Florida Blue
Reviews and Complaints

My name is Stacey P. Adams and I can be contacted at [protected]. I believe my employer Marlyn Enterprises of Jacksonville is committing some type of fraud. I was recently found out when I went for a medical appointment by a medical care providers that I am no longer covered by Florida Blue Insurance. I contacted Florida Blue customer service and they refused to give me any information other than the policy was canceled on January 31, 2020. I was never told by the company I work for that my insurance was cancelled. I have proof that my employer deducted money from my paycheck for "Blue Cross Health Insurance" on the following pay periods 12/22/2019-1/4/2020 for $133.00, 1/5/2020-1/18/2020 for $145.99, 1/19/2020 -2/1/2020 for $145.99, 2/2/2020-2/15/2020 for $145.99, 2/16/2020- 2/29/2020 for $145.00 there was no money taken out on our next paycheck but we were told that our insurance was going to be reinstated in 1-3 days. The person I spoke to on the phone said if I could show proof that the money was taken out I would not be responsible for my medical expenses. Because my insurance was not active due to the negligence of my employer and no fault of my own I now have outstanding medical expenses that will not be covered by insurance that I paid for but never received. Please assist on how to proceed.

Your company is sending out lists of providers who are not really accepting certain plans of coverage and saying they are, THEN telling me it's the provider's fault. This is unacceptable. You are passing the buck onto your sick consumers, it's wrong...You need IN PLACE at very least a department of of employees who are responsible for reviewing in and out of network providers, CONFIRMING week in and week out which providers are INDEED in network and UPDATING your system... otherwise you are simply being neglegent toward your customers...THIS IS NOT A PROVIDER'S RESPONSIBILITY, THIS IS YOURS, REACH OUT TO THE PROVIDERS ON YOUR LIST AND UPDATE IT. IT'S THAT SIMPLE, otherwise you are actually causing your patients much extra stress during a time of illness and need.

Customer service looks at my plan then sends me lists upon lists of providers who turn out NOT to be in my coverage network...it is of NO good for your employees to be doing this if it is not accurate information. It would be MUCH better use of your labor costs to actually do your homework and update your data base! Pay the same people who send me these inaccurate lists to go find out who is really on the plans.

I currently have pneumonia and the struggle to locate follow up doctors in network has been obsurd. The local providers have actually been the ones to FINALLY inform me which doctors are really covered by my plan, NOT Florida Blue.

As soon as I feel better I will be making a complaint to my local representatives as well as the BBB in hopes of making a change in requirements for the insurance company responsibilities because "That's not our fault" is a cop out of an answer.

Florida Blue, stop sending your customers lists of physicians you say are covered and are really NOT. This is irresponsible...Do something to clean up your data base and maintain it if you are REALLY trying to provide for your customers.
Thank you,
Rhonda Rudkin

P.O. Box 1798 Jacksonville, Florida 32231

My name is, hoa v dam, my son philip and I have florida blue health ins. I put his $4. Month payment on my checking account auto pay. Bank contacted me I was bouncing checks in my checking, I said impossible. They showed me how florida blue deducted $ 712. From my checking account because they allege my son didnt send in his yearly income paperwork, and lost his exemption discounts for 2 months. This middle of the night embezzlement caused me to bounce checks and had to work out payment plan with one utility company. Why did i, nor my son get a letter of cancelation if not pay $356. Month. I do not speek 100 percent english, im vietnamese. I attempted many calls to resolve this situation of my money back to me. No luck. If this email doesnt work, I shall see legal help to get a court date. My ins membership information is : vmah19072893 happy holidays, someone with a heart please help me. Hoa [protected]

I received my statement Nov 27 out lining what was bill and who billed Florida blue
I noted a billing of 3500 dollars in dental work that was NEVER DONE TO ME i suspect it was TLC dental as they try to get the patient to pay money out of pocket for things and procedures that are covered by the dental plan the particular agency is located on Sheridan street in Dania beach Florida and have had a few arguments with the litte unprofessional office manager who exaggerates service Florida blue has been defrauded out of 3500 but some fake claim and they are doing nothing about it as I do not care but this deducts from my annual dental benefits and reduces what I can have done MY ADVISE TO EVERY ONE AND TO FLORIDA BLUE DO NOT USE TLC DENTAL SERVICES AT ALL THEY AREA MONEY HUNGRY LYING BUNCH OF THIEVES AND DO NOT CARE IF THE INJURE YOU AND WILL LIE TO YOU THEY HAVE DEFRAUDED FLORIDA BLUE OUT OF 3500

Use this company at your own risk! I have been trying to get a prescription authorized since April of 2019 when I had to change insurance due to a job change. My GP sent the request multiple times with back up as to why I need the medication. After a few months, I received a letter stating that the request had to come from a specialist. So I made an appointment with a cardiologist who sent in the information. The Doctor let me know that FLA BLUE WOULD FIGHT THIS BECAUSE THEY DON'T WANT TO PAY FOR THE MEDICATION! And boy is this true! I called Fla Blue back in 10/2019 and was told the prescription was approved and they transferred me to the specialty pharmacy to be filled. And that was a lie - it is now 11/2019 and Fla Blue is saying that the prescription WAS NOT authorized and they NEED MORE INFO FROM THE DOCTOR! Prior to the change in insurance, I had been on this medication for months through United Healthcare and I don't understand why Fla Blue is not authorizing it. Be advised that I am filing complaints with the Fla Dept of Financial Services, the Fla Insurance Commissioner and anyone else who can assist with getting me this medication.

My name is Olga Hobson and on10/28/2019 before 7:00p.m. I contacted your company to get more information on your Florida Blue Bas medical insurance plan . I was initially preparing to find out more information on your wellness program which I at one time was interested in. After five transfers to various departments my last transfer was by a man to a center that dealt with cars or something in relation to that. Upon this transfer a lady answered the phone, and I told her what I wanted. She said I had the wrong number. I explained that I was transferred to her department. I then asked her if she could possibly transferred back. Her reply was "I have nothing to do with that". At that time she terminated the call with nothing further to say.

So overall I spent close to 40 minutes being transferred from one place to another before being hung up on. I called back explained the information that I needed regarding your wellness program which initiatally sounded interesting..Howeer at this point it has been proven to me that this is an each and every man for himself business. I only hope that you will begin to tape your calls with customer service representatives so that you can maintain what clientele you have left.

I was given a prescription for a medically necessary device by my doctor in November of 2018. I had to pay out of pocket for this device. I submitted the medical claims form for reimbursement in December of 2018. My doctor also submitted a claims form on my behalf.

Over the ensuing 11 months I have contacted FLA Blue no less than 6 times, each time FLA Blue has instructed me to submit more information. Each time I complied. I was told after each interaction with a customer service representative that I would be contacted regarding my reimbursement. They never contacted me. I always had to call them to follow up.

Finally, 1 month ago, I called for the 7th time and this time someone in customer service, Shamika, told me that FLA Blue had mistakenly sent a check to my doctor for the reimbursement of my medical device even though it clearly showed by my receipts that I submitted that I had indeed paid for the device. I was instructed to contact my provider and tell them that they have to send the check back before I get reimbursed.

I contacted my provider and told them this request by FLA Blue. He got me in touch with the billing dept. and the contact person there told me that I need to get the check #, date of check and amount of payment. I have spent so much time on the phone with FLA Blue, countless hours in total more than 40 hours on the phone trying to get this issue resolved. I have no way of getting this information. I will have to call FLA Blue AGAIN, and then speak with someone who will tell me that they will look into it.

I am a physician and I am appalled at the horrific customer service provided by FLA Blue. I am truly disgusted by the unwillingness and/or inability of FLA Blue to straighten their ERROR, not mine.

I am not sure what to do at this point. I am worn out by this process. It should not take almost a year to resolve a claim nor should the onus be placed on the claimant to resolve a mistake made by FLA Blue.

If I could cancel my policy, I would. Unfortunately, I can't.

David Zamos, MD

I was pre-authorized for hip replacement surgery for 10/10.
In an effort to TRY to alleviate my extreme pain for 6 weeks until the surgery, my doctor suggested I try an injection of Kenelog on 9/3. I agreed to the injection. It did not alleviate my pain in anyway. I continue to be unable to sleep and unable to carry out my daily activities without extreme pain and assistance in walking. I find out 13 days before my surgery is scheduled that Blue Cross has denied my claim due to the fact that I must wait three months from the time of having received an injection. My doctor had a peer to peer conference with Blue Cross and they still denied the surgery already scheduled for October 10 and said I must push the surgery out an additional two months ! Blue Cross is going to have to pay for the surgery in December anyway, so I assume they want me addicted to painkillers and sleeping pills for the next two months and to have me suffer with a highly diminished quality-of-life.
They are not concerned with patient care whatsoever...they are an insurance company they are not doctors nor should they be allowed to play God. My highly trained orthopedic surgeon would know best for me and recommended the surgery be done as soon as possible which is why it was scheduled for October 10 .

This evil health insurance company dropped my poor elderly mother which she obtained though the (scam) Obama Care. They canceled her policy, didn't tell her, made it retroactive for 2 months after she had 2 tests run. They sent her a payment back just to make it another month retroactive. This is fraud. I just found out about this and I'm helping my mother take legal action. Don't do business with these con artists. Just Google all the complaints filed against them! There's news articles about them all over.

Maria Teresa Junqueira, client and member number of Florida Blue VMYH21840338 must report a poor and unprofessional serving of Dr. Bruce Selden according to this report. I went to his professional help on September 09 at 10:15 am as scheduled. I went there because I was feeling strong pains in the sinus and ears.

Incidentally my husband was with me and he speaks English reasonably well and served as a translator in the consultation.

After some time of waiting and paying the co-pay of $5.00 ( which is NOT the issue) Dr. Selden saw me. He analyzed by asking questions and I did the best I could in answering them . Without taking into consideration that the patient was a foreigner, with little knowledge of English, specially technical terms, he complained that I was not answering his questions. Ill-mannered and hostile from the very beginning, after 5 minutes, he walked away abruptly, leaving me alone and unattended in the room. Then of course I had to leave the premises.

I must confess that this was the most hostile, rude, unethical behavior in the medical profession I have ever seen in my 64 years of existence. Dr. Selden is a shame to his profession and to his own country which is a symbol in the world of humanity and generosity.

An interesting footnote to this complaint is that Dr. Selden announces everywhere in his office that he will be retiring in December... my piece of advice is that he should consider retiring earlier as he can't take his patients and profession no more !
Maria Teresa Junqueira

As Director of Neuroscience for The Villages Health, The Villages, Florida, I am requesting an investigation of Florida Blue Bad Faith practices. Over the last 3 years we have seen increasing blanked deniels of MRI requests by Neurologists seeking to care for patients with Neurological diseases. In most cases, these deniels do not even address the issues raised in our formal exam and history.
While peer to peer is allowed to appeal these deniels, it has become routine practice to keep the physician on the line waiting for over 30 minutes, repeatedly ask for the same information multiple times by multiple telephone operators and then finally when put in contact with a "peer" physician, this physicain is not educated in neurological diseases or practice and frequently states that he or she does not have the authority to countermand the deniel.
I believe this reflects bad faith and is illegal in the state of Florida and I am requesting a review of this practice. I have also contacted the Florida State Commision of Insurance Regulation.
Sincerely
John Castaldo MD

Cory lloyd told me about insurance plans and he sent information in my email and i told him not to process my debit card until i call him. I told him not to put me on automatic pay. I checked my account and notice there was a $25.35 charge on my account pending from purchase authorization
u65 binder bcbsfl. I called the company and they told me that the charge was for dental. I never asked for any of that. I didn't authorize any of those charges! this is pure fraud! all because they probably want some sort of commission! no ! no! no! i had to call my bank and cancel my card! this is insane! i hate that fact that they processed my card anyway and i didn't authorize anything! this is very fraudulent! i don't want nothing to deal with florida blue! crooks to the pits of hell!

FL Blue cashed my check for six months of premium since Jan 1, 2019, but they have never even activated my plan till today!

I made many phone calls regarding this issue, nothing has been resolved. Their customer service is a nightmare!

They kept sending me the wrong billing statements for five months now, the worst I have ever seen!

They made promises to correct this issue for five months now but every time when I called I heard the same reply that my plan has never been activated. I wonder why they cashed my checks quickly, but they take for so long to get my plan activated? My only medical claim this year since March has been denied even when I have a plan!

In early December 2018 I chose to change my Florida Blue plan to a new Florida Blue plan with a lower monthly rate. Apparently they failed to submit the plan I chose. I paid the premiums every month despite never receiving an invoice for 2018 or 2019. I have been on the phone for hours with multiple Florida Blue employees and everyone keeps passing me to another person. I have also sent multiple emails to the 2 people who I dealt with when I changed my plan. One left me a message to call someone else. The other never responded at all. I asked for their managers and of course no one contacted me. No one I talk to ever puts notes in the system, so the next person asks for the same story again, and each time they do nothing and tell me to call someone else, or tell me they will transfer me and force me to give my story again. I pay $800.45 a month and receive no support. I would like to have my chosen insurance plan installed as agreed to in December 2018.

Preauthorization submitted for nerve ablation due to herniated and bulging disc pain (being treated over 12 yrs now by this dr). The authorization was denied and I was told I cannot get the info or why. We have spent 30 days trying to get info to be told now it's because it has to be medically necessary. The dr submitted FULL details, at length), on why this is indeed medically necessary. It has become a clear pattern by FL Blue to deny care and medications first in what feels like intentional stall tactics. In the meantime, I'm left to either go w/o proper care or have to pay for it myself as we spend hours on end being passed from person to person. It's a shame that BCBS, which used to be the best of the best and actually cared, now has no regard for patient care.

This procedure is not a pleasant one but is our last try in a long long list of things (PT, epidural blocks, chiropractor, back braces, etc) before surgery. The next option if this doesn't work is multiple surgeries, which I'm trying to avoid and as medically necessary as it is, I have no doubt we'll run into the same opposition as we've seen already.

I feel, as a senior in FL, that FL Blue is intentionally making approvals SO difficult and time consuming that Drs and patients alike finally give up. They don't give straight answers, refused to disclose my own patient answers to me and they certainly doesn't care about my quality of life or the fact I'm in excruciating pain 24/7. When did patient care become the least important part of the process? I understand you're a business, but our lives matter and if my Dr of 12+ years isn't the best expert to determine care needed, a clerk somewhere certainly isn't. We spend dozens of hours supplying info and on calls to be passed off repeatedly with no resolution. I'm beyond frustrated and disappointed that my health and my pain means so little to you. This isn't some cosmetic procedure nor some minor health issue. This is shameful to put $$$$ above care.

I am a FL Blue member trying to have my premium changed to a non-smoker rate.
In November 2018, we requested the proper procedure to change my premium to a non-smoking rate and were instructed to submit a negative result for a "Continine" urine test. We were told a negative result for this test was all that was required. I had the test performed January 7, 2019 and faxed the results on January 11, 2019.
I received your letter of January 14, 2019. On January 22, 2019 I called and spoke to Vernon, Tina and Angel who informed me that the medical records from Dr Shah were all that was needed to get the non-smoking rate, which was then quoted as $224 monthly. On January 23, 2019 I faxed these records as requested. I also included the dates I stopped smoking & stopped using the patches, and a copy of the Continine results. (As reference) Dr Shah is a pulmonologist, who I went to see to get a base line reading. He requested x-rays which were also done for a base line reading. I have not been treated for any asthma, bronchitis, or pneumonia episodes in over a year, nor have I found it necessary to use an emergency inhaler. You interpret his records to say I have minimal COPD - I'm not taking any medications for COPD, so it must be minimal!
February 4, 2019 Called and again asked to submit more information. This time to submit a letter from my doctor, stating I am a non-smoker. Faxed copy of letter on February 12, 2019.
BCBS needs to train their customer service reps better or at the very least give them better scripts to read from. Each rep I spoke to told me different information. No one was able to give me the correct premium information. I had to wait until the 1st premium for the year was deducted from my account to find out what I was paying. I am past being frustrated with BCBS, this whole situation is an excuse to deny my request.
Each time I submit the requested information, I'm told I need additional information, and that nothing else is required, and then I receive a request for additional information. This has become harassment, requesting additional information again, again, and again. I'm being penalized for a pre-existing condition, and being discriminated against as a previous smoker. If I was a new customer, I would say I am a non-smoker and receive the non-smoker rate, with no questions asked.
I am a non-smoker, as proven by the Continine test. Therefore I am eligible to receive non-smoker rates.

I would like to know when I get into my account I get a message telling me I have unauthorized access and to make an option of finishing up an application or make a payment. Does that mean my account is locked or blocked? I have been trying for 2 months. I got one thing taken care of but now I need help. Otherwise if you can't help mail me my monthly statement. Also when I got my new cards my number was changed