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This health insurance company is grossly mismanaged, morally bankrupt, and predatory. My health insurance through BCBS was dropped without my knowledge. However, they still took near $600 dollars from me after my drop, but refused coverage for my medical needs. After my insurance did not respond when a hospital ran my information, I called to see what the problem was. I was told I had been dropped months ago, and that I was outside my appeal period. However, it was IMPOSSIBLE for me to appeal, as I was not made aware that I had been dropped.
After several hang ups and empty "we'll get back to you" phone calls through customer service, I visited their offices in person. I sat in front of a representative, openly weeping, after I was told to wait until November to enroll for 2021. I am sick, and have gone under anesthesia 3 times in 2019 for various issues and tests. The precise nature of my illness is still undetermined, and a full year without medical insurance puts my health in extreme danger. The dispassionate representative told me in monotone to "take a deep breath". Additionally, I was told that I had been dropped due to "unemployment", despite being privately insured and employed for over 2 years at the same business.
Highmark BCBS has stolen from me and cited false information for an insurance drop, and then neglected their obligation to inform me of the drop. This company is more interested in saving themselves money (by dropping a high cost patient) than the life of a human being. Disgusting business ethics, and a shameful display of prioritizing profit over people.
Blood work at a in network provider is not actually covered. Upon trying to review my benefits booklet online I'VE come to find it's currently unavailable. While still logged into my account I decide to search for other plans when I come upon my plan with full explanation of benefits. In there it states that blood work is covered if the deductible is met or not. After speaking to a customer service rep who informed me that it falls under the new year deductible of $800, I told her about what I found. She said sometimes they make adjustments when the new year begins! Yet it does not say anywhere about this so called adjustment, besides the fact I would think anyone with this plan should be notified! THIS IS FALSE ADVERTISING about health plan coverage!!! BEWARE!! I don't believe this is legal and intend on pursuing this further!!!
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Highmark BCBS of DE completely scams unknowing consumers who have done their research and due diligence and attempts to uphold them to standards of fact finding that their staff is not even capable of. Example: I have Highmark BCBS of DE with an annual deductible of 2k and only in network providers are covered. Great. I reside in NYC and see an endocrinologist in RI - ALL confirmed in network providers based upon information in my customer profile on their site. I get blood work 2x as ordered by my doctor in RI (I have been following this process for 6 years). I hit my annual deductible far in advance of these visits so I am like great, finally 100% coverage. I receive bills for this lab work that was at an in network provider so naturally I think this is an error. This goes on for months of back and forth with LabCorp and BCBS.
Bottom line they are saying I am responsible because while I have BCBS of DE this lab while in network for me is not in network for BCBS of RI - AN INSURANCE PLAN I DO NOT HAVE. How would any consumer ever know that this was even possible? In fact in the many times I called none of their staff new it was possible - it took months of research and untangling to even figure out the reason it wasn't covered. So I appealed naturally thinking any rational human would see that this was a clear error and blatantly takes advantage of unknowing consumers. Nope they denied it saying I should have known and now if I'd like to appeal again I can pay a $75 filing fee to do so. This is the epitome of why consumers have such a strong distrust within our healthcare system. Please see attached where it says it's out of network for BCBS of RI - I HAVE BCBS OF DELAWARE!!!!
It completely 100% disgusting that NO insurance company considers dental health a major part of the insurance!!! Most heart doctors and lung doctors wont see you until you have had a complete dental clearance because it has been proven for over 30 years now that your teeth affect heart and lung health!! And the insurance companies KNOW this and still screw over the policy holder.
I have to be rushed by an ambulance. Blue Cross Blue Shield tells me that I will be paying the full amount of for the Ambulance service. BCBS did not pay their share being my insurance company because they keep insisting that the Ambulance was Out of Network. Well in fact in my Policy Page 13 under “Summary of Benefit” clearly states that under Ambulance service I will have the greatest amount of benefits that the program can provide. It is always tagged as “Same as network services even if it’s Out of Network and Page 21 under Emergency Care Services it was stated “you’re covered at the higher, network level of benefit for emergency care received in or outside the provider network. This flexibility helps accommodate your needs when you need care immediately”.
In my two formal letter appeal to Blue Cross Blue Shield I keep insisting that it is too absurd that during 911 call you will have to ask if the ambulance that is coming is In or Out of network. Another reason that they gave me when I made a call was, it is useless if they will contribute a payment because the Ambulance service is Out of Network. They have no control of the fee that the Ambulance Company will be charging on me but at least they must do their part based on the policy agreement. I am aware that I haven’t met my deductible so I will be responsible to pay that service however they would have share a payment first then the rest is my responsibility.
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I have not been able to sleep in my bed for over a month, I use a cane to walk & I trip & fall with the numbness. I have pack pain, leg pain & hip pain. I have had 3 spinal surgeries & degenerative disc disease. My last x-ray showed that the disc is completely gone & the other are almost gone. I have been to the emergency room & Blue Cross still says that my MRI is not medically necessary. I only get 2-4 hours of sleep a night because the pain wakes me up. I think I have to sue Blue Cross when I fall & break my hip next.
Have returned to Highmark again, as their customer service is wonderful. Paying $13 a month is reasonable for a Medicare supplement. Doctor choices are excellent; as are pharmacy options. Convenient local office.
I've always had good experience with Highmark. Customer service is friendly and knowledgeable. Health coaching outreach was appreciated. Wide selection of consumer tools to support informed decisions.
My father had a stroke and we are supposed to have 100 days of coverage in a skilled nursing facility. They stopped payment on both the skilled nursing facility AND his physical therapy after only 20 some days. Heartless.
We have a recurring policy with them and my wife had two hand surgeries. One in Oct 2018 which was mostly covered. In November I removed one dependent from the policy and it send them into a tailspin. They charged $200 more than the monthly premium and the after numerous calls reduced the premium to 4 times the original premium. Before I made the change I called and asked if her upcoming second hand surgery would be covered. They said yes, however every time you call this place you get a new rep and have start all over again. Well the Dec 2018 was not covered and applied to a new deductible and not out pocket similar to the surgery in October.
Seven calls were made when it was finally escalated to an investigative unit who finally told me they would not cover it and I am responsible for the entire bill. They will not connect me to this department as they claim they do not have extensions. Stay away from these people if you possibly can as they don't give a damn about their policyholders and can't explain reasoning as to why the second surgery was not covered.
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