Highmark Reviews

My problem is I try to talk to you a representative because I've been having issues. All I wanted was a case worker and the representative hang up on me. I contacted a supervisor after been dealing with issues for a month dealing with people hanging up on me. I just want the whole gateway health plan to know we are humans. To not have my bad day but I don't put my bad energy on everyone else I did talk to someone but the end of day I don't want to be disrespect. When that lady hung up on me I had a bad day already like I said I don't put my bad energy on no one.

So Highmark in its infinite wisdom has dropped weight loss meds from coverage. Why? Cost. Plain and simple. They chose a blanket answer to a problem that is dealt with individually every month when you have to contact your physician to get it refilled. They document your weight, BP and side effects. I am sure there are people who aren't using it as prescribed but that falls back on the individual case to deny not block everyone. I hope someone sues the daylights out of them and it's a class action one that costs them millions.

I am dealing with retiree benefits. The segment of the company I deal with has no email or website. I have to call or mail everything. They are waiting for this small group of customers to die-they simply do not care AT ALL if you get any help or ever get paid. I hate this company with every ounce of my being. DO NOT use this insurance if you EVER want even a mediocre experience. ABSOLUTELY AWFUL. 0/10. When the class action lawsuit gets filed, I hope I get a call from an attorney.

Husband's work switched from UPMC which never had a problem with, never ever had to call customer service all around no worries. Well they switched to this insurance and all I got to say is I and others are demanding we go back to UPMC for we are the ones paying!

If I could give Highmark negative stars, I would. Their handling of weight loss medication coverage is not only disheartening but downright unethical. I was approved for weight loss medication when I was considered “morbidly obese,” and with the help of that medication, dedication, and support from my doctor, I was able to drop into the “obese” category. You’d think this would be a success story. But instead of supporting continued progress, Highmark decided I wasn’t “fat enough” to keep the medication covered. Yes, you read that right—still obese, still at-risk, still under medical care—but not fat enough anymore.

Had two calls this morning from two different Matrix reps trying to schedule in home appointment and saying that Sunday May 11th which is Mother’s Day was their only available time. They were quite pushy! Of course we said no. As an aside, I just lost my mother. Not impressed with this group!

I am in a financial bind because of information that multiple representatives at Highmark Medicare and or Express Scripts regarding my medications. Before I committed to an additional recommended drug in January, I contacted Express Scripts (mail order co. for Highmark) who handles the pharmacy claims etc. to discuss the new $2000. out of pocket for Medicare members in 2025. I repeatedly called and spoke to reps or supervisors confirming each time what I had been told. Based upon what one supervisor told me in January that the total included what I paid for a covered drug and what my part D plan paid. He directed me to

In my 23 years of adult life, I have never had such horrifically bad service from ANY company. Their website works randomly or not at all, and when I can actually get to their login screen my login creds never work. I try to reset the password using the info they request, member ID #, first name and birthdate and the site tells me it's wrong. I spend 45 minutes on the phone with someone who gives me a temp password, which works, then I create a new one, which then doesn't work. Rinse and repeat this scenario over and over again. I can access my claims, benefit info or search for covered doctors or services. I can't wait until next year when I can switch from this god-awful insurance company.

They "accidentally" dropped our renewal in Jan 2024 despite being active on Jan 1 and COBRA being paid. They had to reinstate. Then in Feb of 2025 while COBRA was still active, they somehow expired both myself and husband. Then after being denied an MRI on Mar 2 due to "coverage expired", I spent over 6 hours March 3 on on the phone getting it reinstated only to find out they forgot to reinstate Rx as well. Had to call back.

Absolutely terrible! I was on Wegovy for 5 months, lost 20 lbs and my high blood pressure was under control and then they changed the criteria. Denied for Wegovy and Zepbound by a pediatric doctor that reviewed my case and I'm a disabled adult limited on how I can exercise. Why do they go against my doctor's advice on drugs that ARE covered? The premiums that I pay are absurd, but if I had Medicaid it wouldn't be an issue. They don't even deserve one star. I was on Wegovy for almost 6 months and they covered it but because I lost 20 lbs but I wasn't anorexic looking they won't cover it and my blood pressure is all messed up and they don't care.

Took 6 months and 5 or more phone calls and sitting on hold for 40 mins at a time to finally get refunded for health insurance payments I paid and then was told my insurance was cancelled. They refunded me $177 after I paid $290 that they need to fully refund. Now I try to login and I can’t access my login. Of course.

A sad excuse of a disaster for an insurance company. Worst insurance company. I had in 35 years and they just don’t seem to care. More denial more confusing answers. Even when they deny something, they just tell you to reach out to your doctor cause they don’t have a clue. Wish the government would investigate them or they would get sued. Unfortunately, I am stuck with them.

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.)