacement after 5 years. I got CPAP made by Phillips in 2015 and when I requested the new one they turned me down because of the recall. CareCentrix is subcontractor that does the dirty job. In short, despite of the fact that I pay approximately 6000 dollars yearly as self employed person, Florida Blue and their partner, CareCentrix are not going to cover a new machine and I will have to buy it online for $750-1500. Stay away from these criminals!
This company denies approval for needed medical testing. They only think about profit over health care. They hire a 3rd party vendor to review and deny claims. There should be a class action lawsuit against them.
Was slapped with a surprise bill despite using an In-Network Lab and despite taking every single precaution to avoid it. I might have well gone to a lab without insurance. The details: On April 6, 2021, my primary care Doctor requested a bloodwork. I did my due diligence of choosing an in-network lab from Florida Blue. On April 6, 2021 I spoke to a Florida Blue Agent to make sure I would choose an In-Network Lab in order to avoid a surprise bill. Furthermore, I read the “My Benefits” book from Florida Blue Health Insurance to make sure I wouldn’t get any exorbitant bill for this bloodwork.
Despite all those precautions, I ended up receiving a surprise bill from my In-Network Lab for the amount of $227.22 because the Assay of Homocystine is not covered by my Health Insurance. One has to be a genius and extremely knowledgeable in order not to be slapped by a surprise bill. As usual, lack of transparency in prices and In-Network options end up affecting us (customers).
I'm on social security. My premium went up from year 2021 to 2022. 57 dollars a month to 165 dollars a month. Does this sound legit? How can anyone pay this and live from day to day. This Florida Blue is a RIP off.
Everyone I have encountered while trying to check on a claim had no idea on anything. I have now called this company 4 times and EVERY time I have called I am on the phone on hold or being transferred no less than 4 hours. EVERY single time I have called I have been transferred multiple times, back and forth from departments and every time having to explain everything over and over again. Either the people they hire are incompetent or the training for these people are seriously lacking. If you have a choice of Insurance Companies, DO NOT choose this one. They are awful!
This is the ghetto version of Florida Blue that they offer on the marketplace. Basically no Dr. takes this one because it is such a hassle for them. This is a scam that the gov and this company is in on to bilk the citizens for money. They don't treat you like a regular Florida Blue customer.
This is the worst of all health care insurance. I was in a car accident in May 2021, it now October and still calling. This was a car accident in which I was transported by ambulance to the hospital in another state. This is COVERED and they have denied all $20,000 plus costs. I have called multiple multiple customer service agents each with a different response. “Oh, that should be paid”. Or no, we can’t pay that… Now in addition to physically being hurt, now it’s emotionally affecting me. In conclusion, they are now affecting my credit by not paying COVERED claims, these Dr's, emergency room and imaging are getting ready to send to creditors. My attorney has also tried multiple multiple times. Shame on Florida Blue Cross. Stay far away.
These people take my money every month $830. In the year 2020 I had prior authorization for specific doctors and treatments. I paid my portion. I paid my bill every month on time. All of a sudden I start getting all these erroneous bills in the mail a year and a half later. A procedure that was done in the beginning of April 2020, they have now decided to take their money back that they had already paid for the claim that was already preapproved and I have the authorization numbers and claim numbers to prove it. They have done this to me numerous times with numerous doctors. I’ve never had anything like this happened to me in my entire life. I don’t know who to call or how to get this resolved.
Every month I call them with another bill that I’ve received after they’ve taken their money back, with blatant lies, like I didn’t pay my bill that month or, their last excuse was the practice asked the patient to update coordination of benefits with other insurance company? I have spent numerous hours on the phone talking to various agents, having my doctors resubmit the claim. My endocrinologist had three claims paid and then reverse the following year later. When they rebilled my Florida Blue options, they only paid one of them but not the other two. When I called back and asked why did they not pay all of them they couldn’t even give me a reason.
This company, there are no words. I’ve never experienced anything like this in my life. They should all go to prison. That what they are doing is outright fraud. I will never use Blue Cross Blue Shield again. If anybody’s reading this don’t do it, you’ll be sorry when they take their money back a year later and you start getting all these bills in the mail from every single doctor you saw the previous year saying you now owe them the full amount. It’s not funny!!! I’m just one person and I don’t know how to handle this anymore. It is so sad and pathetic.
Easy to understand and most doctor offices accept it unlike other insurances that only give you a discount. I am looking forward to getting an appointment for my cleaning and X-rays all included and at no charge.
I received an email on the 4th of July saying that my address has been changed. I had not requested any address change and so I am sure that the account was hacked. They obviously have inadequate security for your personal data.
My 26 year old daughters premium is $830.33 per month for BCBS of Fl platinum plan. For 3 months the company has denied her prescription coverage because she requires the brand. Initially, they required her doctor to fill out a form for brand being medically necessary. The doctor sent in the form. Then Prime therapeutics, the pharmacy division of BCBS, informed us that was a mistake and a tier exception form was needed. Once again, the doctor faxed back the form. Then, prime admitted they made another mistake and yet another set of forms was required called brand penalty waiver.
The doctor filled out the form, faxed it back and then we were told. "So sorry, it needs to be faxed elsewhere." It was faxed then again to that number. Then the appeals department denied it. Yesterday, We were told it is because they never received the form and that second number was not correct either and to fax it to another number. BCBS Incompetence and interference with the health care of my daughter should be crime and they should be held accountable. Instead, the CEO's and company make billions at the expense of their consumer health.
I never have to pay a co-pay. Checkout is a quick. They just look at my card or already have it on file, and say I am done. Couldn't be better.
I'm 68 years old and cannot get test strips from Florida Blue Cross even with my Dr.'s prescription for my diabetes because Care Centrix denied my claim. How am I supposed to test for my diabetes now.
I have had BCBS for many, many, many years through my employers because they were SO much better than all the other health insurance companies! Until 2020, I NEVER had a problem with them! They paid for everything they were supposed to pay for, billing was always correct, customer service was always knowledgeable and willing to help you find your answers, and if any changes were ever made to my benefits, I was notified very quickly!
For some reason, when the calendar flipped from 2019 to 2020, it all went down the toilet!! All of a sudden, I'm getting bills for bloodwork that my copay has ALWAYS covered. I thought it was maybe just an glitch or something, and it was only $8.00 so I paid it. That was in February. Now, these bills are coming in at $60.00! My hours were cut when everybody was sent home in March! My company lets us work from home, but at cut hours, so I don't have the money I used to have. I've used up what little savings I had, because my utilities went WAY up since working from home.
I've contacted BCBS several times on at least three of these bills I keep getting, and all I get from them is "I don't know" or "Look at your benefits"....which tells me NOTHING! That is, IF they respond to me at all! Not only are they sending me bills for bloodwork that is standard with my diabetes care and covered by my co-pay, there is some other doctor's name on my bill! The last time I contacted them, over a month ago now, I asked WHO this doctor was, because he's not MY doctor, and I've never even heard of him! I have yet to get a response.
I think I'm being shystered here! Bills I'm not supposed to be paying or receiving, BCBS giving me the "run around" (and now IGNORING ME), and a doctor I've never heard of......this sounds like a scam to me! BCBS has gone from five stars to ZERO stars! They've gone completely corrupt, shady, unethical, and untrustworthy! They are literally the exact OPPOSITE of what they used to be! Don't trust them! And READ YOUR BILLS!!!
I have had Florida Blue health insurance for over ten years now. I pay almost $800 a month for this insurance. I've been denied two other prescriptions from them, which upset me, but I dealt with it. My doctor prescribed a medication for osteoporosis and it took the girls at the office several days and hours to get it pre-approved with my insurance company. Once they finally approved it they said it had to be mailed to the doctor's office. The doctor's office will not be responsible for patient medications being delivered to them. I was told it would be a $60 deductible, which I didn't have a problem with because it's one shot every 6 months. I called to give my credit card information to have it mailed to me and was told my insurance company would not honor the $60 copayment as previously stated. They were going to count this as a medical procedure instead of a prescription, which it is. I was on the phone three times for over an hour with them and requested to talk to a supervisor stating it is a prescription it doesn't matter if it's delivered through a syringe, patch, a pill or liquid it is a prescription and it should be covered. They said they were sorry but there was nothing they could do. I think this insurance company is terrible and I would not recommend them to anyone. I am going to do some research and find another insurance company. They don't have any problem collecting $800 a month for me, but then when my doctor prescribes something for me they deny it. During this time with the virus and everyone out of a job it's a shame that they treat their longtime customers this way. They are a rip-off.
My husband and I recently got individual insurance through Florida Blue. After being covered by my husband’s employer J.B. Hunt insurance for 20 years by another large Insurance company. My doctor that was my primary care doctor at our previous home in Dallas TX for over 23 years. He took care of my blood pressure medications. I sent proof to Florida Blue that Cigna covered it.
Florida Blue refused to cover my ** that I have been taking and coverage from Cigna for it. Florida Blue demanded my doctor to change the RX immediately to specific drugs they cover (my guess would be they have a financial interest in?) I said NO. I don’t trust a bully Blue customer service person is not my doctor so I paid full price for the **. Meanwhile, I am a retired 64-year-old woman. I have several drug allergies. Don’t sign up for Florida Blue. They are dangerous. They tell you which doctor to go to and drugs no matter what a doctor that treated you for 23 years.
During Covid19 crisis I met with my Doctor Virtual Visit through ** which is a free service provided by my Dr. But my plan only accepts virtual appointments. If member uses ** so Telemedicine visit is $40.00 per visit 80% covered after deductible. So one would think since COVID19 Stay in Place per CDC and Law, was in Place then virtual visits would be free. And My DR who is "In-Network" utilized the service ** which is 100 percent free, even says so on the website itself and I took pictures, Anthem BCBS charged $149.00 for the Virtual appointment, additionally they are confirm I am responsible for $101.21 for the visit. So of a Visit is $40.00 and I was subject to 80% then my bill should have been $32.00, in this instance 80% of Free is Free. Ok, so if my total cost is $149.00 and I'm responsible for even 80% of that the amount would be $119.20.
All these folks must have been taught with "Common Core" because it makes no sense and they can provide zero reasoning other than they are ripoff artists. The entire medical industry in the US is so jacked up. Come November during selection, I'm dumping these idiots and trying my luck elsewhere. In my opinion, stay far Away from this OUTfit, Anything with "Anthem and BCBS". Good Luck. Here is their response cut from the email I received:
"I hope you are Safe & Well! I wanted to reach out to you after having 4/24/2020 date of service reviewed thoroughly and then going thru all of the Policy and benefits updates related to Telemedicine Visits, I realized that I did not provide you with complete information regarding the way this claim is going to process. This was a telemedicine Visit and they are covered, The only provider that is Covered at 100% is TelaDoc(Only) all other Online/Telephonic Providers* Medical Telemedicine visits (any diagnosis):which are Normally Brick and mortar in-network or out-of-network provider – coverage based on plan benefits. And based on this, and being on the High Deductible Plan, this visit would process towards your deductible.
Your Member Responsibility will be $101.21. This claim does not qualify for an adjustment, as the claims department states it already processed Correctly. *I also tried calling, but there was no message center that allowed for me to leave a voicemail. I truly apologize for any inconvenience this caused, if there is any other questions I can answer for you, please feel free to reach out to me at any time."
I pay $800 monthly as an individual for the market place plan... $9,600 annually. Then I have to meet a $16,000 deductible that’s $25,600 out of pocket before they will pay for anything and then they only pay 60% of all claims after out of pocket of $25,600 total between the monthly monthly premiums, & a ridiculous deductible that is not affordable. I can’t believe the Marketplace is turning a blind eye to their unethical, and abusing a system that’s set up to provide affordable plans. I was hospitalized and meet my $16,000 deductible but my balance with the hospital is $26,000. I canceled my plan and have will continue to file my appeal Over and over every month. I found out it’s not the Florida state Insurance Commissioner office to file a marketplace complaint and claim of fraudulent policy actions. Thought I’d pass that on to those who have suffered the unethical actions of FL/Blue.
Terrible rates for ACA, No kind of easy way to pay bills in advance, they make you visit sight monthly and can't arrange for bank payment on next month till this month is processed (ridiculous), no payment due notifications. No easy way to shop services among providers, Huge disparity among provider fees allows for price gauging. They have monopolized ACA in Florida so it's my opinion they just don't give a hoot, I would do business with ANYONE else if I could through ACA. In my opinion this company represents every reason we should have some form or Medicare for all or ability to buy into Medicare.
Florida Blue neither follow HIPAA guidelines nor do US Department of Health and Human Services guidelines, they have some crap policies of their own which are against law. When you request supervisor either rep disconnects calls or supervisor will disconnect call, also they do not want you to record calls as you can clearly file complaint against them. Worst ever contact center for BCBS group. Rude agents and rude supervisors. They do not respect callers at all. They are just tarnishing name of a good company. Never take plans from Florida Blue, rest all BCBS groups are good and provide very good service.
These incompetence ** have caused me so much pain since purchasing my plan almost 2 years ago. I have called monthly to check on my plans (dental/medical). I understand you can't employee quality employees or have the competence to fix the problems at hand; unacceptable for 2 years. My family owns an insurance company in a different state; if this was the case we would have cleared house and hired competent employees, and supervisors...
I have spent over 200 hours fixing y'alls derelict problems and set up automatic draft payments from both my debit account and checking account. I have even gone as far to contact the insurance commissioner of Florida and filed a complaint, which they lied to save their **. Then they blame me for an error they made over 9cents; and pushed it off on me again. Then called them to complain again just to be transferred to a ** Chinese restaurant.... incompetence **. I have full detailed recordings of the level incompetence, both video and written details with names, confirmation numbers, emails, letters of threats to cancel my insurance.... dont mess with the bear....
I'm going to try to keep this short and to the point. Back in October, I had foot surgery to repair a bad bunion. My doctor chose to do it in a hospital rather than an outpatient facility because that's where he performs surgery. Weeks prior to surgery, I checked with Blue Cross of Florida to determine what my co-pays and any other financial responsibilities would be. They told me the facility fee would be my co-pay, the doctor's fee would be my co-pay and the anesthesia would be covered by insurance as long as the anesthesiologists were in my network and their work was done in a network facility (which the facility was in-network). I asked if there were any other fees and they said no. Back in June, I had sinus surgery done in an outpatient facility and these fees were the same so it all seemed to make sense. Fine. The facility also confirmed my co-pay a few days prior to surgery and when I asked if there would be any further fees, they told me no.
So, imagine my surprise a couple of months after surgery when I receive a bill from the hospital for approximately $4,500. I called Blue Cross of Florida right away and asked them what this was about. It turns out this is my 30% responsibility for surgical implements, tools, etc. used during surgery (including band-aids!). Long story short, I appealed the claim, explaining I did my due diligence and called them and the facility and was never told of this supposed 30% responsibility. They said they looked into it and denied my appeal. They say they told me on the tape recording, but they never offered to let me hear it. And I know they never told me it. Now, I am stuck with this $4500 bill, which I cannot afford to pay. I am disgusted with Blue Cross of Florida and insurance in general.
This insurance company is a scam. They do not cover any claims. Went to see my primary care physician twice and would not cover the claims. If you are looking for quality health insurance do not choose this company.
I’ve been with Blue Cross of Florida over 10 years with very few claims and now when I need their help with an expensive prescription I need, they give me the most incredible run around. They are only willing to pay for literally a small fraction of what my dr has prescribed. There has to be a better company out there.
Florida Blue is the worst insurance company! You get different answers when you call. They don't cover anything! My biggest regret was choosing this insurance. I asked if they covered weight loss surgery and was told yes. However, after I was signed up, told the cover a gym.
I obtained Florida Blue insurance and then had to cancel it due to lack of doctors in my area and a long wait for an appointment elsewhere. Not only was the signup process ridiculous as I received emails with discrepancies about my autopay, bill due and login information...I was told it would take 3 days to "see" my cancellation before they could issue a refund. I have called in repeatedly, sat on hold, and have now been told it would take up to 15 days to see the confirmation of my cancellation before they could issue a refund - which will then take 30 days to process. This is unacceptable policy from a corporate conglomerate! They sure waste no time in TAKING money. I wonder how much interest they make off keeping our money for 45 days before they make an effort to refund it!
Been calling for 3 weeks now to get my insurance renewed since they didn’t process it. I have yet to receive a call back and no one can tell me what happened to my insurance. No one ever gives a direct answer and you just get transferred from department to department.
I needed interim health insurance coverage between COBRA and Medicare. Got coverage from Florida Blue through the health care exchange. Their customer service is substandard; you get conflicting answers when you call. Links in their emails often don't work. The website is poorly designed and frequently down. I'd never consider Florida Blue for a Medicare Advantage plan and will be happy to end this coverage.
I have read many of these reviews and at least feel better about not being the only one being treated so bad. Florida Blue is the equivalent of a Ponzi And/or Pyramid Scheme. One group, customer service, the number on all our membership cards, says do This and then when claim is filed, the claims group says the Service Team had no authority to authorize this action. Net result, Florida Blue pays nothing. Never returns calls and only seems interested in you during the enrollment period. Advice to all: AVOID THIS INSURANCE COMPANY. They add no value.
They stalled on my medications to run out the clock on 2019. The doctors' offices are limited to The Physician's Group. The waiting time for a basic appointment was up to 1 1/2 hours. For a flu shot! I avoided going to my GP because of waiting times. I would. recommend ANY company over Florida Blue. They said I was paid in full, then said I 23.05 short on a payment from months ago. I paid immediately! Still no meds. Horrible company!
Blue Cross Blue Shield of Florida Company Information
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- Blue Cross Blue Shield of Florida
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