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Do NOT try to get a "Free routine physical" from BCBS CareFirst. You will open yourself up to many many many bills from services and billing parties you never heard of conjuring up reasons to take your money. They are crooks and grifters. When it comes to health care in America NOTHING IS FREE NO MATTER WHAT THIS INSURANCE PROVIDE GUARANTEES. My doctor's office used the wrong code to bill me, the third party billing company put my address in wrong. And all of these errors/mistakes were my responsibility to fix. It took me 8 hours of phone calls and paperwork and runaround to avoid most of the bills, but they are still coming. I get a new bill from a new mysterious company every week from a routine physical that should be covered and "Free". It is not. It is a lie.
It is a HDHP HMO with PPO out of area. You can't beat the BCBC provider network and predictability of costs with co-payments instead of coinsurance. CareFirst has a great network where I live in the Washington, DC metro area. The only downside is their customer service is below average.
I recently submitted a claim and after submitting, received the popup with the reference number and also received email. Now, being the first time I split the claim in case something went wrong, didn't want to put all the eggs in one basket to so speak. When I logged back in to create another claim I notice there were no submissions shown that I had entered. I contacted tech support and while nice enough were not able to recover it ... fine, I'll do it again.
The second time I may have entered the wrong address, home address instead of clinic address. I emailed to see if they could check. While waiting for email I created a second claim. When I eventually received email I was told once submitted no corrections could be made, not even the address. They then said it appears I already resubmitted the claim. I wrote back and explained no I didn't resubmit the claim, they are two different claims. I then received an email back stating that there is no way to cancel a claims submission and the claim will be processed twice, one will deny as a duplicate. First time using CareFirst support - not remotely impressed! -Rick
I'm someone who's never been fired from any customer service job or any job for that matter who is just astounded by how incompetent CareFirst clerical workers tend to be. While moving once my card was misplaced so I needed to order a new one. It took about 7 calls before they finally got it right. Later I had some bloodwork done to determine whether I have one genetic condition. There were clerical issues yet again until that was worked out. Finally and most recently a woman on the phone said I could renew my membership quite a while before the Jan 31 deadline. I went ahead and worked with her. She said it was all recorded on the phone. My phone records indicate clearly that I called. Well what do you know? My insurance status isn't listed as active, and after 2 phone calls later I've had no one effectively help me once.
One male said I'd renewed on Dec 24 and that I needed to do more? I renewed nothing on the 24th because at that point I was still working on sorting out the clerical error involving the blood lab which wasn't done until the 28th as an email shows me still reaching out to the blood lab then which by the way was worked out. I told him that, too. Worse yet? I'd almost gotten a surgery this February that CareFirst said they covered - a tubal ligation because I have bad genes and have never wanted to procreate. Well I was approved and scheduled for the procedure. Thank goodness I cancelled or they wouldn't have even covered it like I'd gotten a letter stating they would because the recorded phone call renewal of my membership was apparently never entered into the system! I only cancelled because of the post tubal ligation symptoms
I read other women had experienced - thank goodness I listened to them and thank goodness for everyone on the site telling the truth! I once must have waited about 40 minutes only for my phone call to be forwarded to Nobody at all! It's shameful! Even if someone does fix this latest issue I don't want to work with them ever again! I am beyond tired of this bs and appreciate that I don't actually need anything right now. This insurance only seemed really necessary for if I were injured in a car accident, but honestly after reading what a lot of people have written I doubt they'd even help me there because they can barely help any of us with a simple phone call! Avoid them like the plague if you can and just beware of their bs in general.
I had private health coverage with care first and auto payment was set up for that for years, end of 2018 I had to make changes to my insurance through Maryland health connection but I selected the same plan with care first, the only difference is my daughter was removed from the plan. I received welcome letter from them and another letter notifying me that my policy has changed from the first one to the second one and they are stating the new amount due. I was shocked when I checked my bank account online to see four transactions by care first, two for medical and two for dental for both the old policy and the new policy. I called them to fix this mistake and to find out why all these double charges. They were so rude and informed it's too late to fix this issue and they can't refund me the old policy payment that was charged by mistake. I'm looking for new provider now and I don't recommend this scam company to anyone.
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Individual deductible is 16% of my annual income and combined family deductible is 32%. No benefits are realized until annual deductible is met, which amounts to having to pay provider's full rate (minus insurance "discount"), so the stated $50 office call runs anywhere from $75-$100, until deductible is met, which at the rate set, it won't. Further, premiums don't count toward deductible (contrary to my experience with other legitimate insurance). Further yet, the so-called prescription drug benefit is non-existent.
According to the carrier's own literature, prescriptions are supposed to be covered at $10/45/60. Yet my FORMULARY asthma medication costs me over $200 retail. When asked why my prescription isn't $10 per fill, I'm told that coverage doesn't go into effect until I meet my individual deductible. So, in effect, I pay around $780/month for a discount plan. Run as far as you can from this plan. You're probably better off going to an exchange under the UN-affordable Care Act (Obamacare). Looking to start/join a class-action lawsuit against BC/BS CareFirst for insurance fraud and file criminal complaint with my state's insurance regulator.
We paid thousands of dollars for nothing until we got smart. They don't even offer dental or vision. They keep changing their plans and keep raising the premiums for less coverage. They even are trying to rip off my mother after she has died. They owe us a refund and I am waiting for them to figure that one out.
VERY SHADY business practices. After 6 months of good coverage, CareFirst decided to change how they processed my kids' necessary specialty asthma medications, without ANY notice. We went from having a monthly $30 copay to owing around $7000 in the last 6 months. After months of calls, where I did got a different answer every time as to what was happening, I was finally informed that these prescription medicines were no longer processed under our drug benefits, but were now considered medical equipment claims.
The medicine still showed up in our drug benefits as a covered prescription with a $30 copay, but only if it was filled at a regular pharmacy. It was always and continues to be a specialty medication that has to be shipped directly to our doctor. Picking it up at a pharmacy was NEVER an option. They claim that our benefits coverage didn't change, just how they define this product, which makes little difference to me. After months of appeals, they did not make any changes and we are out a ridiculous amount of money. This is exactly why people despise insurance companies!
I have been in contact with CareFirst since December of 2017 trying to get claims paid. Every time I call I get a different answer as to why they are not processing. They say call back in 14 days - I do and then they tell me to do something differently. I have over 10,000 dollars in claims pending that are covered underneath my plan. I have been reimbursed a total of 600.00 totals YTD. I am disgusted with everyone I have spoken to at CareFirst. They are not helpful. It is a covered expense which they tell me on every call but then say it isn't processing correctly. I can't do anything about that. The services I am receiving are medically required - again acknowledged by CareFirst. However, they will not pay me back in a timely manner. I have submitted and resubmitted paperwork a total of 10x to them the local plan and the appeals.
So I’m going on vacation for two months and I got authorizations for all of my prescriptions but I have two pain medicines that are very fragile. I guess you would put it these days because they are **. So that means I’m a drug addict because the government says I am LOL. So anyways I go to get my vacation fill on all of my medicine but since I am leaving out of town actually out of the country for two months the day after tomorrow I am filling my medication two days too soon. So they won’t!!! Idiots!
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