Highmark Reviews

I have been a type 1, juvenile onset diabetic since I was seven years old. Within the last year Highmark Blue Shield has started refusing my insulin prescription every time I try to fill it stating they need the dosage information even though the dosage has never changed under my current physician. This has forced me to ration insulin for months, to which Highmark has zero concern. Their customer service seems to exclusively be based outside the US and they have zero information about your plan when you call.

WORST HEALTH INSURANCE I HAVE EVER HAD. Their website NEVER LOADS. How can I find coverage if I CAN NEVER ACCESS THE WEBSITE. Their phone tree is also complete trash. Utter trash. TRASH. TRASH. TRASH.

Very frustrating website that is not customer friendly. Can tell it was designed by programmers FOR programmers, and not for consumers. Some of the problems I ran into: a) no easy way to print a temporary ID card for people who buy individual coverage; b) if I lived across the road (in another county) my premium would drop by a lot and I would have access to a much better plan; and c) my doctor listed as “not covered” even though his claims go through every time I see him. Exchange plan members seem to be second class citizens to Highmark, and they make no bones about it. They act like we’re pariahs. No other choices here though.

I have engaged with the Highmark customer service staff on 5 occasions in the last 3 weeks. Each call promised a follow up within 1 to 5 business days. No follow up occurred. Each call was handled by a polite well-intentioned person that was not capable of clear communications in English. I do not fault the people. They seem to be trying their best. But when my effort is to confirm that we actually have coverage in place this is very frustrating. When I log into to the web site, and it says we do not have coverage and yet the calls to the service center say that we do have coverage this is not very reassuring.

The worst health insurance provider I have had in my fifty years of life. They have denied services requested by my primary care provider, as if they know what is better for my health than my doctor does. I can't wait to get out of their service at the beginning of the new year. Money hungry insurance providers have ruined our healthcare system, and these fools are at the heart of everything wrong with it.

Highmark now decided routine diagnostic blood work was preventative care and not covered. Same for removal of inflamed skin tags. Denials come frequently while I was just notified of a $200 monthly rate increase. Upon appeal, they have not responded to the appeal. Highmark has made it clear that they don't care about health of their customers. It's a numbers game for them. The more they deny, the more they keep. Try to call customer service and someone from offshore answers after a long wait period and repeats the same sentence over and over. And they won't allow you to talk to someone in the US. And you get disconnected at least once every time you try to reach someone. Highmark is awful and I would find another company who cares.

EVERY year I have a physical Highmark denies payment for part of my lab work. I have to contact a patient advocate and jump through hoops to get them to pay. This year has been HORRIBLE. Every time I call a patient advocate the story changes: It was coded incorrectly, Medical history supporting it must be submitted, it requires a letter of Medical Necessity... My doctor's office has done everything they've asked of them at this point and still... denied. I dread my physical each year knowing I will have to deal with them. I've called for help 5 times now. I HATE dealing with this. Get your act together Highmark BCBS!

My sister called Blue Cross/Blue Shield 1-800-275-2583 twice for information on deductibles and copays for an out of network provider. She was disconnected both times. I called twice and am now on hold for over an hour. When logging into ibx.com/login Notice the Terms and Conditions. The accept check box and submit button are greyed out.

The OTC WEBSITE they have nothing you can buy...Everything is out of stock... It's impossible for me and my wife to spend $80 each a quarter.. Highmark needs to get a new supplier... If I remember correctly 2025 the OTC allowance is even higher..So what good is a benefit if you can't use it.

Their website searches are inconsistent with customer service reps in finding in-network doctors, dentists, etc. Their website will offer contact information in your searches only to find out they aren't accepting new patients. The website will give you results, you see the doctor, then come to find out by a customer service rep they aren't in network???

If I could give -5 stars, I would. I would be better off not having ANY insurance than having this insurance, and I'm not being dramatic or kidding. The "customer service" is horrible, the use of Accredo Speciality Pharmacy is criminal, and the blatant money-saving measures that HighMark has put into place is disgusting. I wonder how many Highmark "customers" have died waiting for their meds to be covered, pre-authorized, denied, refused, lost, etc. I'm so happy that the CEO got a raise this year, because I'm sure he needed that new yacht more than I needed my life-sustaining medication refill which was denied. There is a special place in hell for this company.

Highmark is the WORST insurance that I have ever had. They don't cover anything at all. I pay $500 a month just to pay another 5k before they will consider covering a single claim. I've never heard of such thing. If you're looking for a good insurance I had United Healthcare for 5 years and they were excellent. They covered most everything and were wonderful to communicate with. For reference I had a baby in 2023 with United and paid $930. I have what my employer & highmark said was the same coverage as I did with United and now I'm paying $4,698 to have a baby in 2024. Highmark is legally robbing its customers. I'm sure this company alone is the reasons thousands of Americans die home alone because they can't afford medical care EVEN WITH INSURANCE.

Depending on your prescriptions they have to be mailed to you. Then when you need a refill every month have to call and talk to 4 or 5 different people. Then hopefully you get your meds if some crackhead doesn't get them first. Life saving meds thru the mail is retarded. Hope I don't die before I get them. Worse insurance company I have ever had the worst luck of having.

Upcharging $50 for the power charger for hearing aids. Like getting the hearing aids without the charger Is an option. Kind of piggy being at the CEO keeps bumping up their pay raise is $10 million and that was of 2022.

STAY WAY FROM HIGHMARK, PERIOD!!! AT ALL COSTS.

I would have given it a 0, if there was an option. My daughter had been trying to get her claims paid for a whole year. They have been denied because they think there is another primary insurance. We have proved to them there is any other insurance, many many times and they still refuse to address it. Now the debt collector is after us. The amount of time we have spent on phone calls and the stress is crazy!

If you ever need a prior authorization for an emergency medication that your doctor prescribes, prepare for it to be denied. Not sure why I pay an arm and a leg every month for insurance when someone sitting behind at a desk more than likely with no medical knowledge, can just deny a medication that my child’s doctor says she needs based on a few key words and certain requirements. Ridiculous.

Have wasted more of my time than I would like to admit with trying to receive reimbursement for covered expenses from this company. I am starting to think they deny claims that are legit for bogus reasons to see if they can get out of, or delay, paying claims. When I have called to question the reason the claim was denied, I have had the customer service representative, after looking over the claim, tell me that they don’t know why the claim was denied. (This has happened to me more than once for two different claims.)

Classic case of an insurance company who never sees you but tells you what your doctor prescribes is just not needed even though they are a specialist that you were referred to due to severe symptoms that the regular primary care could not solve. Rx denied so I had to pay out of pocket but at least the Rx solved the problem. Highmark is all about paying as little as possible and their consistent 1-star rating reflects this.

I enrolled in a premium plan which costs a substantial amount annually (more than $33,000 a year - both my share and and my employer's) for a family coverage. Despite the high cost, the plan often complicates covering even small prescriptions, like a $40 medication. If you pay out-of-pocket and file for reimbursement, the process is exceedingly inefficient and cumbersome, seemingly designed to dissuade people from pursuing small reimbursements, considering the extensive time investment needed for multiple mailings and follow-ups. It appears that no action is taken on claims for months unless you repeatedly contact them to prompt a response.

After having CIGNA for years my company switched to Highmark. One week after my routine yearly physical and bloodwork I received a bill for $800 because Highmark only covered half of the blood work tests done. This was very upsetting since it was just a yearly physical, I called member services but they said there’s nothing they can do. Highmark only covers a handful of the bloodwork tests. This makes me not want to have any physicals in the future. Sad.

They need to make their app easier to use. It is very poorly done. Every time I try to select a doctor it sends me to another site that doesn't load. It is very confusing and discouraging. I wish it ran like Kaiser's patient portal.

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.