Blue Shield Of California
Reviews and Complaints

HORRIBLE CUSTOMER SERVICE AND OVER AN HOUR WAIT TIMES VIA PHONE!

Been waiting for over thirty days for diabetic supplies. BS keeps rejecting my insurance for these supplies and it gets kicked back to COSTCO who kicks it back to my doctor. It's a vicious circle. Doesn't have to be this way.

Been with Blue Shield now for approx 3 yrs. They are great to deal with. I don't see why they are getting ripped on the Complaintsboard.com page. Dr. recommends a proceedure and within 3 or 4 days its approved. Dont believe what you see on these reviews.

Mental Health is NOT a priority for Blue Shield. My plan exceeds $600/month and I have not had one appt made, no call backs, no responses from providers that are listed in their network and every time I speak to a rep and each doesnt know about the previous reps 'lack of progress.' Hold *** exceed 30 mins, which is ridiculous given its a mental health aspect. They need to be audited.

BlueShield is ridiculously expensive and almost every time one of my doctors needs to get approval for something, it is denied as Medically not necessary. My doctor and I explore all options and make a decision as to care. How can a "doctor" that has never seen me make a decision that my doctor has recommended! Preposterous! I have to appeal everything and in most cases appeal to the state board. Blue Shield is the WORST!

What a mess, Blue Shield is the worst health insurance provider I have dealt with. Both my allergist and acupuncturist I found through the Blue Shield online portal. Both were in-network when I made my appointments, but now showing out-of-network and I am forced to pay the entire cost. I was never informed I needed to tell my acupuncturists billing department to *** American Specialty Health, not Blue Shield. I feel like I am paying Blue Shield confuse an abuse me while I am trying to be proactive about my health and heal.

I'm sure most medical insurance companies *** but what I despise about Blue Shield, which I have been with for over 20 years, is that they seem to automatically reject claims that should be covered, on a regular basis. For many of my claims, often annual preventative visits that are 100% covered, they reject coverage. I have to call every year to basically yell at someone anywhere from 1-4 times. Eventually it gets fixed, but they are consistent in this integrity-lacking behavior. I am sure they hope that people get lazy or assume they are wrong or just give up.

I have had blue shield for many years and then the medicare supplement plan. I never had too many problems but now know that I was paying way too much especially for the medicare supplement plan. I had automatic payment and one day had to call to give them my new credit card and was told that my plan F had been changed to F+ with more benefit but the cost was less. O some how they locked me out of my online account and did not make the co pay for a Chiro visit. I spent the last 2 months of 2020 with no medicare supplement And hoped I did not get cover. My new plan F with another company is $152 less a month ten blue shield

This is my first year with Blue Shield of California Dental. My first EOB arrived after I received service from an in-network provider for a filling. The EOB stated the allowed charges were $141 and that the plan paid $48 after a $50 deductable, and Co insurance of $12. This leaves a balance of $93 due from me. The plan states that the procedure is minor restorative, and coverage is 80/20. I called to ask why the plan was only paying $48 of an allowed $141 expense? Even when you include the $50 deductable, the coverage is only 69.5%? Neither the representative, or the manager could answer the question, or do the math! These companies are steeling from us!

Honestly, the healthcare system has become absolutely defunct. Blue Cross/Blue Shield/Anthem are a let down, as are all the others, based on patient interviews. In my experience, insurance is often unhelpful and unkind, focusing on bureaucratic games. Despite checking for coverage, billing departments find ways to sidestep it, leading to billing issues even for routine in-network procedures like mammograms. It's disheartening and disappointing, lacking integrity and value.

Blue Shield cancelled my insurance 1/1 without notifying me. I have been paying my premiums of $944.97 via HealthEquity/Wageworks automatically, and the most recent payment was 2/22. I was able to get my benefits coordinator and HealthEquity to finally resolve this issue, but when I tried contacting Blue Shield to get a new card, they were very confused and could not tell me a straight answer. Some representatives told me I had no coverage and others told me I did have coverage. I also noticed that I owed $113 for SARS-COV 2 for vaccinations which they advertise as covered My doctors appointments and medication refills were delayed due to this. Poor, confusing service that is putting patient lives at risk. I am a physician, and have been volunteering with the COVID vaccine rollout, and this behavior from Blue Shield Insurance of California is disheartening to say the least.

It's 2 weeks that I've been attempting to get my money back from Blue Shield that they erroneously over debited my acct. It's illegal for them to take money without authorization and deplorable that they are still holding my money due to their incompetence in correcting their mistake. I even gave the initial agent a heads up not to debit my acct twice as the second payment wasn't due yet. But he did so anyway since most people at B.S. are not paying attention. He said it would be credited the next day and that I would receive a confirmation call. But both failed to happen. Since then I've spoken to a supervisor and a manager, just to get more excuses and that they'll get back to me . All a bunch of run around. They can't follow through on promises, return calls, etc. This has taken much time and been frustrating making me question if such an incompetent co. will come thru when I'm sick and can't deal with this B.S.

Absolutely the worst *** ever! I tried to schedule mental health services and contacted their doctors - not one doctor/therapist on BSC's list contacted me. I spent hours contacting therapists and none replied. So I call BSC and they don't help until you keep pushing. Finally they put me in contact with an online/virtual provider but that system is way too complicated. Instead of calling you, they send you cryptic emails to get online to speak to someone. Oh, that isn't all. I am scheduled for a colonoscopy. I call the office but it's not the office that schedules appointments. Huge run around to finally maybe get the correct office contact - wasting several more hours of time. I call the office and get put on hold for 33 minutes. So backaswards! This morning I was scheduled for an appointment at 8am. I get a call at 750 am and was told the rechnician called in sick and they have to reschedule the appoint for 2 months later. Just stupid! Open Enrollment. DO NOT SIGN UP WITH BSC.

Blue Shield of California is the MOST incompetent company I have ever dealt with. I found out I was moving in a few months. I called the company to inform them that I wanted to transfer my insurance to Missouri 2 months from the date of my call. Within 3 days of calling and requesting transfer paperwork, I was informed that my health insurance had been cancelled immediately because I know longer lived in California! They said their "records" indicated that I no longer lived in California. When I called them back to inform them that I was the one who told them I was moving and I needed to continue my health insurance for 2 more months, they refused and said I need to prove I still lived in Ca. even though I was the one who had informed them of my future move. After countless call backs and hours on hold and sending them all paperwork they requested, they still refused to reinstate my insurance. I would never recommend this company to anyone. Every person I dealt with was a complete idiot.

I cannot bring myself to give Blue Shield of California even a single star. They are that bad. I have had a Medicare Advantage Plan from Blue Shield of California called Trio for over three years.I have a chronic condition - Diabetes and I am totally insulin dependent. I had problems with getting my insulin syringes though they gave me the insulin. After contacting Medicare, they finally filled my request. Keep in mind that for a person with diabetes, not having insulin can be fatal. In 2019, after experiencing extremely poor glucose control, I was referred to an endocrinologist by my PCP. The endocrinologist prescribed a continuous glucose monitor and insulin pump therapy. I received approval for the glucose monitor. It took the insulin pump manufacturer almost four months haggling with Blue Shield before reaching an agreement to offer me the insulin pump directly rather than through a distributor. This is because the HMO that I had to work through HILL PHYSICIANS - had no distribution agreement for this pump. For some months now, I received all my supplies without much of a hassle, Just recently Blue Shield/Hill Physicians decided NOT to expedite my approval. This leaves me manual measurement of my blood glucose - something that put me at risk in early 2019. When I requested an expedited review I was told that unless my life was at risk, neither my supplier nor my doctor could request an expedited review and approval. I also had horrific problems with payment for services for my wife when she had insurance through Blue Shield. It took us months to resolve. Both Blue Shield of California and Hill Physicians are very egregious in their behavior. They are arrogant and almost criminal in their behavior. I believe that they should be barred from offering health insurance. If for any reason you have health insurance through Blue Shield of California and or Hill Physicians - my advice to you is to run away from them as fast as you can and seek another provider

Hello,My wife has a Blue Shield of California Trio HMO. *** of ***, *** was chosen as her primary do ctor. His name is on her card. When she called for an appointment she was told that they do not take her HMO. Upon calling Blue Shield they apologized and assigned her another *** st 530 S Lake to n ***. Called this doctor and she is not located in *** but about 20 miles away in ***. My wife has now been assigned another doctor which we hope is valid. Although this occurred about two weeks ago the Blue Shield provider directory still has not updated the information and the misinformation is still there. This can be easily verified by googling their provider directory selecting the Trio HMO Plan, then primary doctors and using ***. We are paying large premiums every month and Blue Shield is not honoring the contract. We would like a premium rebate for the month of October.Regards *** and ***...

Dear complaintsboard.com,I'm asking your help to resolve the issue with my health insurance company, Blue Shield of California. My annual maximum out of pocket amount is $28,200. On July 15th I had orthographic surgery at *** hospital. I had met $28,200 prior to my surgery. However, Blue Shield didn't fully covered the surgery. In October I received $7,598 *** from the hospital. I immediately contacted Blue Shield and their claim department sent documents for an audit. Audit case number was # ***. Three months later, on December 15 I received another *** from hospital in the amount of $7,562. Apparently, Blue Shield paid only $35.38 out of $7,598.17. The audit department has all my receipts but simply fails to add all of them: $25,000 for professional surgeon fee and $2,475 paid to *** prior to surgery. The dealing with the Blue Shield costs me a lot of stress and time and their failure to be professional puts me in a danger of being reported to c...

Blue Shield of CA told me they'd cover my meds, took my money, and now won't cover my meds. That's the simplest explanation. More thoroughly: I asked, repeatedly, in every manner and fashion, if at any point they, BS of CA (how's that for an acronym) would change coverage. I was promised, assured, and lied to. The sales rep said ALL MY MEDS were covered. Of the approx. 11 I am on? They cover ... 2. They don't return calls. They have a social media department that straight up lies to placate and get you off the line. I am on *** A & B. *** encourages a Part D. BS of CA has ONE job: meds. I pay them AFTER they assured me, myriad times, that ALL these medications I have been on, and will be on for the rest of my life in all likelihood (bad motorcycle accident), would be covered. Don't know how else to say it. I see that they have a "D-" rating with you. I wish I'd checked Complaintsboard.com before signing up, since, technically, I can't get new coverage until the end of this year. We all know ...

I live in California and have a PPO *** by Blue shield of California.I got an appointment with the specialist at hospital in another state (mayo clinic arizona). This appointment is a part of my follow-up examination with this hospital. According to my medical insurance plan & it's terms and conditions for any treatment out of state California, I need to get from insurance company a prior authorisation but I have no way to do it. This hospital do not get any prior authorisation by themselves according to their procedures BUT there's no way for me to do it by myself. On the blueshieldca's website there's no any form for it, when I call customer's service there's no option to get the prior authorization as well. The blueshield's representative I talked to could do nothing with it and just forwarded me back to the same customer's automated live with no such an option. So there's just no way to follow the rules and get this prior authorisation to get my coverage working Blues...

I've using *** since 2019, as it's offered through my employer.On December 30, I received urgent covered, covered as per my policy, while traveling. Insurance was not billed directly, thus I paid for the medical services out of pocket and I was given an invoice by the provider.On January 3rd, 2022, I promptly proceeded with the online claim submission through my personal page on the Anthem website, but I found out that the form was broken since a code is mandatory in the form, yet I did not receive that particular code from the provider (nor the provider has one to begin with). Since then, every few days for about 6 weeks, I've been trying to contact the Anthem support center to (a) point out the issue in the online form submission and (b) politely ask other ways to submit my claim, as it's my right as a covered person. I know Anthem has been receiving my secure messages since one time (and only that one time) a representative replied, though without offering any he...

In December , I applied for a Bronze 60 PPO healthcare plan with Blue Shield of CA. Blue Shield of CA has since canceled my plan without timely notice that they were intending on doing so. On 1/14/22, I spoke with customer service advisor *** {LAN1 ***}, concerning lack of notice by BSOFCA that my plan needed to be paid for by 1/15/22, despite already providing my Discovercredit card information to be billed when I originally submitted my application. She reassured me several times that my plan would not be canceled as long has I made my payment in a timely fashion, and she also noted that she would place a note on my account so that the plan would not be canceled. On 2/9/22 I re-contacted BSofCA CS and spoke to agent {LAN1 - swilli22} about how I had yet to receive my healthcare card in the mail. She advised me that my plan was canceled. I asked to have my plan reinstated, she placed me on hold, and spoke with an unknown female Operations Supervisor, who refused to reins...

I've been trying to get a hold of a claims manager for weeks. In the past, I can say the word "claims" and get transferred to claims then ask for a manager but now I have to go through 2 people because their system can't hear you say "claims". Once I get to a person, it takes them a while to schedule a call back from a manager. Sometimes, I'm holding for over 1 hour. I've tried to reach a manager on 3/9/22, didn't hear back. Scheduled another manager call back on 3/15, no call back. On 3.18.22, I spoke with a lead in claims who for the life of him could not understand what was even happening with my situation and had a terrible attitude, so I requested a manager call back again. Whenever I speak with an agent, they tell me a manager left notes that they attempted to call me, tried to leave a voicemail, and sent me an email. But there is no record on my call log of a call or e-mail. I've also checked my spam/junk mail, AND verified my email address + phone number with the agent. They sa...

I contacted Blue Shield in late Feb 2022 because I needed to switch hospital networks and my PCP. The woman said she handled it and it would take effect in March. I waited and waited and waited for my updated cards. I called in 3 times requesting their status and was promised they had been ordered. I needed it for my upcoming doctor *** (I needed them to show the updated information).I finally called again in late March and was told they had never been ordered, and that the agent would immediately order them for me. Still never got the card, but as of Apr 1, I was notified that a new PCP had been randomly assigned to me, in the old hospital network. On Apr 1, I called customer service back AGAIN. I spoke to a very rude woman who refused to find me a supervisor to fix the problem. She hung up on me. I called again and immediately transferred to a supervisor who read all the notes, apologized profusely, and promised she fixed the problem and updated all the info.On Apr 4, I got an elect...

Regarding *** (RX).First,In March we missed payment and lost coverage. When we realized our mistake we sent in necessary and required payment. Afterwards when trying to purchase medicine we were told insurance wasn't active. So then we called and asked and confirmed payment went through. We also confirmed payment went through via bank statements and cashed checks. Later after 2 months and still now insurance we called and payed using a credit card. Few days later still no insurance. Today we called and confirmed all payments were made and that RX would be reinstated. It has not.Also, We recieved a letter telling us our membership was cancelled and to renew we need to pay by a certain date, that date was June 30 2022. We have physical copies of these letter. On phone calls and confirmation with pharmacy our services were cancelled on March 30th 2022 and we were told that was the end date. We just want to pay whatever we owe, reinstate insurance, and go back to normal ...

I live in California and have a PPO plan provided by Blue Shield of California. I got an appointment with a specialist at the Mayo Clinic in Arizona. This appointment is part of my follow-up examination with this hospital. According to my medical insurance plan and its terms for out-of-state treatment, I need to obtain prior authorization from the insurance company, but I am unable to do so. The Mayo Clinic does not handle prior authorizations, and I cannot secure one on my own. The Blue Shield CA website lacks a request form, and customer service offers no option for obtaining the authorization. The Blue Shield representative I spoke with was unable to assist and directed me back to the automated customer service line, which also lacks the option. Consequently, I'm unable to adhere to the rules and secure the necessary prior authorization to activate my coverage. My Blue Shield CA member ID is not available.

Hello,My wife has a Blue Shield of California Trio HMO. *** of ***, *** was chosen as her primary do ctor. His name is on her card. When she called for an appointment she was told that they do not take her HMO. Upon calling Blue Shield they apologized and assigned her another *** st 530 S Lake to n ***. Called this doctor and she is not located in *** but about 20 miles away in ***. My wife has now been assigned another doctor which we hope is valid. Although this occurred about two weeks ago the Blue Shield provider directory still has not updated the information and the misinformation is still there. This can be easily verified by googling their provider directory selecting the Trio HMO Plan, then primary doctors and using ***. We are paying large premiums every month and Blue Shield is not honoring the contract. We would like a premium rebate for the month of October.Regards *** and

I was charged $144 in error for a dental *** I have attempted for many months and for many hours on hold to be reimbursed this money. Blue Shield had told me that I billed in error and also treated poorly by a representative of the company. Two months ago Blue Shield told me to file a grievance which I did. I was given two names for contacts regarding this. Neither is responding to my messages.This is no,I get about the money. It is about a huge business treating someone like me with utter disrespect and arrogance. It is being treated in a way that I am a nothing person not even worthy of a phone call back from the very grievance department that is supposed to be advocating for me against similar treatment by Blue Shield representatives. I want to drop Blue Shield as my Medicare provider but am concerned that if I do I will have no chance if getting my $144 back.They can ignore me but I am determined to be heard and will ket as many people as needed know about this poor treatment. This has been the worst customer service treatment I have ever received.

Dear complaintsboard.com,I'm asking your help to resolve the issue with my health insurance company, Blue Shield of California. My annual maximum out of pocket amount is $28,200. On July 15th I had orthographic surgery at *** hospital. I had met $28,200 prior to my surgery. However, Blue Shield didn't fully covered the surgery. In October I received $7,598 *** from the hospital. I immediately contacted Blue Shield and their claim department sent documents for an audit. Audit case number was # ***. Three months later, on December 15 I received another *** from hospital in the amount of $7,562. Apparently, Blue Shield paid only $35.38 out of $7,598.17. The audit department has all my receipts but simply fails to add all of them: $25,000 for professional surgeon fee and $2,475 paid to *** prior to surgery. The dealing with the Blue Shield costs me a lot of stress and time and their failure to be professional puts me in a danger of being reported to credit debt agency by ***.I would appreciate if Blue Shield will finally pay *** the remaining balance.

on October 6 i had to go to an urgent care however upon arriving to the clinic they were closed and was told I could go to the *** at the hospital next door . I called blue shield prior to entering the hospital's *** department and asked the representative if my insurance would cover the *** visit, she took some time to research and then told me that I didn't have to pay zero dollars, after being reassured I went to the *** and after hours of waiting and not a reassuring outcome, I still had to go to the urgent care the next day and take a day off unpaid form work to my surprise and disbelief I am being charged 400 dollars I tried to speak to someone at blue shield but they all kept sending me from one department to another, I filed a grievance and it was denied without any reasoning, I tried to contact the person that denied me she never returned my calls,I have tried to speak with someone at blue shield and their grievance department but they keep giving me the run around or they hang up on me If I had known that I would be charged I would have never gone to the *** department. I am very disappointment to be treated this way after being their customer for so many years.

Blue Shield of CA told me they'd cover my meds, took my money, and now won't cover my meds. That's the simplest explanation. More thoroughly: I asked, repeatedly, in every manner and fashion, if at any point they, BS of CA (how's that for an acronym) would change coverage. I was promised, assured, and lied to. The sales rep said ALL MY MEDS were covered. Of the approx. 11 I am on? They cover ... 2. They don't return calls. They have a social media department that straight up lies to placate and get you off the line. I am on *** A & B. *** encourages a Part D. BS of CA has ONE job: meds. I pay them AFTER they assured me, myriad times, that ALL these medications I have been on, and will be on for the rest of my life in all likelihood (bad motorcycle accident), would be covered. Don't know how else to say it. I see that they have a "D-" rating with you. I wish I'd checked Complaintsboard.com before signing up, since, technically, I can't get new coverage until the end of this year. We all know the American healthcare system is a joke. BS of CA is worse than that. If nothing else, I want this filed so, hopefully, someone else doesn't make the same mistake I did believing these lying SOBs.

In December , I applied for a Bronze 60 PPO healthcare plan with Blue Shield of CA. Blue Shield of CA has since canceled my plan without timely notice that they were intending on doing so. On 1/14/22, I spoke with customer service advisor *** {LAN1 ***}, concerning lack of notice by BSOFCA that my plan needed to be paid for by 1/15/22, despite already providing my Discovercredit card information to be billed when I originally submitted my application. She reassured me several times that my plan would not be canceled as long has I made my payment in a timely fashion, and she also noted that she would place a note on my account so that the plan would not be canceled. On 2/9/22 I re-contacted BSofCA CS and spoke to agent {LAN1 - swilli22} about how I had yet to receive my healthcare card in the mail. She advised me that my plan was canceled. I asked to have my plan reinstated, she placed me on hold, and spoke with an unknown female Operations Supervisor, who refused to reinstate my plan unless I paid for the month of January. I DID NOT have access to the Bronze 60 PPO during January. Why would I pay for a service I never had access to? I'm requesting BSofCA reinstate my policy ASAP. My subscriber id is *** and my application number is ZIP0128749.

I've been trying to get a hold of a claims manager for weeks. In the past, I can say the word "claims" and get transferred to claims then ask for a manager but now I have to go through 2 people because their system can't hear you say "claims". Once I get to a person, it takes them a while to schedule a call back from a manager. Sometimes, I'm holding for over 1 hour. I've tried to reach a manager on 3/9/22, didn't hear back. Scheduled another manager call back on 3/15, no call back. On 3.18.22, I spoke with a lead in claims who for the life of him could not understand what was even happening with my situation and had a terrible attitude, so I requested a manager call back again. Whenever I speak with an agent, they tell me a manager left notes that they attempted to call me, tried to leave a voicemail, and sent me an email. But there is no record on my call log of a call or e-mail. I've also checked my spam/junk mail, AND verified my email address + phone number with the agent. They say they have 5 business days to get back to me BUT THIS IS WEEKS. I want to speak to a manager because the agents + leads don't understand this claim. PLEASE ASSIST and RESPOND TO YOUR MEMBERS. Desired Resolution: contact by Claims manager or above who understands healthcare + claims.

Regarding *** (RX).First,In March we missed payment and lost coverage. When we realized our mistake we sent in necessary and required payment. Afterwards when trying to purchase medicine we were told insurance wasn't active. So then we called and asked and confirmed payment went through. We also confirmed payment went through via bank statements and cashed checks. Later after 2 months and still now insurance we called and payed using a credit card. Few days later still no insurance. Today we called and confirmed all payments were made and that RX would be reinstated. It has not.Also, We recieved a letter telling us our membership was cancelled and to renew we need to pay by a certain date, that date was June 30 2022. We have physical copies of these letter. On phone calls and confirmation with pharmacy our services were cancelled on March 30th 2022 and we were told that was the end date. We just want to pay whatever we owe, reinstate insurance, and go back to normal however in 3 months Blue Shield has taken 3 different checks and 1 credit card payment but no changes in our status. Insulin was $43 with Blue Shield and now we are being asked to pay $1,035 Every time we call we are told it is fixed or is in the process of being fixed and then days go by with no fix or answer.

I've been using a service since 2019, as it's offered through my employer. On December 30, I received urgent care covered by my policy while traveling. Insurance was not billed directly, so I paid for the medical services out-of-pocket and received an invoice from the provider. On January 3rd, 2022, I tried to submit an online claim through my personal page on the Anthem website, but encountered a broken form that required a code I didn't have. Repeated attempts to contact Anthem support over six weeks to address the form issue and inquire about alternative claim submission methods were met with silence, save for one unhelpful response. Anthem's consistent refusal to assist or acknowledge my right to submit a claim for review is concerning. I now formally request a clear and functional method to submit my claim.

I contacted Blue Shield in late Feb 2022 because I needed to switch hospital networks and my PCP. The woman said she handled it and it would take effect in March. I waited and waited and waited for my updated cards. I called in 3 times requesting their status and was promised they had been ordered. I needed it for my upcoming doctor *** (I needed them to show the updated information).I finally called again in late March and was told they had never been ordered, and that the agent would immediately order them for me. Still never got the card, but as of Apr 1, I was notified that a new PCP had been randomly assigned to me, in the old hospital network. On Apr 1, I called customer service back AGAIN. I spoke to a very rude woman who refused to find me a supervisor to fix the problem. She hung up on me. I called again and immediately transferred to a supervisor who read all the notes, apologized profusely, and promised she fixed the problem and updated all the info.On Apr 4, I got an electronic letter from Blue Shield once again saying I had been randomly assigned a new PCP back in the old hospital network again. What the h*** is going on? I called customer service and talked to 3 idiots reps and 1 useless supervisor named *** who refused to read the account notes before hanging up on me.My question is this: Do you even know what the h*** you're doing there? What the h*** is going on? I want a competent supervisor to contact me to fix the mess they've made.