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I have a PPO Blue Choice plan through the Marketplace. The problems began in the fall of 2017 when a scheduled outpatient in-network specialty visit and outpatient test showed up on E.O.B.'s Service Descriptions as "Emergency Med Visit" & "Emerg Med Test." I was not treated in an emergency setting, nor an emergency room. My medical condition was not treated by my provider as emergent. Since these first 2 incidents, I have had 5 more with "Emerg Med Test," "Med Emerg Visit," "Medical Emerg Labs," appear in the service descriptions on E.O.B.'S.
Working with my providers, we discovered together that my medical records DO NOT INDICATE EMERGENCY CARE. The medical coders with the providers looked at my chart, coded everything correctly (meaning no emergent care nor emergent testing) and still mysteriously once the UB04 form reaches the hands of BCBS-IL it all becomes emergent with me paying more than the calculated 40% per plan booklet for these scheduled outpatient visits, labs and testing. It all rest in the hand of the Illinois Attorney General's Health Care Bureau at this point. BCBSIL reasons have always been inconsistent. The worst experience was when a BCBSIL customer service rep on a conference call with me and the provider billing rep stated that I had a medical emergency, a severe medical emergency and that my doctor ordered speech therapy. Bit codes 205,206,228.
What? My response, "Do you have the right patient?" I am a retired emergency medical technician in the state of Illinois and someone not licensed to practice medicine is telling me that I had an emergency! Not only that, I asked the BCBSIL rep if I sounded like I needed speech therapy! The provider billing rep had never heard of BIT CODES. The now 7 incidents of this are still under state review. Upcoding medical care, testing and conditions to emergent is fraud. The outcome has yet to be determined. What a nightmare. Until I was on the ACA, I never encountered this.
Started having severe tingling, numbness and pain (sometimes debilitating) in my left arm, hand and 2 fingers. The orthopedic doctor I was referred to ordered a MRI to find out the cause. The MRI showed disc bulging at my C5 and C6. 2 steroid packs and daily pain medicine did nothing to help the worsening pain. He ordered a steroid injection. Blue Cross Blue Shield is DENYING the claim for the injection as MEDICALLY UNNECESSARY! I don't know who these asshats are that decide which claims to okay, but they are absolute idiots!!! The large company my husband works for unfortunately switched from United Healthcare to BCBS of Illinois this year. BUYER BEWARE!!!
What a freaking ripoff. I'm paying almost $1000 a month, getting little for it. People are getting ** in this country, all so the fat cat insurance execs (parasites actually) can make mega bucks. It is a disgrace. It is immoral.
Finished my blood pressure medicine and insurance company is forcing me to mail order. Why do they have to control all the time? We keep on paying each year more and more and get less and less each year.
They continue to move retired people's medications (**, etc) off the covered portion to non-covered. It continues to raise out of pocket expenses for me, retired and disabled, and my wife who has been disabled since 1997.
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My son was denied health insurance after birth because he was born around the holidays so his social came late. I was told by 5 representatives that this happens all the time and he would most likely be added. I must be pretty unlucky. I've paid and will continue to pay out of pocket for all his doctor's appointments and hospital bills, because they denied my poor infant son. Absolutely disgusting company. I called when I received it and I missed the deadline by a day! 1 day/8 hr period. I asked the lady how can we be punished for not having his social in time. She told me that we should have called to let them know he was born.
Are you kidding me? I assumed the $21,000 hospital bill FOR BIRTH was a heads up. Not to mention in Pennsylvania when a child is born the first month is covered by the mother's insurance regardless of enrollment. My wife is covered and so was my son's first month. Shouldn't be too hard to put two and two together. I was also told you have 31 days to enroll, but 45 for if they make an exception. I did it, I tried. Still denied. Awful, deplorable, scum company. How anyone in high command of this company can sleep at night is beyond me. My employer switched to this company last year to save a buck and it's been a nightmare ever since. Blue Cross Blue Shield of PA is what I had before and they were amazing. If you're thinking of giving this company your money save yourself the hassle of a 45-minute pointless phone call and flush your money down your own toilet.
So sad that we lost the insurance coverage we used to have as a repercussion from Obamacare. Our deductible tripled. We used to have only small copays. Our prescription copay has double and tripled.
We have this coverage because it is the only company offered through my husband's employer. They are a terrible company which pays as little as possible. We are currently in month 6 of a claims appeal for a test ordered which did not require preauthorization but was denied anyway because they deemed it not medically necessary. How would we know that if they don't require pre-approval? The doctor's office thought it was necessary. Now we know to NEVER have a test done without preapproval no matter what they say. I would leave in a heartbeat if given a choice. Don't buy their product if you have any other choice.
I wish I could give this company 0 stars. Please, do not even think about switching over to BCBSIL. I did routine bloodwork when I first got pregnant, and I received a bill from the lab for almost $4,000. Turns out, BCBS did not want to pay without having proof that I was pregnant. For months, they claimed they had been requesting my records from my doctor's office all while the doc's office was claiming they never received any requests. Months later (third trimester) I find out they had been requesting my records from the lab, which obviously does not have my records.
Only my doctor would have them. My doctor finally got the records to BCBS, and they had to go through a "committee" for review which was supposed to take 30 days. At this point, I am now being harassed on a daily basis by a collections agency hired by the lab. Approximately 60 days later, I find out the committee denied the request because they did not deem my STANDARD prenatal bloodwork medically necessary.
Not only have I spent my entire pregnancy dealing with this (I am about to give birth), but I am now left with a massive bill for something that should absolutely be covered by my health insurance. If this company is failing to provide what is necessary for pregnant women, there is absolutely no hope. I switched insurance companies months ago, but not everyone has that option. Shame on you, Blue Cross.
I have purchased the BCBS of IL Blue Precision HMO because it's the only plan the providers near me will take. It has been a nightmare. First, I cannot get any dermatological care because the group I have been assigned to has no dermatologists that can do cancer screenings in the next 12 months. BCBS has advised me to go out of network - or essentially pay out of pocket - or switch groups entirely, thus fragmenting my other care. I have chosen to not treat cancerous lesions due to this problem. I also have an orthopedic issue and there is no provider in the assigned group so BCBS has again advised me to go out of network and pay out of pocket - or switch all my providers to another group, thus fragmenting my other care.
I have spent hours and hours and hours on the phone with them and while they are all very polite (call center is in the Philippines), they are untrained and unreliable. I can't tell you how many times I've been disconnected after long holds and told I'd be contacted, never to hear from them again. Honestly, this is a completely dishonest company and they should be shut down completely. I am told that this policy is what is given to employees of the state as well as teachers. I feel so badly for these people because I know they are also suffering and not getting the care that they are paying a lot of money to have. I am on the lookout for a class action against BCBS because I'd love to testify as to my horrible situation. Do not purchase this policy - it's a very expensive sham.
I think that Blue Cross community plan is great. I have no problems with them. Whatever the problems are they fix it. Love my Dr and clinic great place. One thing I have an problem with I wish they would cover more asthma inhalers.
I have this insurance through my job and I have it because they are so money hungry. I am currently pregnant and I have to tell them in advance where I am delivering or else they charge me $500 in addition to the amount of my delivery that they already make me pay. Also, they only approve it for 3 days which means that if I deliver prior to the expected due date I give them or more than 3 days after the date, I have to call them within 24 hrs to tell them where I delivered or else I'll have to pay $500. Who is thinking of calling insurance when they deliver a baby and whoever knows the exact date they are delivering? Aside from that ridiculousness, if I go to the emergency room (in general), I have to pay towards my $500 deductible then they pay 90% after I reach the deductible. How is that fair? This is honestly the worst PPO insurance and I hate that this is what Dell offers their employees.
I am in disbelief at the length I have had to go to (unsuccessfully) receive the coverage I was under the impression I had (dearly) paid for. After talking with six different representatives (just today) I still do not have a filled prescription after one week of effort. I understand from my doctor's office that this is not unusual. Is all this effort to not fill a prescription without Herculean ‘compendiums’ and ‘proof of manufacturer recommendations’ for my benefit, or for the intention of eluding responsibility for coverage?
First of all, I can't even select 1 star above. If there was a "0" star, I would select it. Left corporate world to start my own business. In Februray 2010, we got a high deductible HSA 5000 plan to protect my family from catastrophe. Our original premium was $640.00 with a $5000/10,000 deductible. Expensive, I get it (but just wait!), but protection of the family from financial ruin was accepted. Today I received another premium increase. In the past 8.5 years we have now had 15 different premium increases with very few claims (only met deductible 1 time when daughter had ACL surgery). My premium is now $2,010.10, An incredible 214% (over 25%/YEAR ave inc). How can this not be price gouging. I have written 2 letters to BCBS of Illinois and had 2 conversations with a so called executive (have name but will only use with official complaint) with regards to the increases over the past several years.
I get the same canned response "with advances in technology, RX drugs and ways to treat injuries and illnesses, we must adjust your premium to stay in line with increased costs..." Again, how can this not be price gouging. I have nowhere to go to get another plan in this state and the best they can say is to join ACA, which isn't much different, and you can never leave once you are in and during my research I would be unable to keep my own doctor or our pediatrician. 15 premium increases shows an average of nearly 2 increases a year. In fact, the year I took one of my children off the plan as she got her own job and insurance, my premium went down...for one month...then the next increase came which was 27% increase. Tell me this was legitimate?
Comments above are just about premiums. Customer Service is the worst I've ever seen. Been put on hold for hours, been hung up on several times (wonder why they ask for your phone number in case we get disconnected) and never called back, most the reps are extremely incompetent and rude as was their executive that called me back after several messages. Continue to get riders that take away benefits...most recent was that they no longer pay for screening colonoscopies. Wife and I both had our over 50 yo colonoscopies within a week of each other only to learn they no longer pay for these...cost me nearly $5000 out of pocket. We appealed them both only to be denied...twice. And, we received the letter acknowledging our appeal AND the letter denying our appeal.
Get this...on the same day and both the letters (one happily announcing "we received your appeal" and the other "denying the appeal") were dated the same day. Wonder if they really did the appeal? I called and got escalated during the second appeal and once we were denied I attempted to call back the escalation agent numerous times with no return call whatsoever...despicable! Something has to be done. Insurance no longer fits into a capitalistic society. If so, I could go somewhere else to protect my family. I truly don't know how these people and this company can look at themselves in the mirror. Cannot think of one area of living expense that has increased this much in such a short time.
This complaint is the cliff note version of our issues. I have dates, details, names, etc. and its time to blow the whistle. Will be contacting Illinois Dept of Insurance. I know BCBS could care less, but something has to be done. A very sad time for a very rich company who takes advantage of those of us trying to make ends meet. They have ultimate control over us as a consumer. This should NOT occur in this country.
If I could give this zero stars I would. I recently signed up with BCBS the Blue Choice Preferred PPO... I am currently 20 weeks pregnant and just dropped from my current doctor. I have been on hold for hours with BCBS Illinois! I asked for a doctor that works with my insurance and they literally gave me a list of about 50 doctors. I spent hours calling about 17 doctors on the list and guess what? Half of those numbers that were given were either disconnected, wrong number or the office let me know that they do not take the Blue Choice Preferred plan! So I called BCBS back and the customer service rep gave me another list with the same disconnected numbers. This is unbelievable!
I ask to speak with a manager and they will not let me speak to one. I asked them to actually update their list and they say “it is updated”. Well how if the numbers are disconnected? I was then told to keep calling and that they cannot call to confirm a participating doctor and hospital for me. One of the reps simply said, “Well I can give you another list” and guess what I called the 5 doctors she gave me and the doctors are no longer there and another number was to a Rec Center, not a doctor’s office! They have terrible service and not in the business of helping customers. They just try to quickly get you off the phone and could care less if you are been taken care of.
This is the worst health insurance I have ever had. Very few doctors will take this insurance. So few, that the list also contains doctors in suburbs and Indiana because there's about 8 cardiologist in the city I can see and they all except for one, have horrible ratings on the internet. The one that has a good rating didn't want to take me as a new patient because he no longer wants to deal with Unified. Do yourself a favor and steer clear of this insurance. I have BCBSIL, Blue Focus Care, Unified Physicians Network. The worst.
Extremely expensive dental plan. Only covers 50% of all dental services. Only covers 2 cleanings/year, 100%, IF you go to an in network dentist. If not, they cover less than 40%. Blue Cross of Illinois also has a limit of $1,000.00 benefits per year. Just think that a simple crown nowadays is about $940.00 per occurrence, if you need two done you are fried. Then you have to pay one full year or premiums before you can qualify for any major service. This insurance is worthless. Do not fall for it. I had to switch to Physicians Mutual Insurance dental plan.
A company so bad it received an "F" rating from the Better Business Bureau. If your company contracts with them for your health care, you might want to switch companies. But then, all American health care is rotten due to the cozy relationship our government maintains with insurance companies. So, if you're young, you might want to immigrate to a country with better healthcare (which is pretty much all other western countries). Good luck.
If I could give a negative 10 I would. Wife has severe injuries to both feet that required an MRI as ordered by her specialist. BCBS denied the test 3 times and it took 4+ months to get the approval. They have unqualified morons that pretend to be doctors and put the patient's health in jeopardy. Finally had the MRI done after repeated arguments by her doctor with BCBS. The MRI shows that she has tears in tissue of the main tendon. She now has a cast on one foot for 4-6 weeks and if not healed, then removal of tissue of another tendon from somewhere else in her body. Then repeat the same on the other foot!!!
If the morons at BCBS had allowed the MRI at the time of the injury as noted by the doctor, this could have been a simple treatment procedure of just wearing a brace at night on each foot for a couple weeks. Real idiots at this insurance company. Now not only may it potentially be a major life altering event and multiple surgeries, but a very costly event going forward with no promises of her ever having both feet work properly once again. There should be open avenues for a patient or family to sue insurance companies for incompetence and also demand that future requests for specific tests, etc. From specialists, be reviewed by real and actual specialist doctors instead of some hourly paid customer service rep. Awful - just awful.
Total Nightmare trying to get anyone to help me at BCBSIL over the phone. I talked to one agent with heavy foreign accent and asked him about HSA's. He didn't even know what an HSA was and was googling it while on the phone with me! Seriously! He told me he was googling it. Days later, and 2 hours on a phone with a "customer advocate" to find out why my wife's PET scan isn't medically covered, when the policy book they sent me says it is. Forget it. The phone operators reach intellectual dead ends, don't know what I am asking, do not understand anything related to health insurance in the USA, won't talk anymore if you keep asking them questions, and then hours later, with my BP through the roof, I was dumped into a disconnect dial tone.
It's going to be a very, very long year with this health insurance organization which takes great pride in taking premiums, while not being willing to help us over the phone, yet claiming to be a "health" insurance company. I wonder if cardiac arresting while talking on the phone with one of their "Consumer advocates" is covered under my policy?
Their online system doesn't retain information. Log into your account and check your "My Documents" and nothing is there... Imagine that! Looking at previous billing history is non-existent and I only canceled my account 2 months ago. Then, when you talk to someone, they refer you to the Health Insurance Marketplace because they're lazy... Then they gouge you on the fees. Navigating through their pamphlets and brochures, coverage plans and plan brochures is like reading an alien language. Their billing system is completely backwards and generally not up to date.
I am on IL Medicaid; & also am required to choose a community healthcare plan. I was on Meridian Healthcare Plan; & using the local Comm. Health Clinic as my primary care provider. This was fine; but was hoping to get a 'real' private Dr. as my care provider. So when open enrollment came around this 2018; I got a letter in the mail from IL State saying they have more options to choose from for required insurance. So; I chose Blue Cross/Blue Shield, & it stated that a well-known local Dr. does take the plan.
So I went into the IL Healthcare online portal, & switched from Meridian to BC/BS. Well - what a mistake! Not only does that Dr. not accept it; neither does any other Dr., hospital, or Clinic in my County take this plan! I am screwed till next year's open enrollment; even though we ARE allowed to switch back one-time during the year. After many hours on the phone with BC/BS, IL Human Services, & emails to our local State Representative - I still was unable to switch back to my old plan.
I have not been on my medication for 6 days while Blue Cross of Illinois denies my prescription. When I was online at healthcare.gov picking a plan for 2018 the healthcare said the medicine is part of my plan. Yesterday I was told that Prime Therapeutics has me trying medicine that did not work before. I wish Blue Cross has more PPO competition in Illinois. Blue Cross is not honest!!!
I called BCBS IL this morning and was on hold for a very unreasonable amount of time. When I finally spoke with customer service, I could not understand her and asked if I could speak to a supervisor. She could not understand me and I could not understand her. We finally got disconnected and I thought surely she will call me back and she never did. So I called back again and the same thing happened. I called back a third time and asked to speak to someone in customer service and they wound up connecting me with somebody in the marketplace that wasn't even affiliated with Blue Cross Blue Shield. I was dumbfounded. The guy I spoke with said this has happened many times. He was from the United States and he worked for the marketplace for Obamacare.
I called back a fourth time later in the afternoon and was persistent about speaking to a supervisor. I was on hold for 25 minutes and finally spoke to a nice person named Stephanie and I got my question answered. They did not cover the procedure I needed them to cover. Go figure. For $1,000 a month nobody should have to go through this. They are a horrible insurance company and they do not care about their customers at all. All they care about is the money. There are no other choices and they know it. I never had these unreasonable prices or horrible service before the (un)affordable care act.
The absolute worst. Foreign cust service. Can't understand the long wait times and frequent premium increases. Obama you really screwed up health care in this country and BCBS of Illinois is taking full advantage.
VERY POOR customer service. I have not been able to get my explanation of benefits for this whole year. BC/BS tells me that I have to get them from the doctor but the doctor's office says, no BC/BS should be providing me with them. I have repeatedly called, been transferred all over, disconnected (even though they ask for a call back number, which they never call you back on). The doctor's office suggested I call and ask to speak to a supervisor. I did that but they won't let you speak to a supervisor until you explain what the problem is. Even after you explain they would not connect you to a supervisor. I was kept on hold twice for over 45 minutes and then without coming back on the line to explain anything they transferred me to my doctor's office. They are rude, and terrible. Maybe if we had more choices for health insurance they would be a little nicer. They only care about getting your outrageously expensive premium. They don't care about people at all!
I had private BCBS of IL. I was livid because I had a test done for asthma and it sent them a trigger that pulled my old medical charts. There were things that were wrong in my chart. I fought the appeal and won. So I thought it would go back and pay the bills that they stopped payment on till I won. Which by the way was over $15,000. They said they would only pay them if I reinstated my insurance since they had already cancelled my policy... Ready for this I had three days to come up with $1200. There was no way. So it stayed cancelled and now I have huge medical debt. I feel ripped off that I paid these people money for months and for what? They didn't pay for anything. My friend who worked there told me they are told to deny then process. BCBS of Illinois is a joke and rob from people.
As I write this, I am on hold with BCBSI. Information about our plan was supposedly mailed to us on Oct. 17. It still hasn't arrived. This is my fourth call to try and get a duplicate. The advocate on the phone just now told me to wait for it to arrive in the mail. Meanwhile, the enrollment clock is ticking. We were told last Wednesday someone would email the information we needed. That has also not arrived.
I had a really bad experience. This is the second time having similar issue. No coordination between Sales department and Customer services. I had a similar issue last year started in Nov 2016 and resolved in April 2017 making 100 of calls. Every time a new story. Same thing happened to me again. My wife and I had a different policies. There was a addition for newborn in family on July. As per them there is a sixty days period to add a newborn in the plan and for the first 30 days baby should be covered by Mother's insurance.
I made call within 60 days in September to add my newborn and also requested to add my wife as well terminating her current plan. The sales person told me that, "From first of October you all are in same plan," and took the money. She said for time in between 30 days and start of new policy in October you will get a prorated bill for newborn. I started getting call from doctor's office that, "your insurance is inactive" even though I paid in full for all previous months and advance for month of October.
I called to check what's going on and they told me that I have to pay 1600$ for policy starting from the birth of child. I told them, "Why I would be paying for 2 insurance policies. I already have the policy for that period and you guys are charging me for second policy for the same time period." The customer service is horrible. Made multiple calls. The system is so inefficient that the automated system ask for the member's details and when you connect to Customer service they again ask you the same stupid information. Just to get there it takes 10-15 min.
I been calling for 2 weeks now. Every time they have a new story, put you on hold for hrs and then automatically call goes to customer survey. Ask for details and callback number and they don't have the courtesy to call you back if call you drops or terminated by their system. With no patience left I specifically asked for the supervisor and told the issue. They messed up at their end the policy. What's I asked and told at time of purchasing the policy was totally different what was done. It's a mistake at their end and now they can't fix it asking me to pay 1600$ to activate the policy until they fix their mess. No timeline to fix the issue and they cannot completely fix the mess what they made. One of the worst in their business.
I pay $1,000/month for this garbage 'insurance'. They'll allow you to see a primary care doc, ok, but if, God forbid, you have to see a specialist? Forget it. You're screwed. That means no oncologist if you have cancer, no physical therapist if you have an injury, no dermatologist if you have so much as a wart. It's the most God awful system ever devised. Literally, I pray for you if you have this insurance, because God knows, you won't be getting the help that you need. Oh, and when you ask why the hell this is happening? They'll say, well, it's cause you're poor and have state insurance (even though you're fully aware the 'state' has NOTHING to do with it). WTF?
Blue Cross of Illinois Company Information
- Company Name:
- Blue Cross of Illinois