Horizon Blue Cross Blue Shield of New Jersey Reviews

If I could give zero stars I would. This company has been nothing but garbage from the start. I haven’t been able to get my flu shot at Walgreens paid for, my antibiotics weren’t complete, and now none of my claims are being paid for. They say they need a letter from my previous insurance that my coverage ended. Never in my life have I had to jump through hoops to get basic healthcare like this. Plus I am paying a premium for it! Not happy at all. Plus the customer service is horrendous.

What they say is Tier 1 coverage turns out to be Tier 2 coverage most of the time. Absolute horrible company with non-existent customer service. Even if you call them to confirm coverage ahead of time you can be mis-advised and there is no recourse. Means nothing that we pay over $25k a year...

I have been waiting a year and half to have a routine claim paid. Despite calling nearly every month for the past year, the claim is still "pending". First, they told us the provider had submitted the claim with the charges broken out separately and they needed to be collated. Then they told us the provider had combined the charges, but they needed to be broken out separately. Then they told us that the charges needed to be combined again. The last time around, the provider (whom was on 3-way calls with us each time) said they would do it BOTH ways so HBCBS could take their pick. And still 45 days later, the claim is still pending. At this point, I think they're looking for ways to delay paying out on the claim.

So my story starts in the year Obamacare came into existence. My birthday has been messed up ever since by one month. With every provider I have to give them both birthdays to see if I exist. More times than not they get paid using the wrong birthday. I call on the average of 3 times per year to straighten this out wasting at least 3 to 4 hours each year. I'm really fed up with this incompetence

I am a therapist and decided to accept insurance for the first time. This will be the first and last time I make this mistake. I have seen a client five time and have not received any payments from Horizon. Each time I call Horizon for help they provide misinformation and the problem is not fixed. At this point, I am losing money on sessions as I am not getting paid and I have to pay for room rent. This experience was/is beyond stressful. I highly recommend staying out of network if possible and saving yourself the stress and loss of income.

There has to be some sort of oversight, this company is ridiculous. They tell you you have to go in network, Tier 1 to have doctors and studies to have it covered without deductibles, and then have absolutely NO facilities or providers available in Tier 1. The call centers are a joke, multiple days calling, multiple hours on the phone, every rep provides incorrect information, does not understand medical terminology, and provides misinformation. No accountability, no lists of participating providers, they literally google and provide worse information than you can find on your own. They are clueless and absolutely not concerned with providing access to care under their plan. I don't know how they are allowed to take your premium payments when they cover literally nothing!!

Nothing but problems with this company. It's outsourced outside of the country so nobody really can help with locating doctors. So many medical services that Horizon recommends, such as radiology tests, are either not approved or not paid for. I've been on the phone every month with them for the last year, and each call lasts hours for several days. What they do should be criminal.

Blue Cross Blue Shield was EXTREMELY difficult to obtain approval for services even though authorized by my doctors. To make matters worse when I left they continued to take money out of my account every month until I called them on it. So happy to be done with them -CHOOSE ANY OTHER INSURANCE!

We pay $19,000 a year for the family plan plus have co-pays and $6000.00 deductible and they refuse to cover most prescriptions. Won’t cover my monthly allergy meds because I can buy them over the counter. I have asthma and was in respiratory failure twice from allergies to dust and chemicals, I NEED my allergy meds. I don’t care if I can buy them over the counter! Why should I have to pay $30 monthly when we pay $19,000 a year. They also won’t cover weightloss meds, I have back issues, bulging disc and I get spasms which are extremely painful since I gained weight from steroids, my knees are swelling and pop out from my weight. The more I do the more pain I’m in. Wouldn’t it make sense to cover the meds than to cover knee surgery or replacements, or physical therapy which I already did and it just makes it worse.

I have Blue Cross Blue Shield Omnia and it has been nothing but stressful and time-consuming to find out any information from them. Their representatives do not understand basic vocabulary of health care and give you different information from each other. You cannot trust what they tell you. You need to call at least twice to make sure. When you ask to speak to a supervisor, you're put on hold and then when someone gets back to you there is a sudden horrible connection so you cannot hear them. Then, either no one calls you back or they call you back with a bad connection, so you cannot have the phone call or they bring you back to someone who is not a supervisor without making you aware that it is not a supervisor you are speaking with.

This insurance provider is such a joke, but it's not funny it's just cruel. Would give them 0 stars if I could. After being jerked around during my entire time paying them for my coverage (a huge premium, by the way), the last straw was them charging me a deductible for testing that was ordered by a covered provider - a service that any reasonable person would expect to be subject to a copay.

I tried to do a 0 star rating but I wasn't allowed. I am absolutely appalled by the insensitive computer like customer service this company hires. I am impressed at their lack of accountability and eagerness to blame everything on the consumer locking you into owing them more money. More context: I adjusted my income in December to increase my monthly payments appropriately to reflect. I noticed I was not appropriately billed nor have I received my dental insurance card. I called today to figure out what the heck was going on. The first man was alright but sent me to escalations because he couldn't help me more than saying I am correct and their system mischarged me.

I cannot stand these guys. Every time I call to check if something is covered, I get a different answer. I used their website to find an "Inner Circle Prime" provider and ended up with a huge bill. Insurance rep says the provider is not covered. Billing department for the provider says they're "Tier 1." Contested the bill and got no help. It is nearly impossible to trust them at all. I called about getting a test covered. The first person says it's covered. The second person says it's not covered. The third person says it might be covered if my doctor fills out a pre-determination form. THIS IS FOR STANDARD PRACTICE CARE! I called the lab and they said it would be $3000 out of pocket, $500 if the insurance covers it, and $300 if the insurance denies it. Also it could be $0 because they're not sure, and these are just estimates. I FEEL LIKE I AM TAKING CRAZY PILLS!

1/23 I made a payment on my Horizon portal to pay for health insurance for month of February. It is now 2/16 (almost 4 weeks) and they still have not updated my portal although I have spoke to MANY representatives over the matter (at least three people). I was told it will not be fixed for another week (2/23) ridiculous. Made me doubt my payment went through. Also - I like to pay for month before about 2 weeks on advance (if I can). Problems with the billing and portal has been very out of sync and going on for over a year now.

Don't know where to begin. Almost every time I want to log into my online account, it has been locked down and I have to call the hotline (which is only open during the week, during work hours). Last time I was told I have to log in once a month or my account gets locked down which I've never heard before and, if true, is frankly ridiculous.

I have been trying to select a PCP for 6 weeks. Horizon does not require me to do this but the doctor's office does. I have called four times and each time the representative assures me the system will be updated in 48 hours. I have even gone on to the website personally to select the PCP and received confirmation that it would take 48 hours. At this point in time the system is still not updated. I estimate I have spent a combined 3 and 1/2 hours between phone calls and navigating the website.

While a member, my doctor's office always had to call them because their automated system is filled with mistakes. After cancelling my policy and getting paper mail confirmation, I received an email a week later saying I would be billed for the next month. Calling the number in the email, the number on my old card, or several other Horizon BCBS numbers on Google all resulted in being redirected to a "Medical Alert Center" which tried to sell me the "I've fallen and I can't get up" device. Despite an hour of trying, I was unable to reach a human associated with Horizon BCBS. If they continue to charge, I will simply report any such charges as fraud. This company is terrible.

The incompetence of their customer service dept. Is unmatched. When you finally get someone they are no help. I could not pay online so I spoke to someone and she tried 7 times and two different cards and claimed something was wrong with the card. when I told her my card works fine it was on her end she ran it again and it miraculously worked. When I asked why it wouldn’t work before she asked me to hold for survey. I asked again and she hung up. My card arrived two months later. They used the same member ID for dental and health therefore my insurance was canceled. My doctors could not submit because dental and health were same. It has been a nightmare for the last 3 months dealing with them.

Good plan if you are heathy and don't need it. But if you are sick it takes 1 hour to enter your info over the phone just to hear automated voice telling you they are not available. Portal doesn't work. It takes too long to find a doctor. Absurd beyond belief. Wasted money. Terrible service.

I am neglected and stressed every day, by my own, Horizon Blue Cross Blue Shield of New Jersey, healthcare insurer! I have no more medication for my Multiple Sclerosis (MS)-related fatigue, thanks to my mega Horizon, stiffing me. Horizon and I were friends for years, as it consistently paid for my necessary, energy-boosting ** drug. I got ** through my Horizon NJ Health Medicaid healthcare program. Until May 1st, when I needed a new, dual, Medicare-Medicaid program.

We applied for coverage for our employees through Horizon Blue Cross. We didn't get any communication from them until suddenly we were informed that our coverage was being cancelled for non-payment. Turns out, they had completely ignored the mailing address on our application and were sending documents to an incorrect address the whole time. No one had their insurance cards, no one knew what was going on. Yet somehow they were able to get ahold of us to let us know they were cancelling the policy.

I would just like to inform everyone to never ever go with Horizon Blue Cross Blue Shield of New Jersey, or just Blue Cross Blue Shield in general for anything. They have no heart and do not care about anyone but themselves. Patients are just a number to them and even when you fight so hard again and again and again to get approved of a surgery that could change my life because medication alone hasn’t been helping for over 10 years.

God help you if they make a mistake processing a claim. It was like living in a bad episode of the Three Stooges. Over 10 months into the initial claim I (not them) am close to having it resolved. Take notes and names w/ every phone call you have to make. Pretty sure they're not allowed to speak to each other out loud with words and are required to communicate via email. Not sure if they are actually typing emails or tapping their fingers on their desks to make it sound as such. Seems like once the emails were "sent", they vaporized. The person in the complaints department was to email me information, that never happened and then we were ghosted. I was disappointed. We'd had this insurance for years without issue. A conference call with an actual human in charge could have solved our issue months ago. But apparently they don't do that.

The customer is always right yet when NJ Direct for Horizon Blue Cross Blue Shield is asked to have checks correctly payable to individual providers, they make excuses instead of re-issuing checks appropriately. They combine providers and patients which mixes up the business and is extra work to get processed. When contacting customer service multiple times about the issues, they get defensive instead and don't fix the problems. Their laziness (instead of organization of what they get paid to do) is what causes bad review.

For many years I had the Silver Advantage Plan paying over $1k per month for single coverage. Fortunately, I hardly used the insurance. When Pandemic hit my business went down so I looked into lower-cost insurance using "Get Covered NJ", the representative told me the Horizon BCBS "Omnia Silver plan was just as good" and didn't explain about the tier 1 & 2. I specifically asked if I could go to better doctors in Philadelphia and was told yes, but wasn't told this would be considered tier 2 and I would have to pay for everything! Doctors visit $300, 10 min test $2,000!! They wouldn't pay the $370 blood work because it was ordered by a tier 2 doctor, even though I had this lab work done at Labcorp in NJ by my home. If you want health insurance that does NOT pay for anything then the Omnia plan is for you!

Since I started working in 2005 I have used this insurance company. They provide me with all the information and care that I need to ensure my health is on point. They have a great network of doctors and specialists. This company is always ranked number one for me.

They were really slow initially in sending us our insurance cards. They did however mail us our cards after constant pestering. They are also slow in processing claims. They are, otherwise okay. They have good coverage of doctors, for both primary care and specialists.

I cancelled your coverage after the first month of enrollment yet I am still receiving bills. A health care insurance provider should have representatives available 24/7. Not Horizon Blue Cross. I have notified them of my cancellation three months ago yet still receiving bills. It's obvious that your your representatives are not only unavailable but illiterate. If my balance is not deleted I will seek legal action for fraudulent billing!

A retiree in NJ and was forced to switch over to BCBS of NJ from Aetna. Need to get to doctor in second week of January. Informed several months ago of switch to comparable plan I had with Aenta. Never received a new card or patient ID card/number. So I try to get on portal and it's telling me I have to register as a new subscriber which I understand. However the link to it WILL NOT LOAD after hours of waiting. Called number given and of course "Call volume higher than expected". Here we go. What a joke.

Blue Cross and "Bait and Switch" Health Insurance. I purchased the silver with a 50% out-of-Network only to find out months later there was no out of Network covered. I spent way over my deductible without any medical bills being paid by BCBS. When I called, I was told, "We don't guarantee we cover any of your medical. Paying your bill every month only guarantees we'll keep your account open." I could not believe what I was told while every out over $4,000 of paid insurance and out of pocket over $10,000. What a racket! I spoke to other people who had BCBS and they had similar stories. Blue Cross Blue Shield needs to be shut down and investigated and there should be refunds.