Anthem Blue Cross Blue Shield
reviews and complaints

My husband has had a policy with Anthem Blue Cross for a PPO since 1997 which covers me and our children. In 2007 I went to work for an employer that provided a HMO policy without the option to opt out. I was not interested in changing insurance usage as I had established doctors, etc. that would not accept the HMO. I contacted both companies and was told that I simply needed to declare who the primary and who the secondary insurance was, so I declared the PPO as my primary and never used the HMO. Every year my husband's insurance would send a coordination of benefits questionairre that I would send back listing the other HMO information. This year I sent it back and suddenly all my claims are being denied by the PPO. Furthermore, they are now going back through prior years and adjusting claims to disallow payments. They state that my insurance through the HMO is primary and that they were not aware of it's existance until the recent questionarre that I returned, which is untrue. They deny having ever received prior questionaires from me. When one of the medical providers contacted them they were told that the policy of the company is to have the insured declare primary (which I did), but that I had changed primary with the last questionnaire, which is untrue. It didn't even ask anything like that on the questionnaire. When I called them back immediately after I spoke with the health care provider the insurance once again said that my HMO is primary and that I cannot declare primary. I am now in the middle of some sort of twisted game where I think my insurance company is trying to weisel out of payment. I know they have lied to me because they knew about the other insurance from the start. Anyone know if a situation like this? The best way to resolve it?

I lost my job because I was 5 months pregnant and the company had to make cut backs. When my state continuation ran out through Anthem. I went to by an individual package from Anthem so that I was sure I'd have the same policy. I was told the maternity addition wouldn't start for 3 months. Even talked about the fact that it should be okay cause you don't really go to the doctor for 2 months so I'd only have a month to worry about. Three days after I paid the premium and 5 days before my policy was to start, I found out it doesn't start of 9 months. Now no one will call me back and I just want to cancel the "maturnity" portion of the policy. Guess thats like admitting guilt huh?

I was an RN for Anthem for 2.5 years. Prior to being layed off 12/31 I was told that my spouse would be on medicare. He has terminal CA. On 1/5 I received a letter from Medicare stating that Daniel would not be covered until July 1st. I called Anthem to let them know. Also, Daniel has skin cancer and was treated 12/5 and his MD called to tell him that he needs to have a rather large squamous cell cancer next to his eye removed. Growth could cause vision loss. Dan is 57. So, I appealed to Anthem on 1/7. Anthem sent me an e mail that I could not open around 10 days ago. Even while working their secure system locks you out of it. I could not access the email after trying twice and then later when they wrote me back. I asked them to just mail it but never heard from them again.

My main concern here is that I also dropped my daughter because she was no longer a student. Anthem has sent Kathryn numerous letters telling her she can apply for COBRA. Anthem did not send Daniel any such letter and on the COBRA sheet Daniel was excluded from having any insurance because I took him off prior to 12/31.

I believe Daniel is being purposely ignored by Anthem because of his lymphoma cancer diagnosis 6/07. And, Anthem also purposely makes it impossible to communicate with them as their security system always locks out everyone. I had to deal with this for years. Seldom does it work right and so they are able to send you an e mail that you will never get but they have proof they sent it and they hold you accountable for it.

That's what DEEP POCKETS can do. I'm so sick of this country and the way MONEY is only for the WEALTHY and WE THE PEOPLE GET SCREWED, ARE TAXED AND FORCED TO BE HELD RESPONSIBLE FOR GOLDMAN SACS AND CITIBANK YET WE CANNOT EVEN AFFORD TO SEEK MEDICAL CARE WHEN IT IS NECESSARY YET THE WEALTHY NOT ONLY GET THE MEDICAL CARE THEY NEED BUT THEY NOT ONLY HAVE RETIREMENTS FROM OUR TAX BUT ALSO AUTOMATIC PAY INCREASES WITH THEIR RETIREMENTS AND CADILLAC HEALTH PLANS,
WE NEED TO HAVE A SOCIAL REVOLUTION AND OVERTHROW THIS EXCESS TAXATION WITHOUT ANY REPRESENTATION.

Never ever buy insurance from these people. They have put me thru it over a drug prescribed by my doctor. If the medicine is over $100.00 they make you try not one but two different medicines and still would not pay for it. I ended up paying for my medicine out of my pocket in desperation after trying for weeks for them to pay for it.
We pay almost $10, 000 per year in premiums. No one in management takes phone calls. They are too busy spending the millions they make for doing nothing. They should be run out of business for defrauding people.

I spent 28 dedicated years of my life as a Blue Cross employee in Kentucky. When Wellpoint (California's plan) merged with our company, older employees, with long unblemished careers, started being fired for "lack of performance." It was no accident that the people who were doing the 'firing' were out of state managers. I called Wellpoint out by emailing the CEO and questioning the company's integrity. Six weeks later I was fired. Within a week I sued for age discrimination and retaliation. Almost 5 years in now, they have stalled in every way possible. How dare a gal from Kentucky pick a fight with the 'Giant'! Their time is running out.

My Doctor wanted a test performed 50 miles from my house, which was still covered by Anthem. The request was made 11/24/08, but due to bad ice storms and lake effect snow, I rescheduled the appointment 4 times. Finally, 1/12/2009 I made the drive and had test completed. Insurance denied claim indicated beyond the 30 day auth window. No problem, Doctor will contact the insurance and get a post certificaiton for procedure. Nope! Procedure needed to be done within 30 days. Now Anthem insurance is fighting saying they can't do anything since we are too far out... hello...
Anthem sucks!

On April 28, 2009, my neurologist prescribed a medication to replace one that I had been on since 2004. I have developed some side effects and find it is no longer effective. We submitted the request per instrucions to request an urgent processing of this claim. I was denied coverage on May 4, 2009. We again were given instructions about how to appeal a denial of claim and again faxed the required forms with the information we were told to provide. I was assured that I would have approval within 72hours as I had already complied with one of the "step therapy" requirements.
As of today, 5/28/09, I have spoken with 19 Senior Services Representatives, been told by one that I would never receive authorization, told by another that I should not have any problems being approved and that my policy will cover the medication, told by another that there is no record of the necessary paperwork reaching the prior authorization department and today I have been hung up on twice.

I would like to know what recourse I have and what options I have left. I cannot affort to pay for the medication out of pocket - this one is over $350 per month and I am on 9 other medications for my MS, Gout and now Neuropathy.

I have yet to have a medical claim paid since signing on with Anthem Blue Cross PPO January 2009. Despite my providing releases of information for PCP both in Glendale and in New Mexico, sending a letter explaining my visits to a local PCP, Anthem tells me they cannot pay claims until they get more comprehensive records from previous doctors. My previous PCP in NM has moved so no records will be forthcoming there. I don't remember signing any documents stating that I am responsible for hunting down and somehow ensuring my doctor of a year ago sends tx information. What legal recourse do I have?

I'm on hold trying to get through to Blue Cross, so I have lots of time to rant about their horrible service. They charged me $2.00 to send me a bill. The bill said to call a number to sign up for automatic pay. Then the message on the phone said it would cost me $15. I pay outrageous insurance premiums and they charge me extra for everything they do. What a RIP OFF! Can't any regulatory group get off the lobbyist teat long enough to control this monster!

Folks, if you think you're covered in case of an emergency by your health insurance plan, THINK AGAIN. I suggest you read the fine print in your policy terms -- that is, if you can find the fine print. I thought I was covered until about 6 weeks ago when I suffered a pulp amputation in my right thumb. I spent a day at the emergency center having surgery performed on my thumb to re-attach the pad. Although badly disabled after the surgery, I was relieved that at least I had insurance. WRONG. They denied almost every single claim submitted to them by the various providers that worked on me. Even when treated by their so called "Participating Providers, " they only pay what they consider a "usual and customary" amount for that service. I ended up having to pay for the entire bill minus $135. The bill runs into the thousands. What's my complaint. Buried in their website, which of course is full of beautiful smiling people and is oh so user friendly, this "usual and customary" amount information is almost impossible to find. Nobody at their own customer service center could find it! Don't waste your precious dollars with this immoral company. Their health insurance is a fraud and a scam. I can only imagine the pain and desperation caused by this company to people who have a much more serious illness.

I called to inquire why a recent prescription was not covered. I spent 35 minutes on the first call without an answer. Two days later, I spent 65 minutes on the phone with them, no answer. Today, I received two voicemails, one from "Michael" and another from "Lauren". They both said they had answers for me and to call them at [protected] and [protected], respectively. Both of those phone numbers are disconnected. I called the main line and they were unable and unwilling to connect me to those extensions or people, and said they were unwilling to hear my claim again since it's obviously being taken care of.

A response to another post indicated asking for the "Executive Inquiry Group" is a worthwhile attempt to get answers to questions that you'd otherwise expect to be answered. Will try that next.

Meanwhile, who is paying my bill for 1.9 hours of phone time?

Anthem Blue Cross and Blue Shield - Staples Mill Road Richmond, VA.

On July 20, Anthem debited $641 out of my checking account without my knowledge or permission. On Monday morning, I called Anthem. Customer service transferred me to Ms. Vera Moyer . I gave her my personal ID number to look up the transaction. She said that Anthem had not taken money from my account, other than cashing the check that I send them each month. Ms. Moyer said she would look into it and call me back no later than Tuesday. She never called. I've called her several times. I have yet to get a call back from her. On Thursday, I received a phone call from Michelle in member services. She assured me that the matter would be taken care of . I called her on Friday to make sure that she had received the information from my bank that I had faxed her. She said she had. The $641 was transferred back into my checking account. I was told by Michelle that the overdraft fees and transfer charges would be returned as well. She said that Ms. Moyer was responsible for cutting the check and that it would be mailed overnight, arriving by no later than today (Tuesday July 31). I, nor the bank has received anything. I have also never received an explanation (verbal or written) as to how and why this transaction occurred. Supposedly a Ms. Sweitzer will send me a written explanation in 10-14 days. I ask for it in writing. Ten to fourteen additional days is a little ridiculous. This has been going on for 11 days now without resolution. Everyone seems to be passing the buck! I feel I have been treated very poorly.