Highmark Reviews

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.

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.

The company has changed ID cards and accounts; nothing works. Change was effective 1/1/2021; it is now 1/27, Cannot use wellness card or get scripts that were previously covered. We are being told to pay out of pocket and submit forms and that they are having issues because of the changeover. Have contacted customer service numerous times. Holds are from 45 minutes to an hour or more. When you finally connect to a person, they transfer you to somebody else and the wait time starts all over again. Sent emails, no response. We were not told the company was changing during open enrollment during November and December and that there would be coverage changes with the name change. We would have left the company. We want the service we are paying for.

We Highmark BCBS in PA & I've only had to call customer service twice, with an average of one call per year. This is due to their well laid out, easy to use webpage & app. Most info I am able to easily find online. Some company web pages are messy and answers hard to find. Highmark has done an outstanding job making the interface easy for anyone. It is well laid out, non confusing and pleasing to look at. I didn't feel overwhelmed with the immense amount of information I was able to find online to fully answer all of my questions.

Highmark has been awful to work with. There is no communication between representatives. When you call you always reach someone different. I put a call into my care navigator on Dec. 22 and still have no resolution. I am in need of IV home infusion services for a kidney disability and so far they have denied care. No one returns phone calls. We have spoken to at least six different people and all have inaccurate information. Some of their medical coverage may be good but their representatives either do not document or read records. There is no communication. It is extremely frustrating. It has been many days since the original call and no resolution. Continuing to deny care can be life-threatening.

We paid LESS for our medical bills WITHOUT ANY INSURANCE from the hospitals and doctors' offices running our bills through their assistance programs for people without insurance than we pay now that they send our bills out to Highmark now! Switching insurances asap! No help at all!

I love it. They're very professional and personable. Everyone is very friendly. They're very easy to get appointments. It's nice because in the same building there is a lab downstairs. They have a place where they can do X-rays and also physical therapy.

This insurance is terrible, reps are not knowledgeable, they are off shore reps, even the supervisor kept me on the phone for close to an hour giving me the runaround. It took FOUR HOURS to get simple eligibility and benefits.

Obviously starting with the horrible price I pay monthly which is absurdly high for a family of 3, my deductible is 7500 which is outrageous, all my co-pays and my blood pressure meds pricing are too much. Only thing holding us back from having a second child is the ridiculous out of pocket cost we would have to pay, so thanks a lot for the horrible healthcare I pay for while people who do not work have it made.

I switched to Highmark in 2020 as they had a lower rate than the plan I had. I picked a Highmark Lehigh Valley plan as I live in the area of PA known as the Lehigh Valley. I go to my normal PCP and they cover nothing, I pay the full price of the visit. I call to ask why. Out of network coverage is ZERO. It seems the Lehigh Valley plan is "Lehigh Valley Health Network" only. So I switch to a LVHN doctor, go for my next check up and get a $200 bill. My $0 PCP visit copay does not apply. I have to reach my deductible first. Misleading in every way, they could have named it "Highmark LVHN" but why be accurate? BTW, my LVHN doctor double billed me for a new patient visit and a wellness visit for the same visit.

This is the only insurance company I've ever dealt with that actually gave a damn about the clients, and demonstrates integrity in their actions. I was very surprised, but they have been consistent in being honest and honorable in the 3 years I've had them. Before this, I would have told you that health insurance executives are grouped with the lowest human slime to be found. I sincerely hope there is no change in their management and company ethics.

Getting worse! I'm in a Hoveround for the last 10 years, first hoveround, no charge, second hoveround, 700 dollars, it's time for a third one, Hoveround don't deal with Highmark no more! So no new hoveround unless it's out of pocket!

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.

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!!!

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.

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”.

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.