CareFirst Reviews

If a plan has no out of network options, then it cannot claim to provide coverage for items that it does not have an in network provider for. In order to truly know what your coverage is you need to research the providers' list for each and every POTENTIAL condition to see if they have a specialist for that. If there is no provider in their network THERE IS NO COVERAGE FOR THAT ITEM.

So - they have my payment and documentation of the plan I chose and they won't give it to me. Can someone help me with this? I need to see a doctor and can't afford to pay both for care and the exorbitant insurance costs! They have been making money from me for many years with very few appointments and now that I need to see the doctor, they can't seem to acknowledge the plan I have. H-E-L-P.

Well guess what? Aside from all the hassles inherent in a HMO (limited to their network of providers, referrals for everything, etc, incorrect billing), after 2 years, without notice, they have terminated the dental coverage, the gym membership, the acupuncture and more. But the worst part is they provided NO NOTICE. I have been automatically reenrolled the past two years AFTER receiving notice of change in benefits, for which the prior two years were negligible.

This year, for 2016 enrollment, I received NO notice of any change in benefits. SO I reasonably assumed there were no material changes. Imagine my surprise when, the first week of January 2016, I call to find out why Delta Dental (CareFirst's contracted dental provider) has no record of my coverage, and the CareFirst rep says it's no longer a benefit! What? When did that happen? He didn't know. Why does it state on CareFirst's website that dental is included? He didn't know.

I filed a grievance and am told that I SHOULD have received a notice of change in benefits. So why didn't I? Hmm, maybe because they don't want to lose members? In any event, this is fraud. They have cut numerous benefits without notice, and the only way I found out was when I called AFTER they had already auto enrolled me. Their supervisor in the grievance department, Terri, told me that I'm now covered by state dental program and to call them! Yes, that's CareFirst's response to the effects of their fraud. So after an hour of calling state offices, I find out that because CareFirst previously provided dental coverage, I have to jump through hoops for state eligibility. In other words, due to CareFirst's fraudulently omission regarding termination of benefits, I am now forced to spend hours of my time and energy fixing a problem not of my own making.

As for the change in benefits? After 30 minutes of using google and searching CareFirst's website I FINALLY found a notice of the change in terms of coverage for 2016. I am a professional with a job that entails a great deal of research, so 30 minutes to find a document like this, one that should be sent to the consumer in the first place, certainly doesn't seem like a minor oversight by CareFirst but rather an intentional attempt to conceal material terms from members. I hope Medicare investigates this company. They really need to go out of business. I'm going back to straight Medicare and look forward to the demise of CareFirst. Awful, deceptive, and clearly taking advantage of those who are unlikely or unable to protect themselves from CareFirst predatory practices.

I had problems with billing online and called them specifically requesting to pay the exact amount that was due. And later I got a letter stating my coverage had lapsed again despite I trying to communicate to him directly. It is clear they are abusing the new laws set forth and robbing people with their rates that have increased 4 fold but covers less. This has happened to everyone I know with their coverage. They should be charge for criminal extortion. $400 a month for a 30 year old healthy male. At that rate I can pay for my medical bills myself.

Next, I got medical coverage in October as I was eligible to enroll because of loss of benefits from a prior employer. In January I got a letter saying that the rate I was approved for was only good for 2014 so my monthly rate would be increasing from $129 a month to $159 a month. If I wanted to change my plan so that I could get a better rate I had to print out a cancellation form, fill it out and mail it to them and wait several weeks for it to go through them and only then could I RE-ENROLL with CareFirst again.

Even though they had all of my information and I still had a plan with them I had to start the entire process over just so I could get coverage and it ultimately left me without coverage for another two months. I couldn't enroll for an online profile until I called in and had them manually delete my old profile that I could no longer access because I had applied for a cancellation. All just because they never told me that my rate would increase significantly after only 3 months.

Next I got dental coverage and once again it was a crazy long process. I had to print out forms, mail them in and wait once again for a response. When I did finally get a response I was actually shocked to see how low the cost was for coverage. $75 for three months of coverage. "Great!" I thought. So I paid three months ahead and thought it would be perfect. On July 28th I logged on to the website to pay my medical coverage premium before I left town for three weeks. I paid my medical bill and then I noticed on the bill tab there was a new amount for the dental plan for $20.32. It didn't say what it was for but I assumed it was an amount owed for a service or something. The strange thing was that I couldn't make a payment towards the amount. Usually there is a "PAY NOW" button underneath the bill that allows you to make a payment but in this instance there was nothing.

So I figured it was an upcoming payment for the next month that it was too early to pay. Nope, when I came back in town on the 21st of August I got an email from CareFirst that same day saying that they had given me 25 days to pay my new "premium increase of $20.32" and since I didn't make my payment that my dental coverage had been terminated effective immediately. I called them and they told me there was nothing I could do to get my coverage reinstated and that in order to get coverage again I could "RE-ENROLL IN 12 MONTHS." I explained to them that I couldn't pay the amount online and that I still couldn't pay the amount because the option was not available. I asked if I could just pay the amount over the phone with them but that wasn't a possibility because "their system wasn't set up for that" and I would "have to wait 7-21 days to receive a final bill in the mail" for $20.32. Then I could mail them a check.

I have yet to receive a bill and I'm sure when I do they will have added some sort of late fee on there too even though I have never even had the option to pay it. Even now when I get on the Carefirst website it still gives me no option to pay this. It's crazy and makes no sense. I did a little research and found out just how terrible they are. I wish I had done that before I got involved with them. I called a few dentist offices and asked them which insurances they had the best experience with. They recommended Delta Dental and Metlife.

I called Delta and it was pretty obvious right away that they were a different type of company. I called and they picked up the phone immediately. They helped me with exactly what I wanted and connected me with a client broker directly who gave me her direct line to talk. She sent me an email within a few minutes of talking to her with a link to all the plans she recommended for me. I picked a plan, filled everything out online, paid for the coverage and she called me back to confirm everything. The whole process took less than 20 minutes and I only had to dial one phone number. I will never ever recommend CareFirst to anyone and I can't wait to cancel my medical coverage with them and get it through a worthy provider. What a waste of time they have been. Good riddance to bad rubbish.

In mid June I still had not gotten any answers and I called in to CareFirst. I was told that it didn't seem like he had coverage but yes, they did have all the faxes and information. The very next day I got an insurance card in the mail when I got home. Of course, it was too late to call since they only have M-F until 5pm hours but, I called the next business day and was told he had coverage. When I got my bill on July 3rd I did not see charges for him and sent an email July 7th stating my concerns. I also called in a few days later when I did not get a response and was told not to worry. On August 1 we went to get prescriptions refilled and found "B" health care to be denied. Of course CareFirst is closed and I can't get any information. On August 3, I finally got an email back to my email sent on July 7 which stated that they wanted his adoption certificate which is not complete yet.

After calling back in while on vacation on August 5 I recounted that he is being added using the qualifying event of losing coverage, not the adoption, to which the person on the phone stated she could not find the information sent. On August 13, when I returned to MD, I talked to another rep who was able to find the information I was told was "lost" and sent it back up for review. When it was sent back I was then told that the application I sent in was the wrong one and would need a different one. When I called back in they now are telling me that he would need his own plan until adoption and even if I wait until adoption I need another form since my plan is a grandfathered plan. I asked for the forms to be faxed to me and was told I would have them in 24-48 hours and would receive a phone call to make sure I got them within 2 days. It has now been 4 and I have gotten neither.

On top of that, I constantly have asked for any billing considerations for the hardship, being a young family a little bit can go a long way. I have gotten no such consideration. Due to the extreme length of time, I lost any ability to get other coverage for my son since it is 60 days past the date he lost healthcare. My questions are: If the application was indeed wrong why wasn't this the first thing sent back? If the documentation couldn't be done, why did he get a card? Why does it take 24-48 hours to send a fax? Why does it take 1 month to send an email that could have avoided the whole situation?

After waiting months for CareFirst to handle my paperwork, my appointment is being cancelled. Meanwhile the ER doctor tells me to take it easy because my mass can burst at anytime. I am sick & in a lot of pain. I've lost 13 pounds in two months. My side hurts time to time and I have yet to see a doctor. There has to be some type of customer training.

I've called numbers provided on the website to talk to someone yet, not successful. I've asked my local bank to look over the check and confirm that this is a legitimate check and they said it was. However they were not able to call and check to make sure it was not fraudulent or of sorts due to their terms of being a local bank dealing with local and customer only situations. I live in Auburn, AL and only have a Columbus, Georgia bank that I make a monthly trip to which also happens to be a local only bank. The check is Wells Fargo and I haven't been there to get inquiry from them yet but I'm seeking out any reviews through here if anyone knows or gone through my same experience. I'm frightened to deposit or do anything with the check in case of it being a scam or fraud. Any help would be great!

I have been paying them every month the price they gave me. And I will pay them for the three months I was not covered. But I am on a budget and I can pay it all at one time. I told them if they would have given me the price at first, I would have worked it into my budget like now. They get paid every month but because of the 3 months I was not covered, they say I am behind a payment.

Immediately I called another representative asking to cancel my policy, she replied I have to fill up cancellation form and send their office to cancel, I told her I did couple of times and requested through online email after logging into my account, she said she didn't see any document to cancel my policy. I asked her to check my previous call note details, then she said yeah I am seeing now. She repeated previous call notes again. What you will do if you are in my place? Every month money deducting from my account. I appreciate if any body give me some advice. Thanks in advance.

From all the above, one question: IS THIS COMPANY A SERIOUS OPERATION OR RATHER A DODO-BIRD OR FLIGHT-BY NIGHT OPERATION? I found out the answer (a clue: it is not the former). So I am glad you did not receive my payment, because obviously you do not deserve any. I will also take this complaint to the appropriate places. PLEASE, COUNT ME OUT OF YOUR SILLY OPERATION AND CANCEL MY ACCOUNT.

Wanda ** @ Care First told me Lab Corp is their only in network provider who they should be using. In March 2014 our policy changed. Because of health cost rising, so we then had a $6000.00 deductible for out of network services. The lab cost was about $400.00 per visit, which is what Care First had been paying. In November 2013, I received a letter stating, because of regulations, the Lab has to move to their own location. Which I had no idea they were sharing the clinics space until then. I knew then if I went to their new location and knowing they were out of network, I would be responsible for paying the lab bill. I called Member Services and asked them what to do and they told me to call or file a complaint with the corporate office, which I did. I first spoke to Sandy ** and she had Wanda ** call me to explain the problem. She said she would look into it and told me she will have someone inform Holy Cross Pain management they must send Care First HMO clients to Lab Corp. I spoke to the Doctor at Holy Cross and he said, he is only a contract doctor there and he has tried to get this changed, but said they will not change it no matter what Care First says.

I informed Wanda ** and she first said she would override the lab bill but then I informed her that my wife is taking a job with the Federal Government. She said their guidelines were more strict and she will have to see if she can override theirs. She said it will take her a week or less and get back to me. Weeks had gone by and Wanda ** had not called me back or fixed anything so if I continued going to this lab, I would be responsible for the lab bill up to 6000.00 and once we changed to the Federal Government's plan, that had no out of network benefits.

I called Care First every week to see what, if anything, they were doing. I called Member Services, the presidents office of Care First and was never allowed to speak to Chester Burrell (their President). Anytime I called, they directed me back to Wanda ** in the executive office. At first she told me she has had someone inform Holy Cross that they must send me to Lab Corp. Nothing changed over weeks or months, so I tried to call Chester Burrell, the president of Care First, again, but his secretary Sandy ** would not let me speak to him and directed me back to Wanda **. I told Wanda that the clinic refused to send me to Lab Corp but she said they were advised. I told her I advised them but they won’t listen, and since Care First has a contract with the clinic, Holy Cross Hospital and the Doctors, since they are all in network, they are supposed to send CareFirst members too in network providers or labs.

In August 2014 our policy changed as I told Wanda ** it would because my wife accepted a job with the Federal Government and again we chose a high option Care First policy. Now we have no out of network benefits, and if I went to this new lab location, I would be responsible for the lab bills. Holy Cross Hospital Pain Management refused to let me go to Lab Corp even though my Doctor there asked me to find out if Lab Corp could do the same tests. I had to get the test panel from Alere and send it to Lab Corp to see and yes they said it was not a problem. In the meantime Holy Cross Pain Management sent me a certified letter dismissing me as a patient. I continued to call Care First and called their main corporate office Blue Cross Blue Shield but again said my complaint will be sent to Chester Burrell.

Now what Wanda has done is sent out a memo flagging only my account, so now, no matter who I call or contact at Care First, they are told not to talk to me and to write via USPS, email or go through their web mail with any questions I have about my benefits, billing or anything. My contract states that if I have any questions or concerns to call the Member Services number on the back of my card just like anyone and that this cannot be changed verbally. I found this out the other day when I called Member Services phone number on my card to find out my benefit information about a new problem I have to have surgery on. My left shoulder is now in pain with a SLAP Tear, which is a new issue. I need to have surgery on it soon. Since they flagged my account to call Member Services and forcing me to write everything, it is impeding my access to my health insurance benefits, which can put my health at risk. It takes them anywhere from 1 day to answer a question to two weeks and some they do not answer at all. (I am a Senior) So if I had no computer or never knew how to use one like my parents, I would be forced to write a letter via USPS.

How Wanda ** can single me out of all members with Care First is a breach of their contract, it’s discrimination and she is doing it in retaliation because I filed a claim which I am supposed to do according to our contract. I was able to speak to a supervisor in customer service. I asked him why this flag was put on my account and he could not tell. I asked if any notes he can see when I had called in show that I ever said anything derogatory, etc. and he replied no.

I was told by Dr ** at Pain Management at Holy Cross that others have complained about the same issue. I was also told that Holy Cross is in network and that their contract with Care First states they are only to send people to in network providers. Care First should enforce them to do this or take them out of network. They should fire Wanda ** for getting paid and doing nothing as well as retaliating against clients and arbitrarily altering the contract we have with them, which is a breach of contract. This is highly prejudicial and fraudulent, we pay the same as others and it clearly states in my policy, on my membership card and everywhere you read on line that if I have any questions or concerns to call the Member Services number or I can send in a web mail which is my choice. It also states in the contract that this wording cannot be changed verbally which is the parole evidence rule. She has caused me days if not weeks of time from work. She should be responsible for compensating me personally unless she was instructed by Chester Burrell to do this to me and if he was, he should also pay for my loss of work.

This has gone on for months and I have not heard one thing from Mr. Burrell personally and I know for a fact that he is aware of this. If you have a problem with Care First, you can call Wanda ** direct number is ** . Sandy ** direct number is ** who is supposed to be Chester Burrell’s secretary, but she will not allow you to speak to Mr. Burrell or even send a message to him. The only thing I have done is called in a complaint for not using Lab Corp. Care First's position is they know they can afford to fight anyone in court and most private attorneys if you call them, tell you for them to handle this case could run you 10K, 30K or some have said $60,000.00 and none of this has any guarantee of winning. If you make too much money, you can’t get a pro Bono attorney, forget calling the Bar Association or any attorney referral service. If you have any money, you won’t if you hire an attorney and Care First knows it. They also know most people do not know how to file in District Court Pro Se. For an issue like this, you yourself can do it if you follow the steps. This can be filed as a breach of contract, or sue for Specific Performance and probably Bad Faith Contract.

I recently sent Care First a web mail stating this was done in bad faith which they could be ordered to pay punitive damages. Because I mentioned this, Care First then replied for the first time with reasons they flagged my account. They only gave me a vague response, by stating they did not like my tone, substance or nature of my calls, etc. They did not say I used profanity or disrespected them in any way, which gives them the option of later making up any lies if I have to file in court. If you are having issues with Care First contact Wanda ** by writing her at ** or contact Sandy ** if she does not allow you to speak to Chester Burrell, CareFirsts President @ ** .

If you have insurance through the Federal Government and need to file a complaint with the OPM Office, you can call Arlean ** or her supervisor William** at **, but do not expect any help. I also after a week received a reply from the director of OPM Health Care, John O'Brien but through the regular OPM people who did nothing anyway. I also wrote the White House and my Congressman. I must have called 100 different phone numbers at OPM, and they either do not answer, or return a call or if they do pick up say they have nothing to do with the Health Care. OPM should be the poster picture of Government waste.

No wonder they are losing their client base in Arizona. I worked there as a manager and used to get the complaints of their customers and sadly my team. They are tired of it. No wonder we they can't keep them. They do pay pretty well but with all the issues it's not worth it. My director and folks complained about the COO all the time but my director was just like her. My predecessors all warned me about the company but I didn't listen. I am sorry I didn't listen. My warning to others are don't take their services or work there.

They can't get dates correct. They can't get paperwork correct. They can't manage their communication center. They can't keep up with their employees and policies. Employees lie to get you off the phone and don’t record conversations then because you can't prove that you called them.

That’s money out of your pocket. I use their online billing system and funds aren't applied/mysteriously lost. I have put in over 20 hours trying to fix the headache called insurance because CareFirst employees are incompetent and it is my believe are told to follow less than ethical practices to get more money out of their members. When I think of CareFirst, I think of the most underhanded organization I have ever had to deal with. Billing and Customer care are fowl, unethical and my options are? Sounds like a monopolistic organization to me.

Needless to say it is November 3 AND THEY HAVE NOT ACTIVATED MY ACCOUNT! I have called at least 2-3 times a week and every time I call they say they are "escalating my account to be activated" or "we are doing an emergency escalation to fix your problem." I paid for the month of October and have received no Insurance. The past two weeks they will activate the same day apologizing profusely and then immediately deactivate my account the next day!

Did I mention I am 6 months pregnant and to make matters even worse as of last week I have pretty serious bronchitis and can not see a doctor because I don't have an active insurance plan. I can't pay for November because they haven't given me a bill. Needless to say, I am pissed, they are horrible and I'm going to switch BUT NOT BEFORE I GET MY MONEY BACK!

That's Maryland, DC, VA & DE National Capital Area of CareFirst!!! On top of paying their president about $10Million a year (if you really want a good one, look at previous presidents retirement fund payouts!!!!). They average an 80% profit margin, meaning only 20% of your premiums actually go towards your healthcare. They have fake people sending letters that no one knows who they are and the letters mysteriously disappear in their database, but yet when you send them a copy of their letter. The problem seems to get fixed rather fast with no explanations. Sometimes you can call them and actually get an answering machine stating, "They are not taking calls at this moment." What huge corporation would run a company like that and get away with it... Besides our gov't?

They will give an entire department a vacation, oh I'm sorry, a "learning class," on a nice island somewhere (that's how they stay non profit, I guess). Literally the dept has one person answering phones but cant tell you one piece of information. If you really want to laugh, go to Owings Mills and take a look at their 5 building compound parking lots. There is not one car in there under $50,000. It's a disgrace to see where our premium money is going towards. Sitting in their parking lot will make you want to vomit!! They have security guards at their front doors and you can not get past them for nothing, that should tell you A LOT!!!! They conveniently keep their received paper mail in a secret locked box for two weeks before they open it, then YOU are late!

I have appealed claims to them for 18 years and they have almost NEVER even responded to any of them!!! I had a 5 hr surgery that cost $51,000 and CareFirst paid my surgeon and surgeon's asst $2777 for the entire surgery!!!!

No wonder no doctor wants to work for them. As a broker, I have one thing to say to ALL OF YOU. It's called the Maryland Insurance Commissioner!!!! That's the 3 magic words!!! You don't even have to say it, just submit a simple paper complaint to the Maryland Insurance Administration. Don't play CareFirst's game, don't give them one second to delay or stress you out. Go immediately to the Insurance Commissioner!!! It works like a charm and really fast too, its almost amazing how fast they can fix something when the Commissioner comes after them.

Here I go again I call and wait to talk to CareFirst just to be told the computers had lost some of the account information and I would have to re-enter it which I did and double checked it and was told to wait till the 9th of Mar. to see if it is taken out. Well, here it is the 10th and nothing has been taken out once again and was told they would monitor it and send me an email. Still Nothing!!!! OH by the way, they know how to send you cancellation notice even though it is their fault!!!!

We have $18,000 worth of claims sitting around, not getting paid. All our other insurers are online. It's impossible to get any answers. There is no "supervisor" that can help us; I can't find anybody online to help me. We are a small, two-provider office, and we cannot afford not to get paid while CareFirst puts me on hold. CareFirst is without a doubt the worst insurer that I have to deal with, and that includes the Medicaids that we have. Their phone system is positively Byzantine, customer reps are often rude, and it's never clear whether you've selected the right option on the phone tree. Also - their fee schedule is terrible; even most of the Maryland Medicaids pay better than they do. This is a travesty, because they have a real grip on the Maryland area - they are our biggest insurer next to Medicare.

For as much money as people are paying for the "privilege" of subscribing, you'd think they'd be able to afford some real state-of-the art website at least, but no. It's pitiful. I can't look up claim status if a patient is out of network, although they administer these payments. On the other hand, Medicare, a government-administered program, has a high-quality phone tree where I can get real answers, and if my answer can't be found there, customer service reps are knowledgeable and able to help. This is one example of private enterprise doing a wholly sloppy job because they think they have a monopoly.

Can anyone explain to me how the deductible was met and not met later in the matter of 1.5 month in the same calendar year? The supervisor was less than friendly. When I asked for her supervisor, she refused to connect me to him/her. It took a few screaming matches on my end to get Heather to tell me the name of the person above her. She said that she does not have a supervisor; she has a manager. Isn't it the same thing? The manager Steve has not answered the phone and did not call me back. Heather refused to provide me with phone numbers of managers/supervisors. As a result of the computer error, I ended up with $441 bill from the hospital and over $1,000 bill from the chiropractor. I do not know where else to turn. Please help.

Three weeks later (after I had returned to the same facility for a follow-up visit), I received a bill in the mail for $100. Turns out FEP Blue has changed their plan and no longer covers urgent care. This is their game. You literally need to scan and memorize your policy every year, then call them ahead of time to make absolutely sure. At this point, FEP Blue is a discount program, not an insurance plan.

How are we expected to come up with that much money and still pay our monthly expenses? Why would we not have gotten any documentation stating the cost hike to $733/month? So after getting the statement we called and spoke to a representative again, and they stated there was no way we were told it would be $356/month. When we reaffirmed that we were told that, they said we could file a complaint with the state commission if we wanted to.

Why do we continue to allow this insurance company to fleece us, and nothing is done? Why are we passing health care bills when the lobbyists are allowed to buy politicians votes, and dilute the bills to nothing again? How do I make the insurance company accountable for their actions?

I asked them if he had gotten sick, they would not have paid for his claim so why should I have to pay for the time he was not covered by them August 2009-March 2010, that the money they were holding on to and collecting interest on it until they heard from me should least go toward future premiums. I was told that they would not do that and I can cancel the policy and they would refund the $1550 that they had and I would not have to send the $1120 which would have gone toward the two missed premiums July, September and for the present one in March. I wanted my son to have insurance without having a long waiting period to get one so I paid the $1120 along with them keeping the $1550. It seem that that is insurance fraud to keep people's money knowing that their insurance has been cancelled.

They should have contacted me regarding cancellation. If I had known his insurance was cancelled, surely, I would not have been still paying on his premium. I wonder how many other clients they see have they done this same thing to. I'm sure a lot of money has been collected because of their policy of not letting people know their policy is cancelled and still holding and collecting money on the policy along with interest accrued on the money they are collecting. I am asking for restitution by returning the money they held when he was not being insured and to continue his benefits with the $1120 that has been sent in to cover his premiums until April 2009.

Ultimately, they removed the penalty only to apply it to my deductible. They were not able to explain how they could impose a penalty, remove it and then give it a new name and still charge me for the 20% that they agreed was erroneously applied. I paid the hospital $1,800 US upon discharge. Had Carefirst been responsible, they would have likely allowed about 1/3 of $1,800 charge and I would have paid the hospital $600 upon discharge as I had estimated prior to admission. I am now trying to recoup the difference between the actual charge and the billed amount. Carefirst has yet to discuss this with me, and I have submitted my second and final appeal to them as of the last week in November. No, I have not heard anything from Carefirst about this second appeal. They responded to my first appeal by saying the claim was properly processed. They continue to stress to me that I have a $10,000 deductible. I am well aware of my $10,000 dedutible, but I know that the $10,000 is reached by applying successive allowed amounts and not billed amounts. They have not explained why they have denied my claim.

I am almost certain that they have violated laws for not explaining this denial to me in a timely manner. Furthermore, to not even have a polite conversation with me about why nobody was available to assist me when I was in an emergency room 1,500 miles from home is beyond belief. Lastly, I think that they know they have made a serious misjudgment and are now hoping I just go away.

I would like to give you another example of how this firm operates. In August, my doctor suggested I get an MRI on my sore left shoulder. Because of my $10,000 deductible, I wanted to get an estimate of my out-of-pocket expense. I made two calls to the MRI provider and one call to the radiologist after Carefirst instructed me to do so. I reported the procedure code to Carefirst, and Carefirst told me the allowable charge was $419. As my budget was $450, I had the MRI done. After the procedure was done, Carefirst sent me an Explanation of Benefits that now showed my out-of-pocket expense was $793. I called Carefirst and asked them what happened to their estimate of $419? They explained to me that it must have been a mistake. I told them that that was not my fault ,and I wanted them to correct the estimate to $419. They told me they would not do it and I would have to ... you guessed it...file an appeal. By now, I doubt it would surprise you to let you know that they denied that appeal, too. This company needs to be stopped.

Once I tried to uncover and set a market for these fees, the providers and insurers treated me disrespectfully and kept fee information well guarded. The MRI provider and the radiologist will now likely submit my accounts to collection. I have excellent credit and have decided to accept a blemished credit record to make my case. It is worth noting that I contacted the two providers and explained that their contractual business partner Carefirst caused this problem. The MRI provider has tried to contact Carefirst, but has not heard from them in two months. The radiologist refused to speak with Carefirst and indicated that only I had the problem with Carefirst, not them. I would like to think this is merely an aberration, but I somehow suspect that I am being mistreated because I was able to obtain my non-medically underwitten health policy because I was HIPAA-eligible. Althought I manage my hypertension and diabetes very well, perhaps Carefirst loses money on my policy and would like to see me cancel. In any event, they have treated me poorly. I have been trying to get coverage elsewhere, but other companies are slow to respond to my insurance needs. I could sure use your help to correct they way Carefirst has treated me. Thank You.

I'm mis-charged a total of $1,574. Also, I spent about 30 hours of uncompensated time trying to recover these expenses.

After countless phone calls and faxing of my medical information still to date (Apr 2006) I have had no feedback from Carefirst, and when I call, I am always told that they haven't recieved my information. I am then given a direct fax number and reassured that this is not typical and that it will be gathered by, the person I am speaking with, and taking personally to the review board. I have had this same conversation with over ten people at Carefirst, all stating they will call and keep me updated, including supervisors and customer care speacialists, and still no response.

Finally, yesterday, I spoke witha customer service rep and was then trasfered to a supervisor, who never returned my call, even after stating that I will not call Carefirst again, instead my next calls will be to the Insurance Commissioner and a lawyer. It is now the next day and still no phone call. I have had insurance through BC/BS since I was born, always through a employer, and never had a problem. Now that I am an individual member it seems that Carefirst could care less if I am a very dissatisfied.