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Reviewed Aug. 12, 2023
Have had work covered health insurance for 50 years and most of that time have had no issues (MVP). I'm retired and my former employer canceled our previous insurance and offered this mess stating it was comparable to our MVP. Well I had to contribute to my premium for my last 10 months before going on medicare. To say the least it was my worst experience with insurance in my working career. My first appointment involved bloodwork with a scheduled office visit. Well I get a bill on my portal saying I owed $585 out of pocket wth? Never in my life has this happened.
Called customer service and I kid you not was on hold for 2 freaking hrs. and when I did get to talk they said this couldn't be handled by that rep. Had to call the broker who actually sold the insurance to the municipality I had worked for. She did get it resolved but I ran into the same problems with 2 following Dr. visits. Worst experience I have ever had in my career with insurance, actually I would rate it 0 instead of 1 star. I knew there was trouble with it when you are put on hold for 2 hrs. That's telling me numerous customers were having trouble actually made me nauseous and then to get denied action after 2 hrs. Of listening to repetitive on hold music that will test anybody's fortitude! Avoid this insurance or you'll probably end up on blood pressure meds.
Reviewed July 2, 2023
Absolutely horrible since they took over. Since when are you only seen for a minor checkup for your annual visit and you are not allowed to discuss any health concerns with your doctor without being penalized with a fee for talking? I was unaware of this change last year and had to pay $72 for a three-minute conversation on a minor health issue. If you have health concerns you have to make an office visit appointment and discuss those concerns with a physician’s assistant, not the doctor you just had your exam with. I am furious I am not being told vital health information verbally, but put down on your print out you are given checking out. I was not told VERBALLY about two serious health issues. MY DOCTOR NEVER TOLD ME BECAUSE HE ISN’T ALLOWED TO SAY ANYTHING. THIS IS TOTAL PATIENT NEGLECT.
Consider your annual check-up like your car’s inspection. If anything is wrong, you are charged extra just like an oil change for your car. Also, they changed the coverage for seniors. Regular coverage 10 chiropractic, 10 physical therapy, and 10 massage appointments with co-pay. Now SENIORS have to pay out of pocket for massage treatments (I am not talking spa-like massages) till you meet the $200 total, then you are reimbursed. Really, isn’t this discrimination? I am going to explore other options before I have to decide to continue this health coverage by September. Do yourself a favor and check other options than HighMark, I do not give them any "high marks" at all.
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Reviewed June 28, 2023
Highmark's messaging portal for claims is very unhelpful and they routinely go far past their own and State mandated turnaround times. The call center is equally unhelpful - staff are not trained and generally cannot problem solve to actually reach a solution. The messages and information a patient submits is not arranged so you constantly have to re-submit documents. Highmark has repeatedly started claim processes over again, and come to the same conclusion they need more information but won't specify what information they need, and the customer service representatives can't articulate what is needed. Can seem like a bit of a scam at times.
Reviewed Jan. 19, 2023
I pay for my insurance out of pocket. I was with BCBS WNY for three years and everything was great. Last year Highmark took over. Premiums increased, deductibles were increased, coverages eliminated and customer service is virtually nonexistent. Their accounting department has lost my payment twice (this is an EFT from my checking acct). I had to call to straighten it out. Was on hold for over 3 hours the first time and 1 1/2 hours the second time. Do not get insurance from this company. You will end up being disappointed and frustrated!
Reviewed Nov. 3, 2022
No no, like ACTUALLY the worst insurance possible. Let me give you a general run down:
- $15 PER appointment (Doctor)
- $25 PER appointment (Therapist)
- $75 per script of basic medications
- $150+ for LIFE SAVING medications, MINIMUM
- $250 to literally SET FOOT in a hospital waiting room (Family Practice or otherwise)
- $500+ for this random thing that never happened
Highmark takes full advantage of you if you're living just above the poverty line. Like absolute FULL advantage. The amount of random charges I have for things that never happened is disgusting, let alone the fact that they will tell you something is covered, but it actually isn't. My appointments with my therapist are supposed to be $15 even, but they charge me anywhere from $25 - $70 per session. I went to the hospital a few months ago for some serious issues with my stomach, needed some testing done. Per my member pamphlet AND Highmark CS themselves, my testing was to be covered. Well, it wasn't, and I got smacked with a $500 charge.
I literally have to cancel every single appointment I make and have cut myself off from 4 different medications because they want me to pay anywhere from $75 - $200 for EACH 30 day script. They take full advantage of you, and then send you a bunch of spam about how ''great'' they are. Never again will I deal with Highmark.
Reviewed Oct. 3, 2022
This is the best insurance plan my company offers. Until this plan year I had not had any issues that were not easily resolved. My problems started in July of 2021 when my chiropractor closed his office and joined a group practice. Highmark started sending flexible spending account checks to a chiropractor in my home town that I had never been to. I was given details about how to get the new office to send in the W-9. Highmark sent checks directly to me for my copay amounts in that plan year until the W-9 issue could be resolved. The office sent the W-9 in May of 2022.
Fast forward to July of 2022, new plan year. The W-9 was never updated with the Health Savings Account department or the Flexible Spending Account department. I was informed in May that checks could not legally go directly to me for HSA money. Checks were still being sent to the chiropractor that I had never seen and I can no longer get this checks at all from Highmark. Direct to patient checks is no longer an option with the new plan year. I have now discovered that none of the HSA checks or FSA checks have been sent to multiple doctor's offices. I am paying into this insurance that is suppose to cover the first $3650 toward any deductibles or medical expenses the only expenses that I have not had to pay out of pocket are those that I am able to put on the debit card, eye doctor and pharmacy expenses.
Reviewed Oct. 3, 2022
Highmark denied payment for a 1-day inpatient hospital stay via correspondence. I followed the instructions in the letter to file an appeal via phone by calling the Member Services number. I spoke to no less than (5) Member Service Reps (MSRs). They just kept transferring me over and over. One rep I couldn't understand, as he had his microphone turned down. Offshore MSRs give customers fake names, as well. The final rep transferred me to a number in Erie, from which I was disconnected, as it does not accept calls. Two hours, and I was never able to start an appeal. Highmark customer no more.
Reviewed July 29, 2022
My husband has had the same insurance for over 20 plus years never could get him to go to the doctor. Finally he has to see a urologist a few months ago and urologist said you need to get a primary care physician so after 25 years finally gets a doctor goes to see him and Highmark Blue Cross denied claim because of wrong codes being used. I don't understand medical coding but how is it we are supposed to fix everyone not doing their jobs correct. So now after not using my insurance for 20 plus years my husband's first doctor appointment has been denied and we have to pay 200 dollars for it.
Reviewed May 27, 2022
I have been waiting on approval for an MRI for over a week (last Friday). Now going into the holiday weekend (it's Friday before Memorial Day now) I still have nothing. The best anyone can tell me is it is pending a medical director's review. I am walking around on a possible fully torn ACL!!! This is absolutely unacceptable! I have called every single day since Tuesday, sometimes even twice a day! So now I won't get the approval until the earliest Tuesday of next week and then I still have to get on the schedule to have the MRI! WE HAVE TO DO BETTER THAN THIS! For what I pay for this insurance, I shouldn't need to wait on someone else's opinion. My MEDICAL DOCTOR'S OPINION IS THE ONLY ONE THAT SHOULD MATTER!
Reviewed April 6, 2022
Unfortunately, since Blue Cross Blue Shield of WNY has become Highmark BCBS of WNY, the service across the board has become downright awful. They've cut a ton of medications from their dispensary, shifted a number of them to tiers 2 and 3 (higher copays), removed the cap on total out-of-pocket expenses, fail to cover basic bloodwork panels claiming they are out of network (I got them done locally at Quest Diagnostics), cut all out of network coverage (even partial coverage) and make it near impossible to reach their customer support. When I did reach their customer support (on my 3rd half-hour phone call) they told me nothing could or would be done about my issue. Run from this health insurance company as quickly as you can.
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