Horizon Blue Cross Blue Shield of New Jersey Reviews

This is not about the actual services rendered (only used it a few times in the year) but about trying to get out of the plan after I enrolled. I called to cancel my health insurance the first time in early December 2017, and they told me it was canceled. Then I got a charge on my account for January 2018 and I had to call them again to cancel. Same process. Now it's 1/2/2018 and they've charged my account for the full premium despite calling to cancel 2x already. It's just a mess and is completely unprofessional. It's no small sum of money so each time I get a charge I have to scramble to make sure my account isn't overdrafted. I'd highly recommend looking elsewhere if you have the option. I personally chose Oscar, which I'm very happy with.

They failed to pay a claim because they had the wrong termination date of my plan and they cannot fix it or will not fix it and have nobody to talk to fix it - I kid you not that you go from person to person for HOURS and nobody can fix it and nobody knows what's going on. CEO should be fired, jailed or both for fraud and ineptitude.

Our oldest son has had ear "issues" since he was 5.5 years old. He has been in the care of an ENT in all 3 states he has lived in, had multiple tube surgeries w/ adenoids initially removed, and was fitted multiple times for specialized ear plugs when he was younger (b/c he can't even get water from a shower in his ear w/o risking an infection). We have never had any issues with insurance approval and payment until now...with Horizon Blue Cross Blue Shield of New Jersey. Our son is now 20 years old and because the fluid in his ears does not properly clear and builds up excessive wax (affecting his hearing), we continue to visit the ENT as infections occur or every 6 months for wax removal, along with hearing tests as dictated by necessity. The most recent visit in October showed a declining hearing level that was due to his Eustachian tube collapsing.

Anthem Blue Cross/Blue Shield Silver Plan. Been using it since May 2017, had three doctor's visits, one blood test, and 4 prescriptions (one pending), they overcharged me for both doctor's visits and all 4 prescriptions - by roughly 50% on average (over the co-pay and last one was 92%). What's the point of a co-pay?

Took my daughter to a dr and called Blue Cross to make sure the dr was ok to use, they said yes. The dr office said yes and they called Blue Cross. Dr said my daughter needed a surgery and she could do it next week. The dr assistant called Blue Cross and got a verification for the surgery, They have the name of who they spoke to and they have a confirmation number. One week after the surgery Blue Cross calls me and says they refuse to pay since the dr is out of network. Dr assistant calls them and Blue Cross says that number means nothing. WOW.

I wish I could rate them zero stars. I've never had a worse experience with an insurance company. They make excuse after excuse not to reimburse for psychotherapy sessions that they previously reimbursed without a problem. Every month it's a new and more absurd excuse. First they said my provider information was not on the form (um, it was on the provider's letterhead and on the paperwork), then they said it was the wrong state (I have NJ insurance although I live in CA, because my husband's corporation is based in NJ), then they said they were confused by the provider's paperwork and needed her to redo everything (before it was never a problem). It is now September and I have eight months of unreimbursed claims.

Every time you call, you have to give your life information over and over and over. If you call 3 times in the same day, you have to give the information again, THEY claim it's to verify who you are. NO OTHER co. does that. Other companies ask for name and ID or phone number and your info jumps up. When you're not feeling well to begin with, then you know you have to call and get trained like a dog to give the info. How redundant! With all the money Horizon makes, come up with an easier way to identify us. OR just say "Has anything changed in the last hour when you called before?" It's so annoying. Then they get annoyed if you mention it or if you talk too fast because YOU'RE in a hurry too. Use the internet? Not working either, then you also have to call to verify because perhaps that Dr. or place canceled and Horizon forgot to remove or add their name!!! Really? What a waste of Customer time.

As a provider of services for Horizon BC/BS of NJ, if I could have given them a rating of less than zero, I would have. Since becoming a provider, I have experienced non payment of claims, getting multiple excuses for why, and then finding a more reasonable Provider Services person who agreed that they claim form was "clean" and "accurately filled out" who said that she would forward it to a supervisor so that the problem could be address and corrected. I actually felt hope for the first time as this was a rare, helpful and human response from the insurance co., only to be denied again later. This happened to the point where I had to hire a professional biller because I was going broke from non payment and needed to focus on my work, not the constant frustration of not being reimbursed for months of services.

BC/BS has been billing me for several years for "late enrollment". In fact I enrolled 80+ days before 65th BD as allowed. Several CS Reps confirmed I was NOT late, BUT said this is a lifetime penalty. Have tried to email but their NJ site is impossible to log in. I estimate if all billing is paid, which I refuse to do, $40 million a month (minimum) is being stolen from US Public. Given some phony 3rd party to appeal. Government appeal non-existent. This is message I'm trying to get to NJ BC/BS.

I have the Omnia plan, went to a Tier-1 hospital in an emergency, right? The hospital ordered a test that required anesthesia and guess what? GOT-YA. The people that the HOSPITAL hired to administer anesthesia ARE NOT part of my plan, so I pay $1,776.00 for anesthesia, are you kidding me? What choice did I have? Do I lay on the gurney and research anesthesia providers to see if the one the hospital selected is on my plan?

NJ Direct approved my surgery (skin removal from weight loss) the first time. But I couldn't do it at that moment. I had a low blood count. Had to see an oncologist to get it fixed. I informed nj direct and they said I be fine to still get my surgery. I came back and was denied. I want my health care to explain to me why would they denied me from a surgery that was already approved! Regardless I'm going to keep fighting... meanwhile find me a new health care provider since they rather see you die than to get your health back on track.

I called three times for getting registered online and none of those representatives were able to help me. I had to make a payment and they were saying that they don't know if I have an account or not even though I paid first two installments before. Very unprofessional and unorganized.

I filed a complaint with BCBSNJ due to my podiatrist charging me $460 for a pneumatic boot anyone can purchase for only $40 on Amazon. I called twice, sent evidence etc. They responded by telling me that $460 is a fair price to pay. Ridiculous! Clowns like this are why part of the problem! It's not Obamacare it's doctors being allowed to overcharge for items, big insurance paying only what they want to and passing the rest via write-off (increasing our premiums) or payment due by us the already overpaying consumer! Totally disgusting! There's a special place for these kind of criminals that allow this to go on!

I have been a member since 09/16. Since that time I have made my payments FAITHFULLY every month and ahead of time but I keep getting notices that my payment has not been received. Today I received a ridiculous letter telling me that my payment for 03/31/17 is past due and I am facing termination. I called customer service WHICH IS OUTSIDE OF THE U.S. and was told to ignore the letter. I have gotten two e-mails and now this letter saying that I'm past due. When I call, they tell me that I'm up-to-date. This is RIDICULOUS! Every month I go through this. I wish they would get it together and fix the problem!

I've been with HBCBS for 20+yrs. I am the only person on the policy, and I am paying $1000.00 per month for insurance with a $3000.00 deductible. I see a doctor once a year for a physical, which I did about 6 months ago and had to pay for the blood test ordered by the doctor. I am a pretty healthy person, don't smoke, drink 2 beers a week, good weight, sleep great... Soon I will go onto Medicare, and it can't be a day too soon. This company is draining the blood out of me, financially speaking.

Sadly I have had this insurance since January 2016 through my employer. It is the only option provided to me. This is by far the worst insurance ever. It covers nothing. Blue Cross does not have a fee schedule for any of the services they cover. They refer you to Castlight which is a Third Party company who is supposed to have these fees however when you call them they have no knowledge of any medical procedures even when you give them the CPT and diagnosis codes. They use Google to look up the definition of the codes given he is based off the definition it falls into a category in which it could possibly be a covered benefit and there is still no amount of what your cost would be. Their estimate range is very wide and does not provide any specific fee.

My son received a radiology test with dye on his elbow. My insurance policy has no co-pay for radiology tests in office or out-patient services. Horizon claims that because the dye was injected to perform the test that is outpatient surgery with a $300 deductible. Since when is an injection considered surgery. The insurance companies are a disgrace, trying to frustrate you until you give up. I have spent countless hours dealing with a call center in the Philippines. Horizon Blue Cross is a disgrace, we need competition across state lines. Worst customer service of any company that I have ever had to deal with. Call center personnel pretend they are a supervisor with a different name, same person though. What a disgusting situation.

My daughter is a ** addict and wanted treatment. After 10 days of inpatient rehab Horizon would not approve any more treatment. So my daughter asked me if she could arrange for the rehab to bill her and set up a payment plan. But they said she could not because Horizon will not allow this because she is a subscriber. I don't understand how this could be. The rehab said their legal team is working on this matter but it could take months of litigation. This is my daughter's, and Horizon will not allow me to pay. How can this be? Next I am writing to my Congressman. Hope someone can help us before it is too late.

I have been juggling between Horizon and ADB-COBRA service centers for the past 1 month plus, just to ensure that my newborn daughter is enrolled in my health benefits. All payments have been made to ADP starting the date she was born in April, but she is still not listed in my coverage. The Service centers always point finger as the other company and for every call, they initiate new ticket closing out the prior ticket incident without informing/updating. Both ADP and Horizon - reputed business missed to do their due diligence while proving these service centers they customer/client services. Audit them!! Make sure your clients are treated right. This is a total Customer ripoff where the business shows one thing, obtain price from client for it, and then give nothing. I have even started to think of suing these companies!

My son reached out to get help for his drug addiction. He went into rehab only to find out that the insurance denied coverage. His coverage was denied because they stated he had a loving and supportive family environment and his blood pressure was not elevated and no signs of withdrawals. My son is addicted to heroine. Insurance would not speak to me because he was over 18 and they explained they would email his counselor the release form. They never did after countless attempts to get them to send it. He was released and did an appeal and they denied his appeal. He relapsed once again and has gotten himself in trouble with the law also.

When you call Horizon now for anything, you get a call center somewhere out of the US! When asked, I was told, '"we are in the Philippines"!! WHAT?? Some third world country has ALL of my information at their fingertips!! And can sell it, or do whatever they want anywhere in the world and Horizon BC/BS has no real control over what is going on. Foreign access to our personal private information in an instant should be stopped immediately and returned to US.

Have had continual problems thought resolved but not. Have outstanding bill for payment from last year as Home marketplace said not eligible for rebate - thought cleared up in May via conference call was cleared up for 2 months. BC/BS continue to charge full amount again, refuse to cover any bills for 2016 due to outstanding balance of $3,900. Recent conference call about 1 week ago with supervisor and insurance marketplace shows letter sent to BC/BS letter sent on 8/2015 was eligible for rebate! I should not owe extra as had been paying quoted rate. Insurance had been cancelled in October due to non-payment. Amazingly enough no one knows who cancelled. Received no letter. Now nothing in 2016 is being paid for.

While my problem is not as bad as other folks it just proves that Blue Cross of New Jersey is very careless. It all started for me back in 2013 Blue Cross claims that I signed up for Obama care. While I did look at it I had opted to change my mind. According to the morons at Blue Cross that the bills should have been stopped in September of 2015. And now we are going into march still getting them. Lucky for me once I get my home sold having my mail stopped.

I have now spoken to 6 different reps, each one telling me something different re the need for prior authorization for a procedure for my son. The reps say "yes, you need prior authorization. Tell your provider to call this number..." The provider has called 3 different numbers and has been told, "no prior authorization is needed". Meanwhile, if I just went ahead, there's no assurance procedure will be covered. I'm waiting to hear back from them. Seems like a strategy on their part - give the runaround, delay service = no reimbursement necessary! They save, I pay. Stuck in limbo with no treatment and no one to talk to.

DOESN'T Even deserve a star! STAY AWAY!!! The most inept, rude and incompetent insurance company I have ever dealt with in my life and I have worked in both a doctor's office for years and now an insurance brokerage so I have dealt with a lot of companies! Horizon BCBS is a complete nightmare! They make simple things like enrolling on a plan, IMPOSSIBLE! Every "Licensed and professional agent" is so rude and incompetent. I have been disconnected and transferred innumerous times. For weeks not one person has been helpful, just to check the status of an enrollment and payment! It's the most ridiculous thing. STAY FAR AWAY!!!

I have had nothing but problems with this company. From January 1st of this year though approximately May, they told every provider we saw that we were not covered, thought we fixed this several times, took till end of June to get corrected. Now they are pretending not to see codes on bills that are covered items. Even did a conference call with one med biller who kept saying "the code is right there"! It says emergency room visit yet they keep looking for reasons to deny. Never in my adult life have I experienced this before. They search for reasons not to pay hoping the people who have their policy will just give up and pay the bills themselves while collecting our payments. This company should be investigated, something stinks very badly there.

On May 1, 2015, my husband went for a covered visit to Penta Hearing Care. Mei **, the audiologist is part of Penta Hearing Care which is covered by our husband/wife Horizon Advanced Silver plan. On the same day, when Penta's receptionist called Horizon (Debbie, receptionist's name?) regarding payment, Bryson of Horizon said that John's policy has expired. Absolutely not. His visit is covered and we started our husband/wife Horizon Advance Silver Coverage of the policy in April 2015.

My doctor has prescribed me with several medication. But I find it that my insurance company keeps taking my money every paycheck and denying my medication. Why should I even bother paying for insurance if they continue to deny my prescriptions. This insurance company totally gives me the runaround and isn't worth having. Total waste of money. First they deny me testosterone and now they only want to cover 4 pills of ** for a month. It supposed to be 1 a day REALLY!!!

They seem to keep messing my acct up or information up. I want to pay my bills - the very same bills that they send me in the mail. I want to send a payment over the phone. First it's impossible to get a live person, then when I call the number that they provide which is 1-888-778-2005 to pay my bill, it does not recognize my acct or gives me the acct of my dental plan which I want to pay my health part of the bill. Then when I pick (0) hoping that the phone system will direct me to a live person so I can pay my bills, it still did not work. I tried this 5 to 6 times so I gave up. In addition, when I went to the doctor the office said that I was not covered. I called the Horizon and luckily got someone to ask why they said that I am covered from their end. I am so confused. I have never experience anything like this which I feel like I am in a twilight zone when I try to call them. Pls. help if anyone have any answers to my problems.

I've had problems with my insurance ever since I got it and I could never understand why. I always just paid out of pocket because I didn't want any problems with my doctor's offices. My policy is under my stepfather so him, my mom and my brothers all have a different last name than me. Well they decided to, despite my enrollment paperwork saying my correct legal last name, they put my information in wrong so technically I have no insurance because the person my stepfather is covering doesn't exist!

Found out my docs were 'out-of-network' after 6 months of visits & now on the hook for 2K. Cancelled policy and then CHARGED the next month!! Still not sorted out. Arrogant & incompetent. Bad experience from the start.

I had a small group policy with Horizon BCBS of New Jersey. My premium was about $1226/month for an HSA with a 5k deductible. I faxed a cancellation letter in February 2015 to Horizon requesting the policy cancel effective 1-31-15. I was trying to get coverage thru ObamaCare and submitted an application in January 2015. I was approved and qualified for a subsidy which made my premium about $250/month but the start date was 3-1-15. So no one in my family went to any health care providers in February 2015 and no claims were submitted.

I signed up for insurance in January 2015. I went to see my PCP for a routine checkup that same month. Horizon claimed I had no insurance with them and refunded my premium payment. After many complaints and fighting, they still have not resolved this and are taking $800 from me for no reason at all. I am at a loss. I don't know what to do!!! This is the worst insurance company I've ever dealt with!!!

After going through all of the documentation, pre-certs, etc. to get authorization to provide services for an autistic/special needs child - ALL CLAIMS DENIED for over 3 MONTHS and still NO PAYMENT to-date. All codes and units were authorized and documented by Horizon BCBSNJ. Now the parent is at a loss because all of the charges are their responsibility even though coverage was verified multiple times. I have more than 5 documented calls on just this one patient alone. HORIZON BCBSNJ needs to quit posting what they are doing and FIX what actually matters! Authorizing, confirming, and sending documentation of coverage for autistic children and then no payment for three months. HELP ME UNDERSTAND HOW THIS IS OK?? THESE CHILDREN MATTER TOO HORIZON!!!

Had a legitimate Sleep Study done, they, HBCBS of NJ, denied the claim. Said it wasn't medically necessary. All the doctors had told me that this procedure has always been covered by insurance. The doctors said "We have never seen anything like this before". I have been battling the insurance co. for nearly a year and a half. I have been hounded by collection agencies for the last year, and my credit is now bad. Thanks HBCBS of NJ.

Signed up for a policy and without contacting me or broker, they ignored my choice and signed me up for a more expensive policy. No one takes responsibility, no one calls back and no one at this company follows up. Can't even register online as the website is not working. Want to pay my bill and Philippines call center cannot process payment as they are having computer issues. Avoid this company.

Avoid like the plague. They have all their rules and regulation written to perfection in their favor for all claims. They'll take you to the cleaners and back again. Would probably be cheaper to pay out of pocket. Terrible customer service that is uninformed and mostly useless, often taking 1/2 an hour or more to look up basic information.

BCBSNJ has refused to pay claims and keeps me on the probation list as new subscribers and would only pay half of the claim. They constantly refuse to pay for full prescriptions and piece out my medicines. Then when I call them today because I have new insurance, they tell me I was cancelled in October!!! Yet they never sent a letter and they took the payments each month AND authorized procedures. They also said it was cancelled because I did not pick a primary care which I did the first month I had the coverage. Can we start a class action law suit???

I have a complaint going in US District Court - Idaho (Case **) about the Blue Cross use of "outpatient" categorization of medical care, so they can put a greater portion of the "plan allowance" amount onto the patient in the form of increased co-payment. I would be interested in hearing from anyone who has been victimized by BCBS in said manner. Thank you.

Wife's medical insurer, Horizon BC/BS via ACA, advised no pre-approval required for implantation of neurological stimulator to relieve chronic migraine pain, as the procedure required only "same-day" surgery. Procedure performed at Beth Israel Hospital, Newark, N.J. intended to remove previous implantation incorrectly performed (several times) at North Shore LIJ Hospital. Implantation failed in several aspects: device provided no relief at proscribed site, battery/controller subcutaneous implant site continues to be red, sore and inflamed and provides continuous discomfort. Implant does not work, and causes pain itself. Horizon BC/BS now refuses to cover removal of device stating it is an "experimental" procedure. No such determination was made upon initial surgery. Wife is now being forced to retain a damaging, painful device that offers her no benefit. Numerous calls have resulted in no action being taken by Horizon BC/BS.

They are supposed to cover all ER with A HUNDRED $ CO-PAY. THAT HAS ENDED. THEY ARE SAYING UNLESS YOU'RE ADMITTED OVERNIGHT you are responsible for over half the bill because now they are saying you only get $500 for an entire year - they will cover towards diagnostics like blood work and x-rays. So now they are calling ER outpatient. They are out of control. I can't write all I've uncovered but please contact me.

On numerous occasions I have taken my prescription into multiple pharmacies a few days early due to a busy schedule that week, but Horizon BCBS of NJ will not allow my refill early. It's absurd that they aren't willing to be flexible in the least with a longstanding customer like myself. On other occasions, they have demanded a "Prior Authorization" for my medication before covering the fees, in addition to not reimbursing me for paying full price before the authorization takes place. They should treat high-paying customers like myself (and all of their customers for that matter) with gratitude, and flexibility as opposed to treating them like books on a shelf.

I have been using the same Chiropractor for 15 years. My Doctor has had issues with HBCBS and has stopped using them for the last 2 years. I have been paying out-of-pocket and submitting the bills for reimbursement. Once I meet my deductible ($100.00 individual) they are suppose to reimburse at 70%. All was well until around May/June of 2014. All of a sudden, they are not reimbursing me. They are sending the check to the doctor and listing the doctor as accepting a "Multi-Plan Discount Rate". Multi-Plan is another company that my Doctor deals with; however, he still doesn't deal with Blue Cross. Blue Cross claims to have joined on with "Multi-Plan" and insists that they pay based on the rate set by Multi-Plan. Every single visit has the same service/codes on them, and every visit pays out at a different dollar amount.

There is endless claims that have to be completed before they pay. They lose claims. They tell you forms were not completed correctly, but takes a month to let you know this and they tell you in a letter. You have to resubmit a brand new claim. They come up with a new problem, but again don't tell you until a month later through. If I get my coverage, it is after months and months of paperwork and an endless battle. Their strategy is to wear you down so they never have to pay out. The WORST health care coverage we have ever had and there are some bad ones out there. I feel bad for the customer service reps. They are polite and try to do their best, but are unable to help you in any way because the system is set up to stall on payments. You do better to not have insurance than have this one.

We followed their guidelines and my husband met their comorbid conditions for Sleep Lab test for Apnea. Now Blue Cross PPO of New Jersey refuses to pay, leaving a Disabled War Veteran with the bill for almost $3,000.00. We have appealed. We have sent pages and pages of records showing the exact comorbid conditions that Blue Cross' own policies require. We meet everything and they still refuse to pay. Now Blue Cross is saying they will randomly call and will "try 3 times" to reach "The Doctor" (they refuse to tell us which doctor they are calling or when) and "If we can't reach the Doctor after 3 tries, the decision stands". So get this, they can call God knows which Doctor (my husband has seen over 20 Specialists) and they can call at 3AM or Midnight and no one is there, then say they could not get a hold of anyone. This is CRIMINAL!!!!! I do not understand why there is not a Class Action Lawsuit Against Blue Cross.

Dealing with Horizon BCBS of NJ is a nightmare at best. Members are treated as disposable commodities. I just spent 45 minutes trying to change my primary care physician and it was like stabbing my eyes with knives it was so painful! I wasn't even trying to get Horizon to pay out on a claim. All I wanted to do was change my doctor. That's it. Simple. Easy. Nothing difficult. 45 minutes and 4 calls later (each time I was connected with someone), I lost it. I was done! I asked to speak with customer service and the associate on the line told me there wasn't a department for that. Figures. What do they care! I asked to speak with a supervisor and it was a joke. She came on the line and it was a total waste of my time. I had to repeatedly ask her if she would like to be treated as a customer the way I was (hung up on, transferred to an automated survey, told I should do it online, etc. all to no avail, I still couldn't get what I wanted done, to change my primary care physician). I had to survey her, asking her along the way each time if what I experienced was acceptable. Look, I get it. It's a big business and as customer, I'm a commodity. My employer has selected Horizon based on a cost effective analysis. With that said, it really does stink to be treated as if they honestly do not care, which they clearly don't.

It has been brought to my attention that they are illegally denying my claim and using a doctor that is unlicensed as a peer reviewer named Dr. Waqas **whose license was arrested on July 3, 2013 and charged in federal court for fraudulent prescriptions. He is a Peoria doctor facing 32 years in federal prison for illegally obtaining hydrocodone prescription over a 2 year period. He was also arrested on who was arrested for to have read my 1,200 pages of medical records and clearly did not because his rationale contained discrepancies such as it stated that chronic Lyme disease patients have elevated protein levels which has been noted on the blood work. I have attached copies of his arrest records.

I had possessed a Horizon BCBS of NJ Traditional B Plan for over 20 years due to severe vaccine related injuries & damages. When I was lying in the Hospital of the University of Pennsylvania with systemic vasculitis of the colon, where my colon had perforated, Horizon reps contacted my elderly, severely infirm & mentally compromised mother (dementia from multiple strokes) to fill out forms to actually downgrade my insurance status from a Traditional B Plan to a Traditional D Plan, thereby causing the annual premium to rise to $28,500 and the quarterly deductible to rise to $1,500 from $500.

test, and exam. Now, in February, 2014, they recalled the payment that they made to the hospital, 13 months after the visit. I had send an appeal to Horizon on Feb. 5, 2014 regarding another matter. All of a sudden, the hospital billed me for the January visit in the amount of $650. This is definitely a vendetta by Horizon against me for appealing another claim. Can they do this, over a year later. The hospital advised me that I am responsible for the bill. I would NEVER buy Horizon insurance. They are unreliable. I had authorization to get this test on the day of the test.

Signed up for automatic billing via credit card in December. Got past due notice in February, called and was told BCBS is behind in setting up autopay till probably June, can continue paying with card until then. Tried to pay March premium today, was told no credit card payments allowed. How an annual plan can be changed without written notice (at least or) at all in midstream? Bait and switch?

Don't depend on printed 2013 BC provider directory. 9/1/213 Sunday - Doctor's office denied BC insurance coverage for urgent treatment on a painful blister/boil rising on my neck. I checked directory before going to Dr. **, M.D (pg. 147) MT/Lakes Medical Center, NJ to confirm that he is participant in Blue Cross HMO plan. His office attendant refused to accept to Medicare Advantage Blue Value (HMO) insurance. I'll take a sharp instrument and pierce the blister to reduce swelling for pain relief.

I am my sister's advocate Michele **. To the day of 3/17/2011, my sister suffered a stroke at the age of 50. With the grace of God, she beat the odds of what was told to me by the first doctors. Monique would be a vegetable, she is not. HBCBS did not give Monique a chance to rehabilitate. When she entered into a rehab facility, the first week she was sick. The second week, feeding tube came out, surgery to replace. I appealed for more rehab to no avail, sent to nursing facility with all intentions to have her cared for at home. Upon entering the nursing facility, there were staff who fought for her to receive speech therapy, made gains and began to speak. She also had swallow test to which she was getting ready to start on puree and thicken liquids (but not thick like bananas). The time allotted for the feeding was ended because within this time, she had been admitted and discharged to the area hospital too many times to count.

I had health insurance with Horizon Blue Cross Blue Shield of New Jersey (Horizon). In network outpatient lab work was provided by Laboratory Corporation of America Holdings (Labcorp). Due to the limitations of the policy, there was a limit of $500.00 per year for this benefit. During October 2010, I visited my primary doctor. Blood was drawn and sent to Labcorp. Horizon was billed for four (4) tests - two (2) were paid in full, one was paid partially and the last was not paid. The explanation of benefits sent to me did not show the remaining balance for outpatient testing. For the partially paid test, Horizon was billed at $104.00, allowed amount $20.21, and paid $1.85. The last test was billed at $66.00, allowed amount $11.68, not paid.

Horizon Blue Cross had "loaded" my benefits information wrong into their computer system and gave out the wrong benefit information to my acupuncturist (in the chiropractor’s office). Now I owe my chiropractor nearly $2,600 for acupuncture services. They told me on the phone they were responsible. After numerous calls and complaints, they rejected paying for their mistakes.

Dr. Rogena Cain, NP ENT ordered RAST test, which BCBSNJ says was medically unnecessary, so I am responsible to pay the $663 bill to Twin Lakes Regional Medical Center for the test.

I was admitted on August 13, 2010 at Brook Haven Hospital in Long Island and was discharged on August 14, 2010. It was an emergency. I had severe pain at my brother's funeral. I was rushed to the emergency room and stayed overnight. BCBS refused to pay my medical expenses. I have been with BCBS since 1972. I avoid any unnecessary medical expenses as my record can show that I am in good health. There seems to be a pattern with BCBS not paying insured expenses. Since I am a nurse, I know how to take care of myself not to incur overhead expenses. My subscriber ID is **. Please look into this matter.

My health insurance company has been playing games, giving me the run around for the last four months and now I have bills piling up to almost $1,000 and can't get the medications prescribed to me. I don't know what to do.

We have had several problems getting BCBS to pay our claims in a timely manner. CSRs all tell you different things and supervisors aren't much better. We were always promised a call back and only received one out of about 20 promises. I am still waiting for a claim from 2007 to be paid and supervisors admit there is no reason it should be held up but no one can seem to actually process it. Now they are repeatedly denying charges that are covered. You basically just have to appeal everything to get a full payment. It is just plain frustrating and I am about to involve a lawyer. Stay away from this group if possible!

I called regarding no payment of an anesthesia submission that was made as part of a colonoscopy which Horizon pre-approved. Their reason for non-payment was based upon the fact that my $1,000 deductible wasn't met until the day of the procedure. By background, I changed carriers in Sept./Oct. of 08 and in fact had no deductible payments before that day. However, the entire procedure which they pre-approved cost $3,875 - so my $1,000 deductible was met that day. Horizon said that their rules state that the deductible needs to be met before the bill is submitted or they refuse payment. Why does it matter when I meet the deductible - I can't understand at all how they can separate work pre-approved??? Kinda chicken or the egg scenario but a lot more money. Another clear example in my mind of the major problems that exist in our healthcare system - it is a disgrace that companies aren't held responsible. We need massive changes in the system.

I have medical insuranace through my employer. On December 9th I had a vist to the hospital for a heart attack.