Blue Shield of California Reviews 62

Had a life threatening emergency requiring a direct visit to the emergency room at the hospital at night. $12K Bill of which Blue Shield ponied up $0. Worthless insurance and company.

They won’t accept the diagnosis codes from my child’s therapist so they haven’t paid her. Took me a year to find someone in network for my son, For years Ive been hearing that therapists won’t work with Blue-shield because of how hard it is to get paid by them and now our therapist is putting in her notice with them. My kid is suffering from lack of continuity. This cycle keeps continuing. It feels like having this insurance and trying to use them is just keeping my family sick. The alternative is to go into debt to get mental health care.

Their customer service is very unprofessional and rude, if they feel you are challenging them and not agreeing with what they offer, either they hang up on you or ignore you!
I was trying to change our health coverage for 2024 but the customer service was insisting that I should do it online and seemed to be “sleepy/hangover “when I indicated I am having a hard time, she transferred me to mental health department:/) blueshield of ca seems to hire bunch of illiterate looser who can not fulfill even a simple conversations, apparently third class education is enough to be a Blueshield customer service representative. Hate this company.

I signed up for Blue Shield HMO and Blue Shield selected 3 doctors without my knowledge and approval. And after the first website login, I was locked access. After contacted Blue Shield several times, I was still locked. I then had to go back to direct Medicare. But then Blue Shield claimed that they were the best. I learned different. That's why I'm giving Blue Shield 2 stars and for misrepresenting them. Now I'll be still without medical coverage until next February 2024.

Poor customer service in claims dept and they are rude & no one seems to know what they are doing !!!

Negative 100 stars! BlueShield is TERRIBLE! Scroll to the bottom for the takeaway. If you want to read my detailed rant, read on.

Literally paid over $1,000 for a policy for myself and my husband. Today is 11/7/23. Whenever I tried to log in to my account, I always got a notice that said “content temporarily unavailable.” Which led me to cal customer support. Customer support found my application but couldn’t see a status. They said Sales processes applications and transferred me to sales. Sales said “customer service processes applications” and transferred me to CS. I spoke to 5 ppl yesterday in this game of ping pong. Finally with the last sales person I spoke to, I was fed up and when she said “I’ll transfer you to customer service” I said “customer service said you guys process applications.” She said “we don’t.” I asked “which department do I need to speak to to process my application? She said “I don’t know.” I asked “how are you going to transfer me to the department that processes applications if you don’t know who processes applications?”

Fast forward to later in the day and I went to my local Winnetka office. The doors looked closed and I’m assuming they weren’t supposed to let customers in. But I called the vendor number in the door and spoke to the person who answered the phone with authority like I was supposed to be there and he let me in. Once I was inside and he realized what was going on, he looked scared like he wasn’t supposed to do that and I didn’t want to get him in trouble so I waited by the door while he went to grab a customer service person for me to talk to. She informed me that everyone in the office only services Medical plans people and not commercial plans. She said all of the commercial plan people work remotely. So I left with nothing accomplished.

Next day (today) I check the website (still not able to login) and called CS. I spoke to Nora who assured me that I’d have coverage beginning November 1st and that all I needed to do for upcoming doctors appointments is pay out of pocket and then submit to be reimbursed. I asked her if she could send me a document or point me in the direction of a document that has this policy outlined. She said there was none. I explained to her my concern that if I do that in good faith, I could easily be told by someone else at that time that that’s not how things work. And that any company who has policies like this in place would have a legal disclaimer that clearly outlines the policy and the specific conditions that must be met in order for the company to be obligated to fulfill certain duties. She said “I’m not an insurance agent.” [Mind you, I’m talking to a customer SERVICE person. Customer service at any company should understand the basic legal obligations of the company to its customers and should know where to access that information.] I asked if I could speak to an insurance agent. She said no but I could speak to sales. I explained to her the back and forth I went through yesterday and that sales wouldn’t help me unless I was intending to purchase a policy which was not the case seeing as how I had already purchased a policy. She then said that my application is processing and that by Friday I should have my account up and running. I asked her if she could guarantee that. She said “no” and explained that all she sees is application in progress and that there was no date. So I asked her if there is no date, then how could she tell me it would be done by Friday? She said “so who do you want to talk to because this is ridiculous?” I said “excuse me? What did you just say?” Silence. “Did you just say this is ridiculous?” More silence. “Yeah I want to speak to a supervisor.” Call ends.

TLDR: BlueShield doesn’t give a rats behind about their customers. No one will help you and you’ll be given whatever false info the customer service team decides to make up on the spot.

Will find ways to drag out essential coverage. Waiting on months to get medication with what are basically fake authorizations. Then won’t cover basic administration of said medication… I’ll spare you the story, they will only pay their own “special” pharmacy who won’t do s*** and will delay everything as much as they can with flat out lies

Since being a member in 2019, my monthly has gone from 650$ to $820 roughly. This company should be sued

Should have 0 stars. #helpderekfsongs

I have a Blue Shield California HMO plan (my company only offers Blue Shield, no other providers) and the coverage is terrible. I live in Chico, CA - a major city with a population of over 100,000 people and a regional medical center + college - and there is 0 network coverage for providers in my area. My closest in network urgent care center is over 70 miles away in Roseville - when I called to point out driving over 140 miles roundtrip for urgent care was ridiculous the only solution I was offered was that twice a year they will pay for out of network providers as if they were in network providers. That did nothing to address my issue. In addition finding a primary care physician has been impossible, since doctors accepting new patients have waitlists out for a year and that's just the places within my horrible network. It's as if I have no insurance coverage at all. I'm so frustrated with them - the only solution I've been told is to try upgrading my plan for better coverage, but why should I pay more when the coverage is already this poor? This company is terrible and they offer no solutions/recourse for customers who point out their network flaws. Their teledoc was also completely unhelpful, since he just referred me back to my primary care physician (a year out waitlist) or an urgent care center (a 70 mile drive). I wish my company offered another alternative to these guys.

Blueshield has no shield and they don't even deserve ZERO Star. Worst experience ever. I added my daughter to the insurance when she was born, and everything was fine. I had an autopayment. 5 months later I received bills from the doctors for my daughter telling me my insurance refused to pay. I called blueshield multiple times, and they keep telling me I didn't add her. Her name is there online, but she shows inactive. They transferred me to the grievance department which they answer after 31 days. May 26th, Email me I didn't add her and there is no record of a call even her name is added . Nothing make sense. No answering calls. You can't talk to someone who is responsible for the grievance. MOST NEGATIVE CUSTOMER SERVICE. I DON'T THINK THEY EVEN DESERVE ZERO.

I am an RCM Manager. I am on hold as per the usual with Blue Sheild. This post is for Blue Sheild, Blue Card program and Anthem Blue Cross. EVERY time I call I get a rep with zero knowledge of anything. I am left on hold for 30 minutes at a time. The rep just now came back and said "He is still waiting for the account to come up" which is complete BS. These reps keep people on hold as long as possible to meet the required time and do zero work. If I am lucky enough to get someone that doesn't leave me on hold, I get incorrect answers or get transferred all over the world. I am so angry. ZERO ACCOUNTABILITY FROM THIS CARRIER. Z.E.R.O.

Blue Sheild Pharmacy issue !! All Customer service reps being told different info. Nothing resolved. Drug manufacturer, Drug distribution, Cvs Pharmacy , Physician assistance, nothing is getting resolved. I have tried since February to get a refill on a brand prescription that have an authorization approval from my physician and on file with Blue Sheild .
It’s now a NDC issue With drug manufacturer and Blue Sheild. Blue Sheild states not FDA approved. Virtus drug manufacturer disputes this accusation.!!
This is not acceptable , lack of information , lack of communication lack of follow up and lack of qualified experience. There was no issue last year but this February 2023 now has changed. No one responds back with any factual information or resolve . Thank God this
is not heart medication.. No one cares just wants your money. Also cannot speak with anyone in Blue Sheild Managment or qualified authority . On going since 2-14-23 See my health records

They lied about canceling our plan ,they wouldn't cancel it we have recordings we did ourselves and they want to now charge us for insurance we DIDN'T WANT ,we will be contacting a lawyer and also finding other people like ourselves that they've done thus to .This is by far the worst insurance company we've ever dealt with,total scams.

Blue Shield charged me for the FREE Covid test provided by TEST WELL, which they were supposed to close between TEST WELL and Blue Shield according to TEST WELL.

Mirror all the negative reviews here, amplify them 10X more cynically and you begin to approach the truth. Was told that the plan I was inquiring about with Customer Service would be covered by Medicare, only to rudely receive a bill and be told there was nothing I could do about it. I had BS for years, but recently it appears they've become too big to be effective and too corporate to remember who made their success. Sheesh

I have been with Blue Shield since I was terminated from my employer back in 2018 when I got cancer. Another tale of corporate greed. I retired due to health issues at that point at age 62 and was able to get coverage through covered California. My coverage was great and affordable during that time. When I turned 65 I went over to Medicare. This is when things changed. I went over to a Medicare Advantage plan with Blue Shield. The first year was good. This past year not so. I have been billed more than a $1000.00 over and above what my insurance would pay? The previous year same Drs but no extra bills? When I call in the customer service is basically terrible. Always a call center from somewhere else in the world. Some speak great English, but some are hard to understand and converse with to get problems solved. I have spent at least four hours with these various representatives trying to get help. Sometimes repeating myself over and over so they can understand me because their English is so poor. How do they does Blue Shield feel this is okay to do to their insured members? This, not mention outsourcing jobs to foreign countries to increase their bottom line. Long story short I decided to switch to Kaiser. But after visiting a friend in the hospital at a local Kaiser ( another nightmare, my poor friend), I decided that I would stick with Blue Shield to remain in the Mercy Medical system. I canceled the Kaiser insurance before it took affect. But getting Blue Shield reactivated seems to take an act of Congress. I was told by the customer service folks that I would just revert back to Blue Shield. But more than a month has gone by and my premium has not been withdrawn. Calls to clarify the issue are useless. I get various customer service reps who speak broken English and simply do not seem to have access to anything on the Blue Shield server that would be required to help folks. I cannot access my online account as I forgot my password. I request a link to reset my password but it never arrives. So I call in for help, and guess what? They cannot help to reset a password. Was told they would complete a ticket for someone to call me. Never happened. Just a nightmare. And they cannot help me pay my account. The system says it is paid. But it isn't. So now I have a cancer exam coming up that I don't want to miss having survived the initial cancer a few years back. I need to have cystoscopic exams of my bladder every six months. I am going to assume I may get billed for the $1800.00 or more for the exam when the Dr. tries to bill my insurance. Calls to Blue Shield are totally in vain. The reps are not able to understand me half the time and when they do they cannot help. So I am going to have to go out and get other insurance to just be able to see the Dr. How Blue Shield stays in Business with such poor customer service is beyond me. The negative reviews on this platform speak loudly to the issues they do not want to deal with in terms of customer service. All I want is to pay my bill and know that I have insurance. I will add that I no longer go to the Dr. unless it is an absolute emergency or as is the case with the cancer I need to keep it in remission. I am on SS and cannot afford the bills I now get even for a Dr. office visit. When I call and asked about the bills coming in, I got a nice girl named Maria who spoke decent English. She was very pleasant. She was so nice initially until she put me on hold. When she came back on the line it was like a split personality. Her demeanor changed, she became combative. As if she was trained to undermine any questions about billing or why something was not covered. She was totally defensive. And I was not combative with her. Just wanted to understand why I was getting billed this year for services that I was not billed for last year? She told me that was how it was, any more questions? Goodbye pick up your consolation prize at the door! Just shameful customer service. I think greed in American corporations and insurance companies is at an all time high. I pay $80.00/month for this plus another $170.00 for my Medicare. But the coverage is terrible. So I suffer in pain most days and do not seek any help. I seriously doubt any or the other companies are any better. What has happened to our great country and the way of life we used to enjoy. My final years are now spent in isolation as I am in too much pain with arthritis to get out much. I cannot afford to see specialist even with my coverage. Blue Shield you and other Insurance companies should be ashamed of your greed. But instead you increase your profits by using foreign call centers and reducing your annual coverage, while increasing premiums. I feel sorry for young people and the world they will have to survive in any more. So much of it made worse by corporate greed and a total lack of humanity by companies like Blue Shield.

There is no means to get help or reach them. They have shielded customers out, charge high prices to taxpayers, short on service, and deny coverage unjustly

Would not cover my knee replacement surgery indicating the procedure was experimental. Since I am going on Medicare in 6 months, I am assuming they hope to delay for that amount of time. Dishonest company that wants your money without paying for services.

I have had numerous claims that go unpaid. I have spent hours getting my claims paid. The representatives will give me a date and check number and confirm the mailing address of the doctor's office and the doctor's never get the checks!

Also, I found out today that my plan is no longer available and no one called or mailed this information from Blue Shield, which dates back to 2018; I could have had another plan that provides more and is less expensive.

Blue Shield of California's employee's are con-artists and liars.

I have seen a lot f tgat but i really realize thar