Highmark Reviews

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.

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.

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.

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!

No no, like ACTUALLY the worst insurance possible. Let me give you a general run down:

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.

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.

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.

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!

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.