Blue Cross of Illinois
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Blue Cross of Illinois Reviews
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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?
I am the office manager for a chiropractic office and find it very frustrating I can never get through to talk to anybody. I have claim questions for multiple patients and I sit on hold over 45 minutes. Actually probably longer because I always have to hang up. I've spent countless hours on hold. You would think someone would pick up within 5 minutes considering you have to jump through hoops to even get patched through to someone. There are always "high call volumes" no matter what time of day you call. Someone actually answered last week just to tell me to call back later... super frustrating. There are patients who put off care until their questions are answered and your company makes that very very hard.
I had an appointment with a eye specialist in December 2016. He had to refer me to an eye retina specialist, but he warned me that Blue Cross Blue Precision Silver was dropping out of the Market Place and they were not informing any of their customers. He advised me to wait until after the first of the year and when I'm on a new carrier then follow-up with my retina appointment otherwise I might get stuck with an unpaid bill. Well he was right about the unpaid bill. Blue Cross kept playing around with my bill from the eye specialist and after six months it is still unpaid and now they are nowhere to be found. I've spent hours calling one number only to be told to call a different one. I'd forward the bill to them and it would come back saying wrong office. I hate to think how many other people got stuck with bills. I paid all my monthly premiums and what good did it do me. Will never purchase any Blue Cross insurance again.
I am a member with this horrible company customer service... what can I do.? Nothing. Every time I call for a question I have to wait several minutes before any rep. answers, when they answer they put you on hold more than 25 minutes only to answer my question. On 7-10-17 I called around 1:25 p.m. and Shaney answered, after 10 minutes, I asked her to check for me something on a claim, asked me if I am on the policy, she repeated my phone number she had on file twice and she said AFTER 25 minutes that she can't find my name still. 25 MINUTES a BCBS cannot find my name on the policy? Come on. I called before hundred time and they always have my name. I decide to complain about their horrible service. You may deal with them, they take your money but they will give you a ** service.
False Statements and bad customer service - When you get your insurance statement of services, be aware that the insurance portion of the billing - The so-called reimbursement to the provider is 100% false. In most cases, for smaller services like chiropractic care, there is no reimbursement at all! It's just price fixing and way for you to think you received a benefit. Or, in a best case, a small portion of the number posted was sent to the provider. There is no such thing as insurance anymore - Only managed service contracts that are essentially marketing tools to push patients to providers accepting the bad terms of the insurance company to bring in patients that believe it will be financially good for them. You are much better off paying cash prices which will be less than your out of pocket with insurance! Most providers take cash, especially those trying to build a practice.
I've had BCBSIL PPO for at least two years. I took a buyout in 2012 from a multinational telecom company, who sold off our division. Shortly after retiring from that company, I had an injury, which led to a disability, which was finally approved in 2016 and retroactive to 2012. Due to the retroactive approval, I was being forced to take Medicare, as the SSDI was covered for more than two years. Shortly after the SSDI was approved, I received a letter from the benefits dept. of my previous employer stating that all retirees who had become disabled, regardless of age, would no longer be covered under the existing plan and then be forced to use their broker, AON Exchange.
But, when I called AON, I was told I had not been on the transfer list and could renege my existing BCBSIL plan for 2017, which I did. My SSDI approval was made after the transfer list had been sent to AON. So I renewed my plan and waived Medicare and BCBSIL told me I would have coverage as usual. Now, it's May 2017 and BCBSIL is not paying my medical providers the contracted 90 percent IN and nothing or very little on OON. They are telling me I should not have waived MC and it's my fault! THE ONLY REASON I waived MC was because I couldn't buy supplemental insurance and was told I could keep my current coverage, for one more year.
After being patronized on the phone by BCBSIL customer service rep., I asked for the resolution dept. who said they would listen to the recorded conversation I had with their rep in Dec. 2016 and call me back the next morning. That was on Monday, today is Thursday and still no callback! Be very cautious when speaking to BCBSIL and take notes of who you spoke to and when. IF YOU DON'T UNDERSTAND A TERM OR ARE NOT FULLY CLEAR OF WHAT THEY ARE TELLING YOU, HAVE THEM EXPLAIN IT, UNTIL YOU DO! I never had such issues with UHC!
In need of cancer treatment side effect surgery. Pain from side effects could be relieved but the Director of medicine at BCBS of Illinois Exelon said it is not medically necessary and for cosmetic only. Are you kidding me? Two University of Wisconsin doctors and a top Surgeon get a peer to peer and what does BCBS say in the peer to peer, "Sorry this is out of my realm." What a joke, how are they allowed to make decisions? All about the money and numbers, who cares about the people. Director of medicine go back to your cozy office and charity dinners and never put a name to a face, and do us all a favor and don't call yourself a doctor.
I have been paying for their mediocre coverage for years, well over what my surgery would cost, never bringing in my kids for things unless absolutely necessary and now that I am disabled from my job due to a low back problem they deny my surgery 1 week before due to their MD who probably sits in a cozy office all day says it is not necessary due to the MRI not showing enough narrowing to pinch the nerves. Not taking into account the painful discogram I went through that showed two large tears in the discs. Able to get my MD to go peer to peer and still lost. Now I am out of a job, paid a HUGE COBRA payment so there would be no lapse in coverage for this and they deny me at the last minute. I am now on long term disability, which will only last me 24 months, then what. The narcotics dull the pain but I still can't move the way I should. I could easily live another 60 years but this is not living.
I have canceled my health plan on December 16th, 2016 and is February 2nd, 2017 and every time I called customer service they tell me my refund is denied. I need help getting my money back. I got health insurance thru my job starting January 1st that's why I canceled but I was paid. I even got the letter stating it was canceled. BCBSIL got me very upset. I can't believe it. All I want is my $414.32 back!
Back in mid-December of 2016 I canceled my individual PPO plan through Blue Cross to keep it from renewing in 2017. I honestly didn't have a problem with Blue Cross last year, I was just offered insurance through my job and had to choose that because it was significantly cheaper, what with insurance premiums in Illinois skyrocketing this year. During this phone call, the representative assured me that my plan and auto-pay had been canceled. Maybe a week later a $368 premium had been taken out of my account for the plan I had canceled.
Long story short, I have since spoken to about 4 different representatives to get this money back. After being on hold for nearly two hours the first time trying to sort this out, the woman I spoke with said I needed to allow 10 business days to receive my refund. After significant time had passed and still no refund, I called and it turns out she had made a mistake which caused the refund to be denied.
January 18th was the last time I called to set up the refund process once more, and now 11 business days later, still no money. I'm infuriated because it's not easy to go without that kind of money for me and I feel there should be more urgency to correct their mistake, rather than taking over a month now to refund me. I've also had problems with a claim from October that has yet to go through their system, but I'm still unsure why. I do have to say all representatives I've spoken to have been kind. It's their system and flaws that's creating this mess.
This insurance company has the most horrible customer service as far as I know. I spent more than five hours on the phone waiting for them to answer. There is no answer at all. The reason of my phone call was to have an answer why they charge me $289.94 on January 3 and $212.88 then they charge me again $154.95 on January 9. The agent appointed is neglecting me because he does not remember conversations involved during the process. As far as I know BBS is neglecting customers because of the horrible customer service they have. Besides that it is impossible to register online if you do not have an ID#. I do not like this health insurance at all. I hope the Obama Care will take care of this right away.
Right now... I've been on hold for 51 minutes and counting. This is after I waited 25 minutes for rep to call me back. It's 1/26th... and BCBS can't find my plan that I signed up for and Paid for to be active 1/01/2017. My son has severe flu and we just paid $137 for Tamiflu because BCBS hasn't confirmed our policy or sent out cards w/ a member I.d. #. Our premiums are just under $900/month. We've been w/ BCBS for years... It's always the same story when you call in for customer support. You're either on hold Forever, you can't understand the person/or they can't understand you, rep is inexperienced and gives you misinformation... or they disconnect you when they don't have an answer for you. They refuse to let anyone speak to a supervisor.
I having been trying to get pre-authorization for surgery but BCBS of Illinois is very slow in replying. My surgery has been delayed by one week and still no response. I have been messaging them since last week, my messages get a reference number but still no call. What happened to this insurance company; it used to be a good company. Premiums are outrageous and customer services sucks.
Blue Cross Blue Shield mistakenly canceled my health insurance in August 2016. I called them many times to try to get it resolved because I paid all my premium on time. While they were working on reinstating my health insurance, I needed to refill my prescription. The Blue Cross Blue Shield representative told me to refill my prescription on my own and reassured me that the cost will be 100% reimbursed once my insurance was reinstated.
My insurance was finally reinstated in November 2016. I submitted a claim for reimbursement for my prescription but was denied for reimbursement. I paid $185.99 for my prescription, which if I had insurance, I paid less than $20. They said the entire cost of my prescription will go towards the deductible so there will be no reimbursement to me. I should have paid $20 instead of $185.99. It was Blue Cross Blue Shield's mistake in canceling my insurance, not mine. Now, I am penalized for the mistake they made. Every time I called, the wait time was 45 minutes to a hour. Worst company I every dealt with. Very disappointed.
As of 2017 Blue Cross requires you to use Walgreens as your pharmacy. This couldn't be a bigger debacle, with Walgreens being probably the poorest rated pharmacy when it comes to service. I guess this should come as no surprise considering Blue Cross's track record, in fact they're a match made in hell. Between my wife and I, we had two of 12 prescriptions transfer correctly from our previous pharmacy. One prescription with refills was lost altogether. There are no words that accurately describe my dissatisfaction with Blue Cross & Walgreens. STAY AWAY AT ALL COSTS!!!
I signed up for Blue Cross Blue Shield of Illinois in mid-December and paid more than $1000 for my first month's premium Dec. 22. It is Jan. 13 and I still have no ID card or even an ID/group number. I have called about a half dozen times to ask why the delay, sometimes being put on hold more than an hour. They did receive payment right away, but my ID "fell through the cracks". This is incompetence at its worst.
Blue Cross Blue Shield of Illinois is incompetent. When you call, expect inaccurate wait times that are already obscene. If you get coverage in the New Year, do not assume that your insurance is active because it says so on their website. Mine wasn't when the hospital ran it, and then I was unable to get a customer advocate on the phone. I had a good experience with Blue Cross Blue Shield of Texas but it's important to understand that the companies are largely independent of one another. Avoid the one in Illinois.
So to start, as of Jan 1st my policy states it was active via the Blue Cross Blue Shield website. I tried to get my prescriptions filled and I was unable. So the pharmacy called Blue Cross Blue Shield of IL and they stated that my policy was inactive. I paid my premium and everything was in place that should have been. Frustrated as I was I proceeded to call Blue Cross and Blue Shield of IL and waited on hold for over an hour as usual. A young lady answered by the name of Melissa ID ** or **.
She first asked me for my identification number which I provided. She told me she was unable to locate my policy. So then she asked me for my social security number, trusting in her, the confidentiality and trust that Blue Cross and Blue Shield is supposed to represent. I willingly gave her my SSN. She then found my policy and stated it was activated. Naturally, I thought to myself for a moment and then thought of a different question after she gave me an answer I already knew.
I introduce another yet seemingly simple question, "What is the difference between Blue Cross Blue Shield of IL PPO and Blue Care Preferred PPO of IL..." She was unable to answer that question for me and said she could give me a number for blue access. I then said "well, my plan is shown on the Blue Cross Blue Shield of IL website and I called Blue Cross Blue Shield of IL customer service." This is where things got funky. (Mind you, I told her and started recording from this point on.) I asked her what department she worked in and she answered my question with, "Sir how may I better assist you today?"
I calmly asked her again "yes you can tell me what department you work in..." Again she said, "Sir how may I better assist you today?" She proceeded to tell me the call was being monitored and recorded, only at that point did she tell me that. She asked for my social security number again and I then stated that I did not feel comfortable giving that information out to someone who cannot tell me what department or what company she worked for.
Then for many brief moments of silence between me asking for her name and ID number she responded by telling me her first name and her ID number in a manner that was so fast I could not even understand her. So I asked her to repeat it multiple times and each time she forgot a single digit alternating the number in her ID in and out each time. I asked why she was lying to me and she wouldn't answer. I only assume because she knew she was being recorded and she knew she was lying.
After all this I asked to speak to a manager and that I didn't want to be put on hold. She then stated, "Please wait while I find someone to better assist you." I then said "I don't want someone to better assist me, I want a manager." I was told, "one moment please..." I heard her typing and I asked her what she was doing and she said she was updating her policy and I said "you're updating your policy?" She replied, "sir no." So I asked "are you updating my policy" and she did not answer.
She then put me on hold and I waited for a manager as fifteen minutes went by and then the music stopped playing and the line was silent. After about two minutes of silence she finally disconnected me. In total it was two hours of being lied to, taken advantage of, and witnessing a gross exercise of non-compliance, negligence, and the worst customer service I have ever had in my life.
I felt completely violated that a woman who lied to me for over two hours took my personal information and treated me the way she did. This is why I feel like a victim. Like Blue Cross and Blue Shield of IL stole my sense of personal security. If I could rate this 0 stars I would and I will be contacting The Better Business Bureau and any other entity that will further help restore my sense of security.
Blue Cross raised my family premium from $1900 per month to $2990 per month that is a 54% increase. That requires our family of 5 to pay nearly $36,000 per year for insurance. Under the Affordable Care Act insurance has become Un-affordable. Excessive wait times and poorly trained customer service representative add insult to injury. Maybe they should stop spending money on their Bear Tickets for the Blue Cross Blue Shield Seat Upgrade and lower the Rates.
This the worst medical plan I have ever had. You send generic card with fictitious doctors names so you don't have to cover a visit. I have been searching for months and paying out of pocket because your insurance and customer service are a nightmare. BEWARE anyone thinking of purchasing this EXPENSIVE WORTHLESS INSURANCE.
I am a pharmaceutical sales representative and my company insurance is BCBS Illinois. What a mistake I made! I left a great job with a great insurance company to go to work for another company and they over me BCBS Illinois. I was thinking that it was ok but it's been my worst nightmare. First they didn't want to cover my husband. I had to produce tons of documents to prove I was married. Then my migraine treatment that is been cover for the last 2 years with my previous insurance now is not cover. I get headache every day and migraines 2 or 3 times a week. With the treatment I had only 2 migraines in 2 years that had been a life saving for me. But now with a lot of tears in my eyes I have gone to pre-authorization, to an appeal of the pre-authorization that was denied.
Now my next step is going for an External Review Request with an Independent Review Organization. I pay more that $700.00 a month for this coverage. I am so upset and sick of getting this headaches and the insurance company I am paying does not care about my health. They just want my money. BCBS you meet your worst nightmare because now I am getting a lawyer that will fight this for me. Please don't buy coverage with BCBS. They are literally stealing our money and they are not giving the service to their associates.
I (like most) have had BCBS for a long time. I originally had CIGNA before switching to BCBS. I got a notice from my doctor saying that I was no longer insured and I was incredibly confused as to why. I immediately called my insurance asking about it and they said I was late on a payment in January. Obviously I questioned them about it saying things like, "I've always paid on time and am still getting billed", etc. I sent both BCBS and BCBS Marketplace/Silver my bank statements since they claimed it was a billing issue. Both statements had the same information, stating the time/date of when I made payments and showing the company that everything had been paid on time.
I called and the company said they needed 2 weeks to process both statements. I understand that things like that take time so I agreed to the two week waiting period. I called after two weeks, asking BCBS what was going on since I did everything on my end. The BCBS supervisor said that it wasn't a billing issue after all. It was a lack of communication between the BCBS offices and the BCBS Marketplace/Silver.
I spent 2 hours on the phone (I kid you not) on a conference call with both offices notifying them that I wasn't insured and it was on them. They told me that they needed to work out the problem between both departments saying, "I would be insured by the end of the month", and that "getting insurance was guaranteed & the process was infallible." I was hesitant of course, informing them that I needed to buy medicine (I'm Epileptic) and I didn't have enough to wait a month-month and a half. Both departments said that I would be reimbursed for my 'Out of Pocket' payment. I was pretty relieved knowing this since my pills are $700/month.
After the horrific experience I had, I decided to check up with them after two weeks (even though they said it would take a month). The woman I talked to on the phone said that there was no record of the phone call and that I wouldn't be insured. When I gave her the date/time of the phone call she then asked for the names of the people I had talked to for the past 10-15 calls. Of course, I didn't have them thinking that names wouldn't be relevant. I ended up having to describe what the people sounded like over the phone... seriously. She then told me I'd have to file an appeal. She gave me the address and paperwork (through e-mail).
The appeal process is about 1-3 months (keep in mind I am paying 700/month for medicine) so I knew that I would have to wait a good chunk of time. Finally, I got a phone call from the appeal office however; it wasn't good news at all. The woman at the office asked why I had sent the letter there. I told her that BCBS gave me the address and the paperwork. She notified me that BCBS gave me the wrong address and that she felt incredibly sorry for me. So right now, I have paid over 3,000 in medicine and have been thrown for a loop with my insurance. I am currently thinking about suing the company due to emotional distress & the whole scenario. I am beyond upset and am going to call them but if I hear, "I'm sorry and I understand", one more time I will freak out. - Universal Healthcare NOW!
My husband got sent to collections for not 1 dos but 2. Wrote a review a few months ago on 1st and now here I am again. This is for dos back in Feb 2016, he went to a few doctor visits trying to rule off a diagnosis and has been sick since 2015. He goes to a total of 3 doctor facilities in the beginning year 2016 due to 2 facilities not telling him any accurate diagnosis. We just needed some answers. So after a few weeks of finally finding a proper facility and answers. We start receiving bills from 1 facility. We have a yearly deductible and it was met in the beginning of the year.
Now after all my research and findings he got sent to 2 separate bill collectors and is in collections today. I called these bill collectors called BCBS of IL and they stated that the 1st was a error but they are waiting on more data. No response from the bill collectors and now the 2nd claim for 2016 is our responsibility?? I am lost for words with BCBS of IL. How does any health insurance determine when a deductible is to be dropped from not 1 but 2 facilities to the 3rd health facility? So yes just because the 1st facility in whom we paid our deductible to was faulty on doctor notes BCBS of IL dropped our deductible to the 3rd health facility.
This is so confusing on how billing works today. I asked BCBS of IL how and why this even can occur. Their response was "well when some facilities do not require your deductible we choose the next one in line"??? They tell me to not pay our deductible to anyone 'til we receive our EOBs. I tell BCBS that it shows on our EOBs deductible met some show patient resp when I know how to read EOBs. BCBS of IL has no true answers on how they do their billing. Some are quick on answers and some just give away their lies and errors on their behalf. I know that BCBS of IL is faulty and part of the reason why my husband is in collections today. I am a well-experienced biller/payment poster for health and feel that my family has had enough with billing errors with BCBS of IL.
I have had BCBSIL for the better part of 23 years. I have never had much of a problem until now - I need spinal surgery. My surgeon had me do all kinds of pre-surgical testing that took me over a month of continuous work to get completed in time. I have spent a lot of money on these pre-surgical tests that now seem like a waste of time. My surgery date was all set but the day before the surgery it had to be cancelled. According to BCBSIL, my surgeon's office was given the wrong fax number and the insurance co. said no clinical information received. Surgery was postponed until the following week and an appeal had to be submitted. Once all the information was sent to the proper fax number they still denied my claim stating that they no longer cover that procedure.
I suffer in pain every minute of every day. Legs are weak and numb. I get spasms in my lower back and shooting pains in my back and legs. I can no longer do my job functions as required by my company and I risk losing my job. I have a safety sensitive job and am not allowed to take my meds while at work. Problem with not taking my meds is I cannot sit, stand, or walk for more than 10 minutes without debilitating pain. I suffer from depression and my medical problems are making my depression worse. I can barely get out of bed anymore. I live on pain killers and they are affecting my stomach.
I also stand a very good chance of addiction. Constant debilitating pain makes my life unbearable if I am not on my pain meds. I have tried physical therapy, injections, inversion therapy, and numerous pain meds. I am now on Morphine and the pain is still there. I am never pain-free. My spine is bone on bone and BCBS does not think the surgery is effective enough.
What gives them the right to play with people's lives and decide that we have to stay miserable. They collect money from me and my employer every month and it doesn't seem to matter. My surgeon, who I really trust and is very reputable, thinks this is the best measure to correct my back problem but the insurance company is playing god and is almost telling him he is wrong. What happened to Blue Cross Blue Shield of Illinois, they went from being a good insurance company to a HORRIBLE insurance company. If I had a choice, I would never get another insurance plan with Blue Cross Blue Shield of Illinois. Buyers beware. This company stinks.
Medicare Advantage PPO through Blue Cross Blue Shield of Illinois - the Medicare Insurance industry is big bucks. And confusing. I had a Medicare Advantage HMO last year 2015 and changed to a PPO this year. While I understand, Doctors, Hospitals, and Pharmacies have to be in the plan to get full coverage. It is hidden that Labs that Doctors routinely send their tests to have to be in network. When I got a EOB from Blue Cross I called and asked for explanation because an accompanying bill reflected that any extra was my responsibility. Not having been fully informed of this part of in network, I was shocked.
I have spent countless hours with customer service from Blue Cross Blue Shield of IL. including their corporate offices in Chicago, the Labs, Medicare and filed several complaints. I am still waiting on results. I also filed a complaint with Medicare trying to get out of BCBSIL Medicare Advantage. Because of times to enroll, I cannot at this time get out of it. And the BBB got stonewalled because BCBS said they cannot discuss my case because of HIPAA guidelines. I need help, this is a billion dollar corporation. Please help. The date I filed my Medicare Complaint was 4/2.
BCBS denied reimburse for my gym usage for December 2015 because they said I wasn't covered, when in fact I was. New coverage information was keyed in on December 25, 2015 for calendar year 2016. This in fact goofed up hundreds of reimbursements. After calling BCBS complaining, I was given a new ID number to use. Which in turn I give to gym just to use this one time for December 2015. Now it just so happens that this number is not useable. Did CSR just give me a line of "crap" to get me off the phone? Who knows if I'll ever receive this $20.
My daughter has degenerated disks, one is bone on bone and another is more than halfway to being bone on bone. She was scheduled for surgery in Arizona where she works for State Farm Insurance. Unfortunately, State Farm headquarters is in Illinois, consequently all SF employees have BCBS Illinois. BCBS Illinois denied my daughter's surgery a week before the surgery based upon BCBS claim that my daughter's surgeon did not provide documentation on the non-surgical treatments. This is a total lie by BCBS Illinois! Even the BCBS doctor agreed with my daughter's surgeon regarding the necessity of surgery.
I have spoken with other people who also have BCBS and their surgeries were also denied with this same lie as well as claiming that BCBS never received any documents at all. This is the worst insurance company on the planet. I would like to thank BCBS Illinois for coercing my daughter into becoming a drug addict as only class 4 narcotics will mask the extreme pain she is experiences 24/7. I do not live in the same state as my daughter. I made arrangements with my own company to allow me to work from another state. I am also out the cost of airfare between Michigan and Arizona. A small price to pay when considering my daughter's quality of life is diminished significantly. If I could give BCBS Illinois negative stars I would do so. If you are unfortunate enough to have insurance with BCBS Illinois, I recommend you change your insurance to a better provider.
The phone line experience is horrible!! Deceptive. It so disrespectful to keep a client waiting for 2 hrs only to get in touch with a customer agent. 3 days and no answer? Give a break. If this is the best portrait of the BCBS in Illinois, what can you expect when you are in the doctor's office? Dump Blue Cross Blue Shields in Illinois.
BCBS of Illinois has really disappointed this time. I've had them for over 20 years and the past 15 I have suffered from chronic migraines averaging about 20 per month. I have tried every drug, acupuncture, hypnosis and nothing has helped until I found out about Botox injections a year ago. My migraines have now been reduced to about 3 to 4 a month and I feel like I finally have my life back... until now. They just sent me a letter denying my claims for the Botox because my migraines have decreased by 60% so they don't feel it's medically necessary. What?! The reason why my migraines have decreased is because of the Botox you idiot!!!
Now they'll be paying my bills when I have to go to the emergency room at least 3 times a week. All these people care about is money and not the well-being of their customers. So now I will suffer and probably lose my job all because they won't pay for the treatment I need to live a normal life. Thanks BCBS, I'm glad I've been so loyal to you... I will be sure to never recommend you to anyone.
I was a member in Blue Cross and Blue Shield of Illinois for almost 2 years. I have always been so unsatisfied with their customer service(took months to change my PCP, long hold time when you contact and etc) so I decided to cancel my membership. Unfortunately I have already paid my premium fee one month in advance so I was told I would get refunded. I have never did!
I called 8 times, spending hours on hold and nobody ever answered me. What makes me really upset is that every time I called I was told a different thing! Two times I was told I would get a call back and I never did! Once I was told my request is rejected and she does not know why! Two other times I was told I have been refunded by them 2 days ago and I will receive the money soon! But when I asked her which account is the money paid to? She said she does not know! And of course I have never received a cent nor a right answer why! I just feel so sorry for myself and people who has to deal with this insurance company!
We were loyal BCBS customers for over ten years. Being self-employed, we paid our premiums for our PPO plans out of pocket. With the healthcare reform, our premiums increased significantly for our plan. To maintain the same premium payment, we had to change to a lesser (Bronze) plan with higher deductible. Fine with us, as long as our basic preventive services were covered. Our physicians have always accepted BCBS PPOs, and we were informed by BCBS that the Blue Choice PPO was comparable to our last plan. Great. We enrolled in the Bronze PPO 06 plan figuring we would pay visits out of pocket, but basic, well-child and adult physicals would be covered. I go for my physical and receive a bill one month later for $1700 from the physician indicating BCBS did not cover the physical and associated preventive tests.
I called BCBS immediately to find out if the claim was submitted incorrectly as our basic preventive services should have been covered, per the policy. Per my physician website, they accepted BCBS Bronze PPO 6. The representative, whose name I have on file with the date of the call, indicated yes, my plan covers "100% of preventive care… adult and child physicals and tests". She stated she was resubmitting the claim, not to worry about the physician bill as BCBS would correct the matter. Given this, I proceeded to make my son's well-child appointment for one month later. I then received a bill for his visit ($1100) and a past due notice for my visit as they indicated BCBS did not cover my exam or tests.
Immediately, I called BCBS to dispute their failure to pay. I spoke to two individuals who stated my dispute was being referred to their claims department and would be handled within ten days. While I never received a call, I did get a collection notice for the bill associated with my physical. I immediately contacted my physician group's billing department to inform them I was disputing the insurance denial. At that time, the billing rep stated other Blue Choice patients were experiencing the same difficulty and frustration that BCBS was not covering services. It was not just me.
After getting a stay on my account with the physician, I again contacted BCBS as ten days passed and I did not receive a call. It was during that call that the BCBS rep informed me the preventive services were not covered as our doctors, who we have been seeing for 10+ years, we’re out of network. This was the first time I was given that information. We would never have signed up for a plan of which our physicians are out of network and I certainly would never had scheduled my son's physical if I had been informed that his well-child visit would not have been covered. I would have appealed to change plans immediately.
I have sent two letters to appeal and will be submitting a complaint to the state, but this seems to be a larger issue of misinformation by the insurance company because now our physician's website explicitly states that take BCBS PPOs but NOT Blue Choice. We must not be the only people that have been misinformed. I hope this gets investigated further.
Diagnosed with Lynch Syndrome after having uterine cancer. I am at 4 times the risk for breast cancer. After thinking I might feel a lump they denied the MRI suggested by my doctor since I have dense breasts. When they told BCBS of IL I was at risk for breast cancer they said, "Well she's at risk for many cancers!" Denied.
I had a back injury, 3 herniated disk in my lower back. It took them a month and a half to let me get an MRI When I knew something was terribly wrong. I've broken bones and never had pain like this before. Now my doctor requires I have back surgery so I can go back to work (been off for almost 4 months now). He does a new procedure that has a higher success rate And doesn't do the old fashion way of taken out bone to get to the disk. Results in a better long term effect this way. After having my MRI I was informed I have arthritis in my lower back so as I get older it will get worse. So BCBS will only pay for old way of doing the surgery Resulting in a weaker lower back from time of surgery till I kick the bucket. I quad, work out and play sports. I'm too active to have a weak lower back I'm 32. If I have surgery done way they want I will have to watch what I do and how I do it until end of my days.
I have appealed and again appealing. They do not want to spend a little extra money to get it done the right way. Both doctors have said if I proceed the way they want it done I will be back in surgery within a year because of my slight abnormal spine and making it more weaker Or become a couch potato. Not my lifestyle. Frustrated beyond belief for something I'm paying for and not receiving the benefit I pay for. Would be like having your car insurance fixing your car with parts that are lesser value and won't last as long as what they are supposed to. Never had BCBS before but I am not impressed by any means. I would highly recommend not having them if at all possible.
I contacted Blue Cross in March 2015. I was told if my primary faxes a prescription for ortho massage, I would have 20 visits covered. If I went out of network, Blue Cross would only pay 90%. I have had 6-7 denial letters. Yesterday they called to inform me: My total claim's $2,300. They are only reimbursing me $324. How do these people sleep at night knowing they are denying coverage to people that are sick?
Insured through husband's employer with a half-way decent policy, but Blue Cross inconsistently pays dental claims and has denied needed procedure estimates in the past! We get the feeling they'd like to eliminate our dental coverage altogether, since they hate paying anything! Most recent claim on an emergency root canal, after the deductible was covered, they only paid $160! That is nuts! Leaving us with a huge bill with the dentist! Is that why we pay thousands of dollars a year? For crappy coverage?! Of course we filed an appeal and of course they sent a letter saying it was covered correctly... but still no actual explanation! These people have no consciences! We are not dropping this. Will make phone calls and if necessary file a complaint with state board of insurance!
I can't tell you how many cases I've worked on where the claims weren't adjudicated correctly, or the member is misinformed by the carriers' customer service staff. It's even confusing to us! But we make it through it, and help the members resolve the issue. I don't think the carriers do what they do maliciously, they just have way too many people interpreting the coverage and the law, and a lot of them aren't educated enough to make an informed statement. It really is maddening. My advice? Find yourself an agent who's licensed to help you through your future enrollment. No only do they help you enroll, they help service your account and advocate on your behalf with the carriers. At no additional cost to you!
My policy was written in 8/2013 as a Blue Edge HSA policy with access to BCBS's largest network of providers. Now this Winter 1/2015 we start to have problems with our long term providers suddenly being denied as out-of-network providers. What!!!??? Come to find out BCBS has altered our policy without our knowledge or consent to a health reform network... "Blue Choice".... that was created after our grand-fathered policy. I have tried several months to resolve this with BCBS! No one is listening and their reviews system is useless. I have a contract for a specific policy! I did just sign up for a lesser quality substitute! Please comply with our contract and process our claims!!!
We also have a deductible issue! I was to have a 3500 individual with a 7000 family. Do you think they processed as such...! No way! It's a scam!!! I have reference numbers of documented phone calls with pre-certifications. All to no avail! Their consumer support is setup in such a way to deny deny deny and reject even if you have many supporting documents to prove your cause. I am now taking this to The Illinois Dept. of Insurance! BCBS is no longer a premiere insurance company. BCBS of IL is a corrupt mess!!!
I have been fighting with this issue since the beginning of 2014 when the new Obamacare plans were being implemented. A Blue Cross employee received a new enrollment from a woman with a similar name to mine, so they decided we were the same person. BCBS entered her information on my policy that I have had since 2006. I met with the Blue Cross department in Naperville, IL in 2014 and was told the situation had been rectified. But I still have confusion paying premiums, and now I received an explanation of benefits today for lab work that is not mine. I know it is this other woman's. Now my health history and her health history are combined. I do not know what to do.
With all these HIPAA regulations and privacy regulations, I am appalled that BCBS would let this happen, and that they would not realize what a big deal it is to me. If this other woman has significant health issues, it can follow me the rest of my life. I do not know what else to do. I already filed a complaint with the Illinois Department of Insurance last year, and they blew me off. Does anyone have any suggestions?
I have a BCBSIL Gold PPO plan for which I pay an exorbitantly high monthly premium. I am pregnant and currently have to visit my OB/GYN every other week. The coverage outline clearly states that I do not need to pay any co-pay after the first prenatal visit for maternity services. Still, every time I visit my doctor, I receive a bill stating that BCBSIL did not pay the complete amount and that I need to take care of the co-pay.
As per BCBSIL, the services done at the doctor's office are not necessary, and because I receive the services at my OB/GYN's office, I need to pay a co-pay every time the doctor provides any treatment to me. If BCBSIL feels that the doctors are overcharging, then why do the patients have to take care of the extra charge!! If there is so much of an issue, why doesn't BCBSIL set up their own hospitals and have their own doctors who will know exactly what treatment needs to be performed! At least the patients will be spared of spending exorbitant amounts on both, the monthly premium and the medical services. Someone, please advise if this is the case with other insurance companies too.
I went to have a Pap test done. I handed my insurance card to the lady at the front desk who quickly handed it back and said "we don't take this insurance" I then asked who does and she laughed and stated "no one!" I paid out of pocket for the Dr. Appointment which was $100.00 and then got a bill for $420.00 for the lab work! I understand being "out of network" and paying more! But the whole point of having a PPO is so you can go wherever you want! I also received an order to get a mammogram done. I left that appointment so upset that I was given a script for an antidepressant. I came home called the number on my insurance card and was given the name of a facility that does take my insurance. I made an appointment with that facility because I had to get a new mammogram order from someone in my network to prevent having to pay out of pocket $500.00 or more for this mammogram.
I got the order and had the mammogram done at an Advocate Good Shepherd Imaging center which took my insurance card, did the mammogram and I was on my way no problem. The next day early morning I received a call from the "Breast Care Center" at Advocate Good Shepherd Hospital stating "something came back on my scans" and that I needed additional scans done and an ultra sound that could only be done at the hospital location. I show up at the hospital location and gave the lady at the registration desk my Insurance card and she informs me that Advocate Good Shepherd doesn't take my insurance and I will have to sign papers saying that I will pay for all the scans and test out of pocket. I refuse the test explaining my $500.00 recent Pap smear and explain I will call my insurance and find out where to go for these additional scans so that my insurance will cover it. I head to my car, upset again about my crap insurance!
I start calling my insurance and proceed to ask where I can go for these additional tests/scans that my insurance will be taken. The person on the customer service line gives me 2 different places Centegra imaging center in Woodstock and McHenry Medical center in McHenry. I call the McHenry number and they are just a call center and only deal with chiropractic issues and I call the Woodstock place and they don't take my insurance. Fortunately the nice lady at the Centegra place in Woodstock voiced understanding and stated she was familiar with the issues people we're having with what she referred to as "Blue Choice plans". She actually gave me information stating "I believe Alexian Brothers takes your insurance, here is their central scheduling number." Mind you she doesn't even work for my crappy BCBS insurance company!
I then called the BCBS member customer service number at 1-800-538-8833 and simply asked, if I were to need to go to the emergency room because I was dying, which hospital takes my insurance? After several minutes of searching he couldn't find not 1 hospital! I explained that I didn't want to wait until I had an actual emergency to find this info out. The customer service person then went on to explain that I had a $500.00 deductible no matter where I went. This only pissed me off more because I am aware of my deductible and that isn't what I asked.
I explained I understood the deductible and that if I needed emergency treatment I would gladly pay that but if I was admitted to the hospital because of this emergency that 1 day in the hospital could cost thousands of dollars and I pay over $230.00 a month for insurance so I need to know what hospital I need to go to if I am dying and going to be admitted so that I can afford to have treatment after my $500.00 deductible was met??! Crickets! Nothing! He could not give me one hospital that takes my crap insurance!
He then informed me that open enrollment is next November so hopefully I can make it until then without dying!!! I could see if I opted for a cheap $50 a month plan or some Obama care but I didnt! I don't receive any help from the government! I pay all my own expenses! I only rely on myself! How can a company such as BCBS offer a plan that no hospital will accept? And if there is a hospital that will accept this insurance why can't customer service give me the name of that hospital? Guess I will rely on prayer and luck to avoid any life crisis until November when Open enrollment happens!
As of today I have spoken with approximately a dozen customer service reps from BCBS and still no one has been able to help me. Blue Cross Blue Shield took my premium and money from March, 2014 to August 2014 and did not cover one penny of my medical costs causing me financial damage and emotional pain. Someone dropped the ball and REMOVED me from their system, this caused me to not be covered when I thought I was. It is too long of a story to write in here. It is just very upsetting--thanks to "Obama don't care."
Our policy started Jan 1st 2015. We paid for Jan and prepaid for Feb for a total of $1,660. We called to cancel the policy on Jan 12th 2015 because we were able to get COBRA coverage that is better. We were told that a refund will be processed in 45 days. We called again the next week or so to make sure that the refund was being processed and it was for both months Jan and Feb. We were assured that it was for both months and were told to wait. We called again a couple of weeks ago to check the status of the refund and were told that it's being processed and if we don't get our refund check by Feb 20th to call again. Well I called today, Feb 19th as I didn't want to wait one extra day as I had a feeling the check didn't come so it's probably not coming.
Today, Feb 19th I was told that the they never actually processed the refund because the request has never been forwarded to the financial dept of Blue Cross Blue Shield of IL. Really??? We have called 3 times and every time we called we were told that it was being processed and we were going to get our refund by Feb 20th. So today, I was told that they forwarded the message to the financial dept and it's going to take an additional 14 BUSINESS DAYS for the refund. This is crazy! Blue Cross Blue Shields of IL owes us over $1,660 and no urgency to refund our money!!! How do I know that this time they actually forwarded the message to the financial department to get our refund??? Am I going to wait another 14 business days only to find out that someone didn't get the message??? This is unbelievable! I will NEVER get health coverage with BCBS of IL!
I was sold an health insurance by Blue Cross & Blueshield hmo pos. I switched to this one due to 2 reasons 1. Doctors and Hospitals are close by, 2. I spend winter time with my daughter in Fl. BB told me before I go to FL, they will assign a PCP in FL so that I would have the same coverage as I have in Illinois. It was a total lie to get you enrolled. When I called BBC, they said there is no such thing. If any one else has the same issues, I think this is good for a class action law suit.
Secondly, it is very hard to get through the line. Their communication is worst than third world countries. Another issue I had is false info on doctors in their Network. I was given a PCP printed in my BBC Insurance Card. I took an appointment and went to see the doctor. The secretary in the office said, the doctor is not in their Network. I lost the good part of my day. The office tried to call them and I also tried to call them. After hours of on hold, they said, I have to pay $60 to see him. My co pay on the card is $10 to see the same doctor. This means I will not be able to fill up my prescription for 6 months. I pay medicare for part B and no coverage till end of May unless, I pay for everything separate. To me, this is an insurance fraud by BBC and I am looking similar case so that we could file a case against Blue Cross & Blue Shield of Illinois.
My doctor ordered a test. The hospital administered the test just as has happened for years. Not anymore! BCBS denied it stating "Member did not meet BCBS Medical Policy Criteria for Coverage". I have to ask why would I know the criteria better than the doctor or the hospital at which the group health insurance plan is through. If I was a doctor or worked for BCBS maybe I would know but that did not seem to work for my doctors. So we got hit with an $1,800+ bill for something that should have been less than $200.
To make it worse they are now doing it again to one of my son's bills this time for $2,100+ and this one we had pre-authorization on. I have not seen a doctor, my back doctor this year, as I am afraid of getting stuck by BCBS. My handicap placard expires in November and he will not renew without seeing me but I cannot take the $2,000.00 BCBS challenge anymore. My whole family is hoping we make it until next year safe and sound when we switch from BCBS.
While away from home my wife required emergency surgery on Saturday, May 31st, 2014. The hospital Mother of Frances Hospital called BCBSIL for "Preauthorization". BSBCIL does not staff on weekends and did not accept the preauthorization. These facts are not disputed. Neither is the fact that on the BCBSIL card and they state that notification needs to be done within two days. These are the issues I have with this requirement:
1) The fact that the hospital called BCBSIL on Saturday, May 31, 2014 is not disputed by BCBSIL. They admit that they are not staffed to receive "Preauthorization" calls on the weekend. If this is important to them, then they should be staffed.
2) The fact that BCBSIL puts the onus on patients to notify them and not on the hospitals. They're putting this requirement on the patients when, especially in an emergency, they are the least able to navigate the health care bureaucracy.
3) The requirement to notify BCBSIL is the responsibility of the Patient, but actually performed by the Hospital in the vast majority of cases. This causes confusion when confirmation is not given to the patient that authorization was accepted. If in every encounter in the past, the hospital was the one that contacts BCBSIL for authorization and in this case tried, but preauthorization was not successful because BCBSIL does not staff on weekends, how is the patient supposed to know that preauthorization was not successful.
4) The amount of the "Penalty" is arbitrary and is not based on actual damages caused by not pre-authorizing. There is no claim by BSBCIL that any unnecessary procedures were performed or that Preauthorization would have been denied if they had been staffed to take the call.
5) That there was no prior notification on the amount of the penalty.
6) That whatever the point of the preauthorization is the operation was done on Saturday and my wife was released on Sunday. On Monday there was obviously nothing to preauthorize, it was already done. There was no "Cost Containment.." issue, which is the bases of the denial. My complaint is while BCBSIL has a rule, the rule is fundamentally unjust, arbitrary and illegal.
7) The term preauthorization is used on the members card, but this use of the term does not meet any of the accepted definitions: McGraw-Hill Concise Dictionary of Modern Medicine: "Managed care The requirement by an HMO that a costly surgery, specialist referral or non emergency health care services be approved by the insurer before it is allowed." Invalid because "non emergency".
Farlex Partner Medical Dictionary: "A prerequisite, often intended as a rate-limiting or cost-containment step, in the provision of care and treatment to an insured patient. A practitioner who expects to be paid for a service must use paperwork and telephone contact with a designated entity (often clerks, but sometime medical professionals), often a TPA, To determine whether the proposed treatment or procedure is deemed medically necessary for the health and welfare of the covered party." Invalid because the BCBSIL was not staffed on the weekend to determine medical necessity, and the penalty was not based on medical necessity but on failure to notify.
Medical Dictionary for the Health Professions and Nursing: "In the U.S. authorization of medical necessity by a primary care physician before a health care service is performed. a referring health care provider must be able document why the procedure is needed."
I was on hold for over 3 hours today, trying to talk to someone in the benefits department in IL - I have been left on hold, disconnected, been given wrong information and even transferred to some other number that had nothing to do with BCBS. I am shocked at how poor the customer service is. Last time I was given incorrect information about a provider being in Network, then actually went there to find out they were not - that was after an hour phone call!! I signed up for this plan BECAUSE hospitals close to me and my Drs. were in Network, only to find out after open enrollment that they were no longer in network.
This is not fair, and not the coverage I paid for. The in network providers should not change after you buy the plan - bait and switch!! I finally, after 3.5 hours, asking for a supervisor, got a person who was knowledgeable and could answer my questions. It is not right to have to invest 4 hours of my workday being on hold and disconnected, just to find out my benefits. They should have people there to take calls for the fortune we have to pay for this. And who takes care of 100% of the bill from the provider they told me to go to that was in network, that was no longer after I went there? I would not recommend BCBS of IL to anyone!! This was Blue Choice Gold PPO.
My doctor put me on a CPAP machine. I stop breathing excessively during the night. I have met my deductible but it starts over in 1 week. They will not go ahead and buy me the machine now. They will only pay to rent it for 3 months first and then they will pay for the machine if my deductible has been met. By then my deductible will have not been met as it starts over in 1 week. This blows and is so unfair. I called them but they just said that was their policy. I asked them could they waive the 3 months of renting the machine first if my doctor sent them a letter stating that I had no problems with the machine during my sleep study and they said no. In other words I'm screwed and will end up having to buy the machine.
I purchased the BCBS Blue Choice PPO that went into effect Jan 1, 2014. One of the reasons I chose this plan was because our pediatrician accepted it. The first few office visits for our newborn were considered in network and were billed as such. In April 15, 2014, we got an email from Town & Country Pediatrics stating that BCBS was no longer allowing them to be "in network", so all of our visits from Feb through mid April were billed as "out of network". Blue Cross blames T&C, T&C blames BCBS and I get caught holding the bills.
We had changed from our regular BCBS ppo for years to the one offered by this thing called obamacare, saving $200 a month, with the same coverage, a $6000 deductible and a 100% coverage after that. We were in the hospital on January 1 2014, and as of today 8/11, I am still on the phone with a BCBS rep for more than 2.5 hours now trying to manually work on the computer glitches that the new obama systems have.
I have paid $7000 out of pocket even though I am only responsible for $6000, and I still have providers after me every week, and I am still calling BCBS every 10 days spending hours on the phone. Oh, and there was a dumbass BCBS rep that doesn't even know how to read my coverage. Ahhhh!!! UGH!! Super frustrated. Someone should start a class action on this for my time loss on these phone calls, and grey hairs!
It is correct they are cheaper but they stab you in the back anytime they see that they can. I am covered only on ER. If I needed ER, I make sure I go to see a doctor first just because it will be cheaper for me if it is not emergency. So last time I went to a doctor for a boiler on my back neck and I was told to go ASAP to an ER. I did and when the bill came, they said I am not covered even though the ER doctor stated I needed ER. They deny me in a letter sent to me. I went to my agent who introduce to deal with BCBS. He wrote a letter to ILLINOIS DEPT. OF INSURANCE, all that after the collection agencies started on giving me all the **.
Long story short, IL Dept. of Insurance solved the issue and made BCBS to pay. I called the idiots to see why they changed mind after 1 year of all insults I had, and why they paid and for what reason... The lady I talked to at BCBS had no answer and said she'll call me in 2 days to give me an answer and still now after 3 weeks I didn't know why they paid it. NOW, I am dealing with my attorney that said he'll be glad to hold and start the case. Hope I would screw them as they treated me. They deserve it.
I got BCBSIL in Oct for Obamacare, 5000 Ded. 100% after ded., had to go to Hospital and paid the bills till I got to $5007 ded. Now they say there's a glitch in the system so it was not paying bills after the ded. and just kept adding them to the ded., now at $10550. They say they are running the claims through 2nd time and all will be paid but I asked if I should pay the bill that are due (which will go on my credit report if not paid) and they say, "No you don't have to pay." What a bunch of B.S. If I ran my business like this we wouldn't be in business long.
Blues Cross has denied me my benefits for 2 different items in the last 3 months - both of which are definitely covered:
1) A prescription was filled and I paid cash for it. It had been covered in previous and subsequent months. I had paid cash at the time of refill because the policy premium was paid late. The premium was caught up and paid in full, but BCBS and their "handling" company Prime Therapeutics continue to deny my rightful reimbursement.
2) I have dental coverage, but they made a mistake at renewal in May. Now they are using the ACA to hide behind, blaming it for their errors, and telling me that I only have pediatric dental coverage - which I never had (I am a 49 year old woman with no underage children). When the error was brought to their attention - they would not just correct it, even though it is clearly a clerical error on their part. They told me I had to contact my BCBS contact and ASK - get that - ASK - them to correct THEIR error. If they want to deny the coverage, they should REFUND my premium, but all I really want is for them to pay the claims that were included in my coverage.
I hope that everyone affected like this joins a class action suit against both BCBS and Prime Therapeutics to see that their abuse of power (the result of keeping OUR money!) is halted. WE SHOULD ALL CHOOSE A DIFFERENT CARRIER and hit them where it counts. I KNOW I DID!
I have been with BCBS IL for years. Since January I have been paying toward my deductible and met it in March. Due to a "glitch" in the system, they are unable to recognize this and therefore, have not been providing coverage. I have been paying out of pocket for all of my medical expenses that they should be covering. They have told me that they do not know when this will be fixed and that I should stop paying providers myself because when they fix the "glitch", I may not be reimbursed properly. What?!?! I am beyond angry and it is criminal what they are doing.
Received two payments without explanation, made several attempts to connect with an individual and/or department that might be able to assist with an explanation on where and who to apply these payments to with no luck. Experienced an incredible amount of frustration with inability to connect to a human being by phone or internet. The telephone prompt being programmed to disconnect the call with a sweet goodbye when the limited options available do not suffice is downright insulting. Next step, snail mail, that's right, US postal in this day and age for corporate communication, completely unreasonable and primitive, certainly does exude the confidence one would expect for a corporation of that magnitude.
Have been paying for healthcare since January and have no healthcare. They take 1900.00 out of my checking account and have not given me coverage because of a "glitch"in their system. I call every other week and am told the same thing, that this takes time and they will have it fixed soon - that I am being put on "the fast track" but I still have no insurance. They still have my $9500.00. I have no way to stop this unless I change checking accounts which I am going to do this week. FYI these phone calls take 2 and 3 hours each because of the hold times. I am thinking of going to Karen Atwood's home (she is the CEO) and begging her to help me.
In March, I searched through the healthcare marketplace, spoke to a representative of both the market place and BCBSIL, and found what I thought was a good plan. I chose the Blue Choice PPO Silver 003 plan. I was told by the BCBS rep that I would not have to change doctors because I was choosing a PPO plan. That was great. I love my doctor. So I signed up. Paid my premium. A month and a half later in May, I went to the doctor, who then sent me to see a muscular specialist. Then in June, I received a notice from BCBS and from both doctors offices that my visits were not covered and that I owe the full balance.
I contacted BCBS on June 23, only to be told that the "CHOICE" PPO has a "limited network" of doctors that I can see. I explained the above to the customer service rep (person 1) who then sent me to a (2) claims specialist, who then sent me to a (3) sales rep to change my plan but the sales rep said that I could not change plans until November (so I asked for a supervisor). He then sent me back to (4) customer service (where again I asked for a supervisor), who then sent me to (5) claims agent again, who finally, when I asked to speak to a supervisor (this is at about the 2 hour mark), forwarded my call, NOT to a supervisor, but to a (6) healthcare.gov rep. Completely out of the BCBS bounce house, the healthcare.gov rep was awesome. She actually listened to me and changed my plan.
During my bounce around of 2 hours of holding and sporadically speaking to people who had no clue why I was forwarded to them, I gained very little information other than the plan I was on only allowed me to see a small number of providers that were "in network for my plan". When I asked them why it was labeled a PPO and not an HMO, and that before I finalized my purchase on the healthcare website that THEIR rep told me I would be covered, they said the rep must have misunderstood the plan.
I was told by all BCBS reps that there was nothing that they could do for me. I continually asked for a supervisor who could direct me to someone who could help me. NOT ONCE DID ANYONE TRY TO SEND ME TO A SUPERVISOR!!! EVEN THOUGH THAT WAS MY DIRECT REQUEST WITH THE LAST 4 REPRESENTATIVES I SPOKE WITH.
Being unemployed at the moment, I sadly don't have any other reasonable priced choices outside of BCBS. But once I am working again and open enrollment comes around, even if it cost me more, I will be going with a different company. BCBS knowingly DECEIVES it customers into thinking they have a PPO plan, when in reality it is a HMO. Because they put the label "CHOICE" on it, they are allowed to get away with basically baiting and switching the customers out of their money and not covering a lot of doctors and services.
My son had called to see if a certain procedure would be covered by BCBS and was told yes it would so I picked him up on my insurance at work which cost me an arm and a leg. Well after the procedure is done and we have bills of over $20,000.00 BCBS is now saying no it was not covered. They are only concerned with making $$$$$. Very rude customer service, dishonest and unethical insurance company. I had only had one claim with them in the 10 years and they applied it all to my deductible!!!!! If I would have known they were going to deny coverage for this procedure would have saved the money paying the premiums and just gave that money to my son. They should be ashamed of themselves.
I have dealt with Blue Shield of Illinois on and off for over 30 years. At one time, this was a pretty good company, with decent plans. No longer. Since signing up for their Gold PPO2 plan in April of this year, it has been nothing but a nightmare. To begin with, they botched the first payment I made over the phone (for which I had the confirmation number), and I didn't even know it hadn't been processed until I received a bill almost a month later. After numerous requests, I still don't have any ID cards.
The Explanation of Benefits statements don't explain anything, except for the amount of the bill and what they paid. No information as to how they are calculated. Wait times on the phone are a minimum of one hour, and I have been disconnected at least 3 times. You can forget about ever reaching a supervisor. At the very least, the Illinois Department of Insurance should look into these people. My advice, if you have another option, take it.
I had enrolled through the market place at the end of 12/2013. And after a nightmare with them, my updated completed application was finally sent to BCBS on 2/15/2014 for blue precision 2 plan and blue dental plan for me and my son for coverage to start 3/1/2014. And since then it's been sitting in the enrollment dept not active to this date. So, it's off the exchange but nobody is doing anything with it while me and my son remain without coverage. I've called them million times to ask why my application is not yet active and that I been calling the financial dept to ask why I never received an invoice and that I wished to pay my premium. But they said no invoice could be generated until my application is activated just to be told by the call center agents and escalation supervisors that my app is complete and is in the enrollment dept still been reviewed.
But they never have an answer for me to what specifically they're reviewing and why is it taking 4 months now for them to activate it. Each time I called, I was told that all my requests were closed as if the issue was resolved when it never was. The financial dept supervisor told me that all they have to do is simply activate it with a single keyboard click and that it's not acceptable how they're handling this. The funny part is, I have received my member ID cards but my plan is not active. All I'm still getting in the mail is the welcome letters and I have millions of them but no coverage!!!!
Last time I called was on 5/30/2014 asked to speak to a supervisor AGAIN and that was gonna be my last attempt to get my issue resolved otherwise I'd just cancel my enrollment and take my business elsewhere. The call center agent was very incompetent and uncompassionate. Told me all the supervisors were busy and could be put on hold up to 20 minutes. I remained on hold for 75 minutes without anyone picking up. Now they will cause me a serious financial hardship if God forbids something happens to me or my son and end up in the hospital because we have no insurance. I called the market place today to ask them to help but they kept telling me their system was down, couldn't pull up my application and even if they did, they couldn't do anything since it was complete and BCBS now has it. I have all my phone calls records and the names of all the people I spoke with since the start of this ordeal. It will be an even worse nightmare to go back to the exchange and request another insurance company I can never win!!!!
Dealing with BCBS Illinois has been a nightmare. Since I enrolled, they have had my bill wrong. I have called countless times and each time I am assured it has been resolved and then I am billed the wrong amount again. When you call on the phone, the waits are over an hour to get through and the recording says go online to avoid the wait. I have written online and I get a message that says you can call customer service. I write again and get a response that the responder cannot help but will give it to someone who can. Why not have competent people respond in the first place?
I have repeatedly asked for the contact information for Karen Atwood, the President so I can make my complaint known, which request is not even addressed. I was set up on auto pay and stopped it since I was being overbilled and despite the fact that it was stopped and despite the fact that I paid the bill directly, BCBS still withdrew money from my account and I had to pay fees to the bank to get the transaction reversed. My request to be reimbursed for that has not been answered. BCBS is glad to take my money but cannot provide an ounce of customer service to refund the money it has overbilled me.
I received a letter in the fall of 2013 from BCBS of IL stating that I needed to choose a new plan due to Obamacare. I chose and submitted my application for a SilverPlan in December of 2013. Before the cut off date in December, I decided to upgrade my plan to the Gold Plan and submitted the new Gold plan application on December 6, 2013. For the month of January and February of 2014, my family of 5 were placed on the Silver Plan while the Gold Plan was still pending. I paid my premium of $1456.07 for Jan. and Feb. On February 28, 2014, I went on the BCBS member's site to see if my Gold plan had gone into effect and I noticed that my amount due for the month of March was $2555.99. I placed a call to BCBS for explanation and I was told that I was being charged for the Gold Plan for March along with the difference from the Silver Plan to the Gold Plan for the months of January and February, BUT the Gold Plan was not processed as of that date, which was February 28, 2013. So they were charging me for the Gold Plan premium but I still had the Silver Plan.
During that call, I spoke with a representative named Graylan, who assured me that I would get a call back by Wed. March 5, 2014. I did not receive a call. I went back online on March 11, 2014 to pay the premium so I would not lose coverage and I discovered that I now had a credit because they processed the Gold Plan but only for my husband, therefore leaving myself and my 3 children without coverage. I placed a call to BCBS of IL that same day, March 11th, 2014 and I explained my issue and I was assured I would get a call on Thursday, March 13, 2014. Not satisfied with that I called again the same day at 2:00 pm and I was on hold for 5 hours, as nobody ever picked up the phone. I called again on Wednesday, March 12, 2014 and explained my situation with a representative and he told me that he could not contact the processing department, only via email and I would have to wait to hear from them. I am frustrated, as me and my children do not have any health care coverage which is due to their error. My applications included family coverage for my husband, myself and my 3 children.
Currently, my husband is the only one with coverage. I do not get any viable answers when I call and we have not had coverage for 2 weeks. I do believe that BCBS of IL had no right to drop us from the plan as I have never submitted any form to stop coverage. Whether I have a valid claim for a lawyer, I do not know, but I do not know where to turn to get help in resolving this matter.
I purchased a policy called Blue Precision HMO from BCBS of IL through the new healthcare exchange. The benefit summary looked too good to be true and it is. I got a check-up on 1/2/2014 from my primary care physician that is in network at which time the doctor made a referral to see a specialist. That was on Jan. 2, 2014. When the doctor's office tried to turn in the referral, they were told that BCBS of IL isn't set up yet for referrals on my particular policy and to try again soon. I've been calling everyday since trying to get information about my policy and what the process is to see the specialist only to be given the run around after waiting between 1-4 hours on hold at which time they tell me confidently to call this number (been given over 10 different numbers all of which do not handle my policy). Other times they just disconnect me altogether.
I have phone records to prove all this as well as internal reference numbers in my file with BCBS that illustrated the full extent of the games they're playing with these new policies... This extends to the doctors as well as the treatment center has also spent equal time and energy trying to find out how to submit claim for my policy or even get a pre-certification for treatment and she's been doing this 20+ years.. She's been hung up on and given false information every step of the way as well. Meanwhile I'm unable to get much needed treatment or a time frame when I will be able to. Meanwhile they took my premium with no problem and I'm stuck with a policy I cannot use... Somebody please help...
I signed up with Blue Cross Blue Shield Illinois in December 2013. My coverage started on 1/1/14. I received a card in the mail and a welcome letter. I have tried to get two prescriptions filled and both times I was told that I am not in the BCBS system. The first time this happened I called BCBS. I was put on hold for 90 minutes and no one picked up the call. My cell phone died. I eventually got a hold of a rep at BCBS the next day and she assured me that I was in the system and there was nothing wrong with my member ID #.
I decided try to get another script filled and again the same thing happened. Walgreens told me that many newly insured customers are having the same problems with BCBS. I suffer from chronic daily headaches and I need to take regular medications. Since I have been insured I have had to pay $100 for medications. I will try to call BCBS yet another time. I am extremely frustrated! Why did I sign up for this insurance????
Our coverage began 1/1/2014 and we tried to purchase a prescription yesterday. The pharmacy was told they have no record of us (even though we have an ID card) and that we need to call. I called three times and waited over 60 minutes each time, yet no agents are available. I tried call another one of their numbers that handles enrollment, and they answered first ring... only to tell me they can't help... just take new customer enrollments. I see their strategy, and it sucks.
On 9-25-13 my wife had back surgery. We got the pre approval as needed. 2 weeks after surgery we get a letter saying the surgery was denied! Blue cross paid the hospital and all other bills except the surgeon bill which is $73,000.00. We have been trying to resolve this as well as the doctor with no results! Now we are going to be liable for the doctor if we can't get this resolved. We have appealed this 2 times already and don't know what to do next.
Made call initially on home line & waited about 30 mins & got disconnected due to low battery. Called 2nd time on cellphone with await time still 60 mins. Waited over 1 1/2 hrs & never spoke to a live person. There was an option to have a call back but I did not use that because I already did that a month ago with no return call. With an overload papers received in mail I have questions esp with deadline approaching can't get answers. Get phone call talking about setting up escrow account for payment & increase in payment. How is this affordable healthcare & I'm going to be penalized.
My experience is a total scam. They have not paid for me since June 1, 2012. So my husband has been suffering with them because this is his retirement insurance. They have been our insurance company for many years. Previous to the date I gave, they have paid out a lot money, never, never a question ever. But that date they stopped was a horrendous time for me. My husband has not stopped paying no matter the cost. Have had to stop seeing my Drs. so I have not been seen for my treatments since then.
Oh!! I think I forgot to mention that I am 54 yrs old and I was diagnosed in 2010 with Parkinson's Disease... If you know anything about Parkinson's Disease, you will know that the longer you go without any Drs, the faster your disease progresses. So I will be getting my lawsuit together. I would be happy for Mr Obama to come to court with me and maybe have a beer with me.
BCBS has my records combined with someone else with the same name but in another city, born the same month and year as I. The only difference is our middle name and social security number but that still doesn't seem to correct the problem! I just got another letter from them today showing my health history along with procedures the doctors have done. Some are mine, done by my doctors but some doctors and procedure are not mine. For example: The other man they have me confused with has cancer. I don't and never have. He's had cat scan, I have not. The info shows other health problems he has.
It's been over 3 years since this started. I've made numerous calls. Have been told each time that it will be fixed. They are very polite but I'm still waiting on the fix. One of my concerns is if the man with the same name as mine should die, what will happen to my records? I keep calling because I have no idea what else to do. Each time I call I go through the same thing with a different person. Does anyone have any ideas how I might get this corrected?
I called BCBS to get information as to what was covered before I went to the doctor. They said I had $2,500 coverage for what I needed done and only had to pay $20.00 for the office visit. Long story short, my doctor's office called to verify this and they were told the same thing. I had the treatment done then received a call from the doctor's office saying the insurance now says I need to pay $1K first, which is my deductible! I asked them to play back the conversation I had with them saying it was covered and they told me in order to do that, I need to get an attorney. They suck and are so out of line! Has anyone ever fought them and won?
Blue Cross Blue Shield of Illinois has really been trying to deceive me and my family as an individual policy holder. On September 1, 2009, we switched from my wife's BCBS group plan to a BCBS HSA plan after she left teaching to be at home with our daughter born in April. At the time of the switch, we were informed that due to being pregnant within the last twelve months, we would have to have a pregnancy rider for the next twelve months stating that and the cost incurred due to another pregnancy would not be covered. Sad, but we did our family planning around the demands of the health insurance company.
In January of 2010, my wife was doing some research and found that if you went from a BCBS "group" plan to a BCBS "individual" plan, that maternity coverage was carried over. You see, by definition, all group plans have maternity (as we found out). Therefore, this no pregnancy cover rider could be thrown out. After calling BCBS and telling them this, the reply I received was, "Oh, the two divisions don't talk to each other," meaning the group and individual. Really? Because when I filled out our application for coverage, it asked for the group and policy number of the plan we previously had. On the application I put all the BCBS group information.
After 3 days of being put on hold, and talking with numerous agents, I was finally told that I had to contact the group side and get a letter that we had previous maternity coverage, and then send it to the individual side. Amazing, isn't it? After a week, everything was finally squared away, and I felt like I had won some small victory, b/c now we had maternity coverage, and could continue with our family planning. This brings me to today.
Two new policy cycles, and another child later, and my premiums are now $250 more a month than back in 2009. I take it with a grain of salt, as we just had a successful natural child birth of my son in May, and after paying our deductible, BCBS paid the rest. So, I understood the new hike in our premium. In wanting to keep my cost down, I called BCBS yesterday to choose a higher deductible plan, going from the $3500 deductible to $5200. Sherry, the woman at BCBS, was very nice and could make the change over the phone. All she had to do was put me in touch with a "Specialist". After being on hold for 7 minutes, the Specialist comes on and says she would be happy to make the change to the $5200 deductible of the BCBS Blue Care HSA.
Interesting, because the Blue Edge HSA we are currently in is a PPO, and Blue Care is the HMO. I asked the specialist to repeat which coverage, and she again states the Blue Care. I asked her what is "Blue Care" and she explains that it is not what I am in right now, but that it is their HMO, with not as many providers. She tried to bait and switch, but I called her on it. She tried to put me in a lesser program (from a PPO to an HMO) for the same premium that was listed on the premium notice change letter I received.
What can we do to get this changed? How can these companies do these things? I understand that I used the health system this year, and my premium must go up. I don't understand the other tactics when I am trying to keep the costs down for my family - the bait and switch, the lies, jumping through hoops to get answers, being put on hold for extended amounts of time.
I have submitted billing for services rendered and have received denials. Please provide contact information, as this is very frustrating! I wind up in voicemail limbo and cannot resolve this issue. Please help!
Five years ago, I signed up through Blue Cross and Blue Shield Basic Blue policy to cover large medical expenses if needed. I didn’t need smaller costs, like office visits, to be covered since I had been healthy my entire life up until January of 2012. Only through experiencing surgery for testicular cancer have I learned that outpatient diagnostic services are not a covered service unless rendered on the same day as surgery or as part of emergency care. My total medical bills to date are close to $11,000 as a result of non-payment. This amount doesn’t include further testing required to insure good health and finding a new plan will be difficult since I have a pre-existing condition.
After researching online, I learned that my Basic Blue plan was discontinued in 2010. I wasn’t notified or offered the replacement product, BlueValue Advantage. The new version covers diagnostic testing, unlike Basic Blue. BlueValue Advantage offers a similar premium to the one I pay as well. I am taking action against Blue Cross for its misleading coverage and failure to notify me of the changes in products. I have notified an attorney and will consult with him during the next two weeks. It’s not ethical for uninformed consumers like me to incur large medical bills when they could have been avoided.
I still have not received premium payment notice for my wife (Cynthia **; I.D. number **). I have requested to have her notices sent to me numerous times in the past, but with no success. When I received my statement, I have to put two checks in the mail with our ID numbers on both checks. This has been going on since 2011. My checks are cashed by Blue Cross Blue Shield, but I still receive termination notices on my wife's policy. I then have to re-instate her and pay past due premiums. I would like to make payments in a timely fashion, but Blue Cross Blue Shield refuses to send me premium notices for my wife. Can someone solve this problem? I am also requesting help from director Illinois Department of Insurance, the attorney general of Illinois, the Better Business Bureau and the Consumer Fraud and Complaint Department. Is anyone out there listening?
I began on the Blue Cross Blue Shield Insurance Plan through my new job. On a Friday, I attempted to have a prescription filled using my Blue Cross Blue Shield card only to be told by the pharmacist that my card was flagged. After further investigation, the pharmacist stated that Blue Cross flagged my account because I had another active insurance plan. My previous plan ended Feb. 29th (I called my previous insurance provider to verify this fact) and Blue Cross stated that the insurance plan was still active according to their system as of March 5th.
After several back and forth with the pharmacy, my former insurance and Blue Cross and Blue Shield, I was finally informed from Blue Cross that the flag was to be removed from my account (this was at about 12:30 p.m.) and it would take about 2 hours to correct. At about 5 pm the same day, the flag was still on my account.
When I called Blue Cross and Blue Shield, they stated that now I would have to get a written letter from my former insurance provider and have it sent to them verifying that I no longer have the old insurance. I then requested to speak to a manager to explain to me why one person tells me the flag will be removed within 2 hours and another state I need a letter to take the flag off. A manager stated there was some misunderstanding and I need to have a letter verification because a Blue Cross and Blue Shield rep spoke to someone from my former insurance provider and my former insurance provider stated to them that “yes” my account was still active - even though Blue Cross did not document a name of who they spoke with or any other type of traceable information.
I spoke with my former insurance provider on many occasions; Friday, Saturday and Monday. Everyone I spoke with at the former insurance provider stated that I no longer had an insurance plan with their company. I called my former insurance provider requesting they send a letter to Blue Cross Blue Shield and they are stating that they can only mail this info to me which will take about 10 to 15 business days! I needed a prescription Friday and I cannot get it filled because of this stupid flag on my account and now I have to wait another 10 to 15 day to have it sent to me!
My question to Blue Cross Blue Shield is what year is this? Do you not operate with phones, computers, and faxes? You can not verify (truthfully - not just saying you did without knowing who you spoke with or having any confirmation number) with my former insurance provider through no other means than mail?! I need my medication or I will become extremely ill. You are messing with my health and it disgusts me. This was the first time I have used Blue Cross and Blue Shield and I am beyond angry with what you have provided me. Your company ought to be ashamed. If ever I have to opportunity to go with another health insurance company I will definitely go elsewhere. On the off chance that someone with Blue Cross happens across my complaint, I hope they take serious consideration into the poor service they provide and how it puts people with health issues at greater health risks when they pull this type of **.
My coverage was terminated as of 09/30/2011 for nonpayment. Payment had been paid on 09/20/2011 and proof was furnished to Blue Cross at least two times.Three weeks ago BC admitted (my 6th phone call) that they had received the original payment and would correct records and pay claims. As of today, 01/23/2012, nothing has changed. I have called three more times but still no results. I am not allowed to speak to a supervisor and over twenty emails (Dec & Jan) remain unanswered. I am very concerned about my credit standing with medical people and the VA.
I pay high premiums for BCBSIL Premier Plus which advertises 100% coverage in-network or out-of-network for ambulance service. I was knocked down to the street by a messenger bicyclist and transported to a local Boston hospital by ambulance. BCBSIL will only pay $523.10 of the $958.10 charge leaving me on the hook for $435.00. Fifty four percent (54%) is not 100% covered.
Blue Cross and Blue Shield denied a claim for my wife from The Mayo Clinic.The head of the Mayo's Neurological department requested a Pet Scan to verify an Alzheimer's diagnosis. It did. BCBS will not pay for it. Their website claims the procedure can be used for "serious" diagnosis. Alzheimer's seems serious to us. We had to pay a $4,500 medical bill, after Mayo lost patience with BCBS, and sent us to collection.
BCBSIL (BlueCrossBlueShield of Illinois) is unfairly profiting from "post claim underwriting in this state now". My wife's coverage was rescinded (canceled all the way back to it's original effective date, as if it never existed). Some insurance companies that do not conduct a thorough health history investigation at the time of application attempt, after the fact, to underwrite your insurance policy only after you file a claim. This is done by the insurance company to try to avoid the consequences of its deliberate marketing decision to forgo initial underwriting in order to increase sales and profits. This rescission took place 9 months after the policy was issued, based on a claim for services at her annual check up.
A minor side note in the doctor's record of the visit was highlighted out of context and redefined as a major condition which the BCBS claims was pre-existing and undisclosed on the application. The doctor has stated in follow-up that no condition exists and there has never been a diagnosis of it previously, and that the pre-approved tests were consistent with routine maintenance check-ups.
After 2 dozen + contacts to BCBSIL, there is continued disregard for their contractual responsibility to pay the claims they approved in advance. They have not honored their obligations by deceitfully doing what is illegal in so many other states. In California, huge class action suits and even the doctors are joining in because Blue Cross has rescinded policies on unethical grounds and still approved tests and operations for which they refuse to pay, leaving the patients, doctors and hospitals holding the bag. Many horror stories in that state alone. My case is identical to hundred of the CA. cases and my contacts are all documented.
Beware folks; you are not secure if you have BCBS, IL insurance due to this pattern of post claim underwriting and rescission to improve their bottom line profits. Insurance consumers, and particularly those who have purchased individual health policies from Blue Cross, need to be vigilant as to this practice which seeks to deprive us, the health insurance policyholders of valuable insurance coverage at a time when it is most needed: after they become seriously ill and submit claims for promised and approved benefits.
My wife is uninsured due to being rescinded (not due to her health). She is forced to live under a high financial risk everyday now. My very high credit score is getting hammered because the bills they say they have paid, in fact have not, claims shown as processed but checks never issued. This will affect my purchasing and approval abilities in all other financial aspects of my life.
Bottom line, BCBS of IL sucks! They bait and switch their customers, which seems highly illegal to me. Long story short, we applied for individual insurance from BCBS of IL for my 55 year old husband in November of 2008. It took until Jan 2009 until they accepted him into the plan. He signed an Amendatory Endorsement stating he had back problems, but they were resolved at the time of the application. BCBS never sent an exclusionary rider or called his back pre-existing. So it was our ** luck that his back went out as soon as we got the insurance. We carried Unicare for two months simultaneously to BCBS, just to make sure BCBS paid the claims. They did pay, so we cancelled Unicare thinking everything was kosher with BCBS.
Well 6 months after accepting the insurance, BCBS sent a permanent rider on his back. We either sign it or the insurance gets rescinded. They had ample opportunity during the application process to figure this out. We don't know what is or isn't acceptable to their underwriters. They should have done their due diligence and examined everything before we accepted the insurance, because we never would have accepted it with a rider. My husband would still have insurance with Unicare if they did their homework beforehand. We never lied on the application. My husband talked with 4 nurses about his back on a recorded line. They knew everything before they wrote the policy.
My husband and I have been trying to have a baby for over two years, this past September I had a procedure done which showed that my tubes were blocked. Then in June I had surgery to try and get them unblocked but it was unsuccessful. The result was that they are severely blocked and my only way to conceive is in vitro. When I contacted the insurance company they said that they will not cover in vitro at all. I have contacted several insurance companies and they say the same thing, some say that it is consider experimental, which I believe is incorrect, since it is proven that it does work. I think this is completely unfair to all women who have fertility issues. I believe that all women should have a chance to conceive a baby. I went to a specialist last week which I had to pay out of pocket for and he said the same thing, I have to go through in vitro. He did say that he could do surgery to unblock my tubes but it would be major surgery and if in fact I did conceive, not only would it kill my unborn baby but it would also kill me.
Before Zyrtec-D,specifically, became an OTC drug, Blue Cross of Illinois covered my use of this medicine. Now, Zyrtec-D is a hybrid OTC medication -- a controlled substance dispensed under law by a pharmacist with limited supply available without a prescription AND a BCBS non-covered medication because it is STILL classified as an OTC, despite the D. By law, now, it is illegal for me to purchase my monthly supply without a prescription. As a result of the increased cost to me (three times as much), I tried a generic brand of the same medicine. It didn't work and at the expense of my health and my pocketbook.
My husband has BCBS of Illinois PPO. Encompass Health Management Systems is contracted to work with my husband's place of employment to pre certify occupational and speech therapy. When I went on the website for my husband's medical insurance in the Dept. of Human Resources, the speech therapy and occupational therapy is listed as paying at 90% in network coverage as long as it is pre certified by Encompass Health Management Systems.
Our 4 year old son has sensory modulation issues, auditory processing, vestibular, oral sensitivity, tactile, inattention issues all with his sensory processing disorder. He has some coordination difficulties as well-that can occur with sensory processing disorder. We went to our pediatrician whom gave us the referral we needed to get an evaluation from an occupational therapist to help with the sensory issues in question. This is needed to get the evaluation itself as well as for the insurance company for coverage. We obtained that from our pediatrician and went to Children's Memorial occupational therapy dept. on April 22, 2008. We found out our 4 year old son needs occupational therapy once a week for one hour. Our insurance information was sent in and Encompass was notified that our son would be needing this therapy one time a week.
We received a letter from Encompass Health Management Systems around May 4th or so dated April 29th, 2008. Encompass is denying any and all precertification necessary for BCBS to pay for our son's therapy he needs. Their reason is, Encompass has been uanble to certify the Occupational Therapy service because services are for acquisition of function normally expected for your child's developmental age. If our son was completely up to developmentally what he should be then we would not need the occupational therapy once a week for an hour a day. We are not looking for a hand out. We are just looking for the occupational therapy service once a week for our son. My husband pays into his plan. The money is deducted from his paycheck and we are not trying to take advantage. We just want help for our son.
On May 8th 2008 I called Encompass to tell them I was going to be filing complaints with the BBB and anyone else that would listen about the unfair practice of denying needed coverage for children. I talked to a woman named Penny after waiting for around 25 minutes for the receptionist or person answering the main calls to find a supervisor. I could hear someone pick up the phone and place me back on hold as if to see if I was still on hold. Anyway, I stated my case to Penny and wanted to know the name specifically of the person Encompass was claiming was telling them from my husband's place of employment to deny precertification for our son's therapy. She could not come up with a name but stated in our benefits handbook it would probably be why our insurance pre cert was being denied. I told her I was on the main website that stated 90% coverage for in network as long as Encompass Health Management pre certified the therapy.
I wanted to at least know what page this denial is supposedly under in the benefit book and the name of an actual person in charge of the denial of pre certification. Penny told me the supervisor in charge of that information was out and would not be back for a few days.-This was 5/08/2008 that I spoke to Encompass. Shetold me she could resubmit it for review. We have the letter from Encompass giving us the ridiculous reason for not precertifying our 4 year old's coverage is because services are for acquisition of function normally expected for your child's developmental age-as previously mentioned. The whole reason for the occupational therapy is to help our son acquire function normally expected for his developmental age. It is only for one hour a week once a week-nothing extra or fancy.
I am upset that the precertification may be denied again for therapy my child really needs from insurance we pay into. We are a middle class family that does not qualify for low income special state funded programs. We rely on our insurance coverage to help us for reasonable expenses. We think that therapy for our son once a week is a reasonable expense. I am sending info. about this off to the Tribune editorial section, state legislators and anyone who will listen to try to be an advocate for my son and other families who are being abused by health management systems and health insurance companies. I just wanted to get the word out through your website as well.
These companies are hoping when we receive the denial of coverage letters that we as the ins. consumer will accept this and not file a complaint or follow up on the denial. We are our children's best advocate and we have to fight for them against unfair insurance policies and the health management system companies they use for pre certification like Encompass. Please just help me get the word out about unfair denial of ins. coverage for our kids.
We have brought our son to 2 sessions so far at Children's Memorial Hospital and have paid over 500.00 so far for 2 hours. This is our rebate check money. After that is gone we will have to use money that would have gone to bills. I discussed filing bankruptcywith my husband. We have looked into Easter Seals but it still would be around 600.00 a month. I am not able to take a job at this time or I would. We have a mortgage and other bills but would forego having our condo if it meant we could pay for our son's therapy. We aren't asking for the moon so to speak just for 1 hour of occupational therapy once a week to help our son. Our last hope is for Encompass to pre certify treatment for our son's o.t. therapy. We are at their mercy with this.
I have had several medical bills denied due to a lack of information that was sent several times. The fact of the matter is that there have been too many incidents to keep track of. I do have information, but it would take forever to find all of it. One incident in particular, is an incident that involved services rendered on 1-17-07 from CNOS (Center for Neurosciences, orthopaedics, and Spine)PO Box 1430 Dakota Dunes, SD 57049. My primary contact at CNOS is Sue. It has taken us over 15 months to get this paid. BCBS kept telling me different things, then kept telling her different things. The last instances they were telling her they needed me to send the dates that I was under United Health Care. They kept telling me that they needed her to send the EOB (Explanation of Benefits) from United Healthcare--United Plan # and BCBS # available upon request (I don't like over the internet information transfer) BCBS Address Via National Automatic Sprinker Industry is 8000 Corporate Dr Landover, MD 20785 - 800-638-2603 or 301-577-1700---United Healthcare PO Box 740800 Atlanta, GA 3037 40800 Ph#800-357-0978.
Today we spoke with Sadequa Via 3 Way Calling. Her Ext at BCBS is 4789. She stated that she needed the EOB from United and that she had a wrong address for CNOS. The address she had was a physical address and would have still reached the same place. CNOS did receive the denials so this is not an issue. Just in case though, Sue @ CNOS faxed a new W9 and the EOB while keeping her on the line. At first, she stated that nothing was received then after persistance, we tried again and to 2 different fax #'s. Eventually, she stated that she received the information. If it is not taken care of this time, what should I do. ALSO, this is not the first time that a 3 Way call had to be used to get things taken care of. The last time, they also said they did not receive the faxed info the first time and we had to fax it again. Needless to say, I have not been happy about this.
My husband works for a Union though. They choose who our healthcare is through and we don't even have a choice that allows us to opt out and just receive the money they take per hour for this. If we did we would have taken the money and paid for a different provider years ago. This would not be as frustrating if we didn't get a different story every time we called on the same issue. The first 4 or 5 times, they told me a different story on what they needed everytime. Call me if you need more info. Sue also said she would help in any way possible. P.S. I don't want to put BCBS out of business. I just want them to do things correctly. Preferrably the first time the claim is sent, then I don't even have to get on the phone and waist hours of valuable time!
Several hours of lost time. Possibly a dent in my credit history. If you want to split hairs, increased stress which leads to increased headaches and pains. Which leads to increased cost for pain medication. Which leads to financial troubles. Etc.
I do not recommend Blue Cross/Blue Shield of Illinois. When I filed a claim, they claimed there was a paperwork error, even though I had proof to the contrary. Now I have cancelled my policy, and again they are claiming a paperwork error, and continued to charge my account.
Several hundred dollars lost plus a lot of time and aggravation.
I received a letter of my bimonthly premium going up and I have only had this plan since July.It went up 32.00. I only make 28,000 per year. I am now paying 332.00 every 2 months. These people are out of control, and have been for years.
Blue Cross Blue Shield of Illinois sent me a letter informing that they are investigating my medical claim, suspecting it was preexisting condition. Fine, it's their right. But one sentence in the letter attracted my attention: "until the investigation is complete, all future claims will be pending." I called and asked why. If the future claims are unrelated to the investigated one, why they would be delayed as well? The rep in claims explained the situation quite honestly. According to her, they do it in order to force me to cooperate and give them the information they want as soon as possible, plus they hope that I would also call the doctor's office, who is expected to give them medical records, and ask to expedite. She also mentioned that if the policy was for 10 people, then all 10s' claims would be put on hold, also with the expectation that nine would press on the one under investigation. I asked if she thinks this could be named blackmailing. She easily agreed. She did not express any shadow of regret, however.
I called for a brochure to inquire about health insurance with the above named company and received it. I comply with all the parameters set forth in the brochure including the height and weight chart that states a male person of my height can weigh up to 305 pounds, per the brochure sent to me. I also qualify under the section that asks if you are presently being treated for diabetes, which I am not. I have an elevated blood sugar that I am treating with diet. In other words, according to the brochure sent to me I qualify for health insurance. Now KAREN **, WHO IS SITTING BEHIND A DESK, is making judgements contrary to what is in the guidelines that were sent to me. My body and my health are probably better than KAREN **'S. AT THIS TIME. It is apparent that this person is not following the guidelines set forth in the brochure sent to me. Either she is prejudiced against me or she is just making her own rules, contrary to what the book spells out very clearly, or she is not going by the same guidelines I was sent.
I don't have affordable health insurance. They engage in deceptive advertising and then tell you to take the State of Illinois program which has a astronomical premium. I think BCBSI should be taken to task for FALSE advertising.
In July, 1999 I had been working for Pepsi Cola General Bottlers, Rolling Meadows for about 3 months. Was new to the insurance and new to the company, in fact I hadn't received an insurance card yet. I was at a company sponsored event at a water park, I received a head injury when I smashed into a cement wall. I was taken away in an ambulance.
The next morning I called the primary care doctor I had chosen, in fact I contacted every primary care physician in the Antioch area to make sure I alerted them to the incident. When HMO received their paperwork on me, they claim they never received the form which lists out my doctors name. So they arbitrarily assigned me to a doctor in another town. Of course according to their records I didn't call and receive a referral from my primary care physician. So they have been denied the charges.
In January of 2002 it was brought to my attention that the charges were outstanding still. I contacted HMO and talked with a Sarah Morgan who assured me that this would be taken care of. She was in contact with the collection companies and they were going to send her whatever statements were needed to clear this up. I never heard from anyone after that and the charges were dropped from my credit report.
In April 10th this year my credit was pulled and it was not listed, the bank I'm attempting to refinance with pulled a subsequent report and the charges were brought back up again. To find out that the charges still have not been paid. I contacted HMO and spoke with consumer affairs who is now disputing that the incident was indeed an emergency.
The economic damage is that this incident has been on my credit off and on for over 4 years now. I was fully insurred at the time and these bill should have been paid. I'm at this time unable to take full advantage of the low interest rates because now I won't be able to refinance for at least another 60 - 90 days which is what I was told was suppose to be the soonest timeframe.
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