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Reviewed Jan. 27, 2022
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.
Reviewed Jan. 22, 2022
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.
As a health insurance company, they do their job. I am not left to do their jobs for them. When I have questions and call them, I am not left ending the call with more calls to make. They are great at doing the legwork that's needs done to answer all my questions. Claims are processed quickly and the wide range of in network facilities and doctors makes it very easy to always have many options when choosing your care. The rates we pay for a married couple is so affordable and after we meet our small deductible, everything is covered 100%, including prescriptions.
Reviewed Dec. 30, 2021
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.
Reviewed Oct. 25, 2021
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!
Reviewed Aug. 26, 2021
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.
Reviewed July 7, 2021
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.
Reviewed Nov. 21, 2020
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.
Reviewed Nov. 20, 2020
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.
Reviewed Nov. 6, 2020
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.
Reviewed July 13, 2020
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!
Reviewed Feb. 27, 2020
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.
Reviewed Jan. 17, 2020
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!!!
Reviewed Nov. 4, 2019
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!!!!
Reviewed Oct. 2, 2019
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.
Reviewed Sept. 13, 2019
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.
Reviewed April 25, 2019
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.
Reviewed April 17, 2019
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.
Reviewed April 12, 2019
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.
Reviewed Feb. 19, 2019
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.
Reviewed Feb. 11, 2019
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.
Reviewed Jan. 28, 2019
My husband is required to get insurance for his job, and my job mandates Highmark. Since we have to have two insurances, we just buy the catastrophic plan for my husband's which is the cheapest. They rarely cover anything, but since his birthday is earlier in the year, they are supposed to be primary and Highmark is secondary. Long story short, I have spent countless hours trying to get Highmark to provide maintenance of benefits. Many, many phone calls. Eventually, I learned that the most effective way is to go through their message center and send the EOB from the other company. This is ridiculous because the other insurance is also affiliated with Blue Cross. Even when I do this, sometimes it takes several attempts to get the maintenance of benefits to be provided.
My husband and I have excellent credit, and I am terrified that our credit rating will be harmed because we are not paying bills that we should not have to pay for. I don't understand why they will not just put a note on our account to provide the maintenance of benefits. There are also services which are surprisingly not covered, such as newborn care when my son was born in the hospital -- ordinary birth expenses. If I could go with another company, I would.
Reviewed Nov. 16, 2018
I've tried phone calls, chats and working with my internal Admin of our account. I never received my reimbursements.The first request was in mid September. I was then told that I would receive a check on 9/25. They have sent me numerous false statements showing that I was reimbursed. I have called the 1-800 number on four different occasions. They keep hanging up on me with no solution. I tried chat and they disconnect my chat line. I was told they would finally reimburse me via direct deposit this week. Still nothing. The first excuse was the person in the office that works on that is gone. The second excuse was their computers are broken. Still no detail provided to me on my dollars owed. No money reimbursement provided. The last person Susan ** told me to call Lindsay and have a Happy Thanksgiving. Gee thanks.
Reviewed May 7, 2018
I have been suffering from pain and numbness since Feb 3. I have had an X-ray and nerve tests, still no diagnosis. My Dr wrote a referral for an MRI. They denied it stating I needed proof of pt or chiropractor for last 6 weeks. Highmark has been paying for both since February so why do they need to prolong my pain and suffering while I get a letter from my chiro that what they have been getting paid for since February really happened. What a bunch of jerks! Wish I had UPMC!
Reviewed Nov. 24, 2016
I sprained my ankle almost 3 months ago. Had several x-ray which came back normal. I have been in extreme pain with my foot. Tried several different braces with no relief. With severe swelling and ankle and foot pain how can an insurance company do this for insurance that I pay for? I have exhausted all avenue on my own. My attorney with be contacting you regarding this matter. This is going to turn into much more than a rejection of a MRI. Because you have a bunch of idiots working in your authorization department. I do authorizations at my job. I work with NaviNet. I know.
Reviewed Nov. 2, 2016
Having had shingles already at 53 I spoke with my doctor and he wants me to have the vaccine as once you have shingles you are at higher risk to get again. I had no idea you could get again and that is not something I ever want again. My immunity was for a few years so now I need to get the vaccine. I cannot get it covered since I am not 60. Even with my doctor's orders, NO... Our contract says 60 and we make the rules. No way to argue the point, ask for a variance, nothing... So where do you complain? I asked what options I had to try and get this covered. The options given by Susan at the Highmark - supervisor - was have the vaccine and pay for it. That is an option that you have. When you are denied coverage you can appeal, however the contract says 60 so it will not be covered. No way to formally request any variances in insurance. Does not seem like the way it has always been.
Reviewed Sept. 19, 2016
They randomly select medications to not cover anymore. Some patients NEED them but just continually get denied life altering medications. Never spoke with anyone that was rude or mean. They are just relaying information. It's to their fault. They offer help as much as they can but their own options are limited. Generally speaking, the coverage is good. Their internal policies are what I believe to be the problem. Plus, they could add a much easier and faster process for people needing exemptions. I was able to see a reputable doctor that fixed up all the issues I had going on. He helped me maintain the battle of getting healthy both mentally and physically.
Reviewed Sept. 16, 2016
I never really had any issues with the claims processing. It usually went through and I never had to file any claims. Of course if I had it probably would have been OK. Never had any issues with customer service because I never had to talk to them unlike many insurance companies I have had in the past. Still can't believe I'm no longer with Highmark. I had to change primary care doctors because they were not covered under my insurance plan, doctors I had been going to for years. I had to pack up shop and leave the ones who knew me. Overall value was decent because I got it through my union, however 2200 a quarter still seems pretty expensive to me considering the company also matched the payment.
Reviewed Sept. 15, 2016
My major use of claims processing use was for my daughter and the hospital or doctor's office usually handled that as soon as I gave them my card so there was little effort on my part. During the five years that I used this provider, I never once had to contact customer service regarding any issue. The coverage options are extensive and include single and family plans with usually three different tiers to choose from to meet every customer's needs. Through my employer I only paid $50 per paycheck for a family plan which included my wife and daughter with dental and vision also included so I don't think that can be beat.
Reviewed Sept. 14, 2016
Very hard to send claims through. My son broke his arm and needed surgery last year. They sent me the bill once and I called to ask if it's covered and they said "sure, not a problem, just pretend you didn't get the bill". I did as they said and the hospital sent another bill, then another, and another. It took almost six months for my claim to go through and for me to stop receiving bills. They try very hard to make you satisfied and to ensure that you are completely taken care of all your needs. Never leave you until all of your questions have been answered. Everything is always covered. Whenever I put a claim through it's covered. Also, I barely have any co-pays and they are always ten dollars or less. Great value! I get it through work so I don't pay anything but co-pays and that's a great value to me. I strongly recommend it because most companies use this insurance.
Reviewed Sept. 11, 2016
I've lost my card and had to submit a claim. And they handled it very well. Payment was made promptly. And all future payments were submitted on time. And never affected my credit. I never had to deal with customer service. The people I talk to when applying for the insurance were very helpful and very polite. They covered all my medical needs. Very low deductibles. Also had coverage on wife and kids. And they provided very good coverage. I would highly recommend Highmark. The value for medical insurance is very reasonable and affordable. For all of my medical needs. With very low deductibles. Highly recommend this insurance company.
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