Complaints

This profile includes complaints for Blue Cross and Blue Shield of Illinois's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Blue Cross and Blue Shield of Illinois

  300 E Randolph St Chicago, IL 60601-5099

• 

  Blue Cross and Blue Shield of Illinois

  PO Box 1364 Chicago, IL 60690-1364

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:04/22/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I attempted to fill my third month of *** (********* and ************) and was in formed by pharmacy that a hold is on rx and I need to fill via mail. I was out of meds in 2 days and didnt have time to use mail. So contacted **** of IL and was told that 90 day rx doesnt require mail order pharmacy. But I have an appointment on May 5 with MD to discuss dose and if current dose is helping. Was advised an override was required. And *** advised override would occur within 72 hrs. I was able to pick up my rx last week finally and missed approx 5-6 days of medication due to this process. I still had a few doses of the ********* left and when I attempted to renew that rx. I was informed today it still has a hold on it. I have been on phone with BCBS ***s multiple times over past 7-10 days, multiple hours spent and still I am not able to get my meds. I am out of ********* and now being told override is being worked on. I am not sure how a 72 hr wait has turned into a full 7 days. I am being told now by *** that they are waiting on my HR group to authorize, yet this was all address with the ************ last week so I feel like the ball got dropped and I am missing prescribed medication that we are trying to figure out dosing on, which is difficult when I havent been taking it consistently due to override issues and lack of communication. Why am I just learning today that ********* wasnt addressed when I was addressing the ************. As they have to be taken together.

  Business Response

  Date: 04/28/2025

  Please see the attached.

• Initial Complaint

  Date:04/18/2025

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I signed up for a marketplace plan at the end of December. I was contacted several times by **** of IL and told that my plan had not started and wont until they get payment. (The payment was sent after enrollment at the end of December) I contacted Blue Cross Blue Shield on 9 January after receiving a letter stating that the ***** period for the new policy payment was over, and was told that payment was still not received in the policy had still not started. I spoke with the agent about just starting the policy to start in February instead. I then reached out to the marketplace team and started a February policy. Several weeks later, I got a notification that the Blue Cross Blue Shield received that payment. They then proceeded to take a portion of that money and apply it to the non-started never established policy. After repeated attempts to get a full refund, I have been unsuccessful. Marketplace tells me they have deleted the file and they cannot backdate the policy. Blue Cross Blue Shield tells me it is not their problem. I would like a full refund of that month premium for the policy that they told me they would never start that they have me cancel.

  Business Response

  Date: 04/28/2025

  This letter is in response to ***** Puffs inquiry, submitted to your office and received by Blue Cross and Blue Shield of Illinois, a Division of *******************************, a ***************************** an Independent Licensee of the Blue Cross and Blue Shield Association, on April 18, 2025.
  
  Due to the Protected Health Information involved in the response of this inquiry a letter will be sent directly to ***** Puff.
  
  We strive to deliver excellent service and appreciate being made aware of instances in which improvement is possible. If you require additional information, please do not hesitate to contact us in the future.
  
  
  Sincerely,
  ***** ****** U312688
  
  Sr. Inquiry Specialist
  Blue Cross and Blue Shield of Illinois

• Initial Complaint

  Date:04/16/2025

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  In jan.i got notice i was entitled to champva / and meds by mail free. I went to health assic.feb.6th 2025 to cancel bcbsil.I had already paid ****** ins. was to end feb 27th.i have repeatedly called them and instr.i had it cancelled.3-93-25they took out a payment fom bank.3/10/25i again went b to healthassoc. And told them another paymental was deducted ******** called **** to again instr them insurance was cancelled. Their excuse was they were behind due to cancelations and i would get my refund in 10 days.3/28/25 i again called bcbs- i was on hold 28 min and only spoke with someone 8min and when he came back i said "28 min on phone and nothing is accomplished" he was no longer happy and said he had pop and a hot dogs he had to finish" and we were disconnected and then I was speaking with **** who then declared "THERE IS NOT 1 PHONE CALL TO PROVE YOU HAVE CALLED AT ALL". I said i have proof on my phone...i spoke to ***** on 1 day she said she was in the ***********. I called health assoc. again(********) she called bcbsil and called me back at310pm and said she" talked to **** and they tried to say they never got request to cancel"and she told them she had proof she faxed them a cancellation and she faxed a copy to them.she saud"that should be the end of that and you should get your refund in 10 days"They actually attempted to take out another payment on 3/31/25 and i ran up to my bank and paid to stop payment ( because it was pending they were able to not pay it. Now I'm getting letters/request for payments etc. I NEVER did get the $ ****** refund from 3/31/25 yet. Because the insurance is still showing up i have been unable to have any medical bills covered by ******* and have not been able to get my Meds by Mail.I made 4 calls to ****** today to file a complaint and everycall was dropped after explaining why I called. Please help settle this for me.

  Business Response

  Date: 04/18/2025

  Dear Customer Relations Representative:
  
  This letter is in response to the additional information received on ***** Prices inquiry, submitted to your office,and received by Blue Cross and Blue Shield of Illinois, Division of *******************************, a ***************************** an Independent Licensee of the Blue Cross and Blue Shield Association, on April 16, 2025.
  
  Due to the Protected Health Information involved in the response of this inquiry a letter will be sent directly to ***** *****.
  
  We strive to deliver excellent service and appreciate being made aware of instances in which improvement is possible.If you require additional information, please do not hesitate to contact us in the future. 

• Initial Complaint

  Date:04/11/2025

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I recently obtained new insurance through Blue Cross Blue Shield via the *************** Act (Obamacare). I scheduled an initial visit with my primary care provider (PCP), who is in-network, to establish care. Following the visit, I was charged $1,533.86. Upon reviewing the claim, the insurance company stated that while my PCP is in-network, the bloodwork was sent to an out-of-network lab.This falls under Illinois Public Act 096-1523, which protects patients from surprise medical bills when treated at an in-network facility by an out-of-network provider, especially for services like lab testing. According to this law, I should not be billed beyond my in-network cost-sharing.During a call on April 11, 2025 (Reference #: 188-145-180), the insurance company insisted I am responsible for the full amount. This contradicts the protections guaranteed by state law. I am seeking resolution and protection under Public Act 096-1523, as well as reimbursement or removal of this unfair charge.What form of relief I am seeking?I am seeking a full waiver or refund of the $1,533.86 charge, as this bill falls under the protections of Illinois Public Act 096-1523 against surprise medical billing. I request that Blue Cross Blue Shield process this claim in accordance with the law and apply only my in-network cost-sharing, if any. I also request that any collections activity be stopped immediately and the charge be removed from my account.

  Business Response

  Date: 04/16/2025

  Dear BBB:
  
  This letter is in response to ******* Andreopouloss inquiry, submitted to your office and received by Blue Cross and Blue Shield of Illinois,a Division of *******************************, a ******************** Company,an Independent Licensee of the Blue Cross and Blue Shield Association,on April 13, 2025. 
  
  Due to the Protected Health Information involved in the response of this inquiry a letter will be sent directly to ******* ************.
  
  We strive to deliver excellent service and appreciate being made aware of instances in which improvement is possible.If you require additional information, please do not hesitate to contact us in the future. 

• Initial Complaint

  Date:04/04/2025

  Type:Service or Repair Issues
  Status:

  UnansweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Their **** are incompetent to say the least. They either have no idea what they are doing or just hang up on you. I call daily for my job and some days I cant even get my work done because 1 call takes over an hour just to be hung up on and start over. Are you not auditing calls? Not training employees? I can hear roosters in the back ground half the time or it sounding like they are partying while not doing their job. It is completely unprofessional and they will never transfer to a supervisor. Do BETTER BCBS!!!!!

• Initial Complaint

  Date:04/02/2025

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Call Summary ****** Customer Service Inquiry ************ April 3, 2025, at 2:35 PM CST Representative: *** *.Reference Number: ********* Purpose of Call: Inquiry about patient eligibility and benefits Details of the Interaction:I inquired about eligibility and benefits for our patient. While *** *. was checking, I asked if benefits/copay would change depending on the rendering provider.He requested time to check and then provided benefits using our MDs NPI.I reiterated my question about different rendering providers. He stated he needed to check another providers *** and gave me the reference number.When I asked if he was ready to take the second providers ***, he said he had to transfer me because he had a meeting with his supervisor.This appears to be call avoidance, as he prioritized ending the call over addressing a straightforward follow-up question.When I requested a supervisor, his responses became sarcastic and dismissive, and instead of transferring me to a live agent, he routed me to the IVR.Concerns:The representative failed to provide complete assistance and improperly transferred the call.Possible violation of call avoidance policies.Dismissive and unprofessional behavior when handling a routine eligibility inquiry.

  Business Response

  Date: 04/24/2025

  Please see the attached response.

  Customer Answer

  Date: 04/24/2025

   
  Complaint: 23152372
  
  I am rejecting this response because:

  The response failed to address the main concern I raised, which was the unprofessional and disrespectful behavior of the representative, *** *., during a customer service call. There was no mention of any sanctions, corrective measures, or retraining provided to the representative in question. Furthermore, ****** stated that a letter would be sent directly to me, but as of this date, I have not received any such correspondence or email follow-up from them. Until I am provided with a clear and specific explanation of what actions were taken in response to my complaint and how ****** plans to prevent similar occurrences in the future, I cannot consider the matter resolved.
  Sincerely,
  
  May Gencianeo

  Business Response

  Date: 04/28/2025

  Thank you for your inquiry. We are reviewing the case and will reach out to the member directly with a resolution.

• Initial Complaint

  Date:04/01/2025

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  TWO separate refund confirmations from ****- for amounts owed (for policy that was cancelled) that was never received. **** confirmed with ***** transaction was never processed. I have spent months and months now calling and emailing trying to find where they sent my refund. I have gotten no where in 6 months of calls. **** has a tracking number that my own bank says is invalid with their processor. I need some assistance, please. It seems as though the money was just sent into the abyss. See refund confirmation emails below: Dear HCSC Customer,Your refund for the payment associated with confirmation code ********** was successfully processed for account ending in *5373. You can expect to receive your $350.00 refund within the next 3 to 5 business days. Here are the details of your payment refund:Original Payment Date: 8/15/2024 10:33 AM CT Original Payment Confirmation Code: ********** Original Payment Amount: $350.00 Payment Refund Amount: $350.00 Fee Refund Amount: $0.00 Total Refund Amount: $350.00 Your refund will be credited to the following payment account within the next 3 to 5 business days:Account Number ending in: *7829 Dear HCSC Customer,Your refund for the payment associated with confirmation code ********** was successfully processed for account ending in *5373. You can expect to receive your $18.08 refund within the next 3 to 5 business days. Here are the details of your payment refund:Original Payment Date: 7/11/2024 11:22 AM CT Original Payment Confirmation Code: ********** Original Payment Amount: $600.00 Payment Refund Amount: $18.08 Fee Refund Amount: $0.00 Total Refund Amount: $18.08 Your refund will be credited to the following payment account within the next 3 to 5 business days:Account Number ending in: *7829 Please save this confirmation for your reference.Thank you,HCSC

  Business Response

  Date: 04/02/2025

  Thank you for your inquiry. We are reviewing the case and will reach out to the member directly with a resolution.

  Customer Answer

  Date: 04/10/2025

   
  Complaint: 23147627
  
  I am rejecting this response because:
  Hi! 
  
  I have received NO new contacts or information since filing this claim with BBB from the company. 
  
  I have one email on 4.3.25 from the same lady that I have spoken to on the phone numerous times (at BCBS) from a previous conversation on 3.25.25 where she stated she would continue to escalate my dispute and seek out resolve from higher *** and get back to me. 
  
  Other than that pre-existing conversation, I have received no attempt at resolution from anyone at BCBS since filing this complaint. 
  
  This has been an open and ongoing conversation with BCBS since September 2024 and I have also conducted multiple three-way calls between a representative from my bank and a representative from Blue Cross Blue Shield, where they have obtained all the information they need to verify that those deposits were never made into my account. 
  
  This money has been owed to me for over 7 months now. 
  
  Thank you! 
  Jessica 
  Sincerely,
  
  ******* **********

  Business Response

  Date: 04/15/2025

  Tell us why here...April 15, 2025
  
  
  Better Business Bureau
  ********************************************************
  *****************
  
  
  RE:       Record ID: *********
  Member: ******* **********
  File #: 23147627
  
  
  To whom it may concern:
  
  This letter is in response to ******* *********** inquiry, submitted to your office and received by Blue Cross and Blue Shield of ********,a Division of *******************************, a ******************** Company,an Independent Licensee of the Blue Cross and Blue Shield Association,on April 2, 2025. 
  
  Due to the Protected Health Information involved in the response of this inquiry a letter will be sent directly to ******* **********. 
  
  We strive to deliver excellent service and appreciate being made aware of instances in which improvement is possible.If you require additional information, please do not hesitate to contact us in the future.
  
  
  Sincerely,
  
  ***** *. U254126
  Sr. Inquiry Specialist
  Blue Cross and Blue Shield of Oklahoma

  Customer Answer

  Date: 04/15/2025

   
  Complaint: 23147627
  
  I am rejecting this response because:

  I have yet to receive a letter in the mail yet as stated in this email. 
  

  Therefore I cannot accept the response and will need more time to review said letter if/went it is sent. 

  
  Sincerely,
  
  ******* **********

• Initial Complaint

  Date:03/28/2025

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  In Sept '24, I needed custom foot orthotics to help control severe pain due to ******** Neuroma. ******************************* is an in-network partner of **** and I found ******** and the related podiatrist via ****'s in-network portal search. ******** refused to process my claim as an in-network insurance claim because they admit that they do not like running the risk of taking reductions for services/products as a result of insurance benefits. I was forced to pay cash ($650) upfront, which I did because the level of pain in my foot was something I needed to get under control asap. After 5+ months of chasing reimbursement for this claim, **** is forcing me to withdraw my claim stating that ******** is an in-network partner and is required by contract to submit claims. ******** is unwilling to reimburse me for my upfront payment and take what they are contractually allowed for reimbursement from ****. So I'm stuck between two parties who cannot play by their own agreed upon legal rules of engagement, and I cannot get refunded from either **** or ******** for money I never should have paid in the first place. **** is telling me that they can file a grievance and educate Graymont on their rules of engagement, which is all great, but none of that results in me being refunded $650. I met my out of pocket maximum for medical costs at this point in 2024 but that should not mean that providers have the right to force me to pay cash thereafter or there is no point in out of pocket maximums existing for insurance policies. I would greatly appreciate the assistance of the BBB in helping to resolve this claim. I believe **************** should be refunding me $650 and taking whatever **** is contractually obligated to pay them for foot orthotics. I will be opening a second BBB complaint against ******** soon hereafter so those cases can be linked together if it helps simplify the BBB complaint processing. Thank you!!! 

  Business Response

  Date: 03/31/2025

  Thank you for your inquiry. We are reviewing the case and will reach out to the member directly with a resolution.

  Customer Answer

  Date: 03/31/2025

   
  Complaint: 23129329
  
  I am rejecting this response because:  I would like the BBB to remain involved.  The business has had 5+ months to make this right so I cannot assume that their response to this BBB complaint is actually going to result in any form of acceptable resolution.  I have also spoken with the business as recent as March 28, ********************************************************************************* but it also shifts the burden of responsibility back on me to deal with the other related party, Graymont Medical Supply, myself.  
  
  Sincerely,
  
  **** ********

  Business Response

  Date: 04/02/2025

  Dear BBB:
  
  This letter is in response to Mr. ********* inquiry, submitted to your office and received by Blue Cross and Blue Shield of Illinois,a Division of *******************************, a ******************** Company,an Independent Licensee of the Blue Cross and Blue Shield Association,on March 28, 2025. 
  
  Due to the Protected Health Information involved in the response of this inquiry a letter will be sent directly to Mr. ***************
  
  We strive to deliver excellent service and appreciate being made aware of instances in which improvement is possible. If you require additional information, please do not hesitate to contact us in the future. 

  Customer Answer

  Date: 04/02/2025

   
  Complaint: 23129329
  
  I am rejecting this response because:  For the same reasons as before, I am not accepting this response and closing the BBB complaint.  I have been engaged with ****************** representatives almost on a weekly basis for months and this claim cannot get resolved because of all the red tape involved.  To me, it's an easy fix but BCBS is too big for its own good and forces these things to drag on and on for months, rather than get a credible person in contact with me so we can resolve the issue quickly.   I've been trying to resolve the claim for months with very little support.  So, if BCBS really wants to put an end to this simple claim, BCBS knows how to contact me to do what's right.  Otherwise, this is going to continue to drag on as it already has for far too long.    
  
  Sincerely,
  
  **** ********

• Initial Complaint

  Date:03/26/2025

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My coverage was provided under *****, which I stopped paying in January. My employer claims to have contacted **** of IL. To cancel my policy. **** denies being told to cancel my policy and continues processing claims This is causing issues with my new insurance, and BCBS of Ill isn't doing anything to clear it up. All I get is them saying it hasn't been cancelled even though ****** my previous employer has sent it over to them on several occasions.

  Business Response

  Date: 03/28/2025

  Thank you for your inquiry. We are reviewing the case and will reach out to the member directly with a resolution.

• Initial Complaint

  Date:03/21/2025

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  **** is denying my prescription because I don't meet the criteria for having been on the drug for 6 months. I have only been on it for 3 which they have proof of but they say I still haven't met the 6 month criteria. I want the dates updated on my pre-authorization to reflect when I started on it. Otherwise this will keep happening every 6 months.  

  Business Response

  Date: 03/24/2025

  Thank you for your inquiry. We are reviewing the case and will reach out to the member directly with a resolution.

  Customer Answer

  Date: 03/25/2025

   
  Complaint: 23100140
  
  I am rejecting this response because: no action has been taken to resolve-they just assigned a case number at this point
  
  Sincerely,
  
  ******* *********

  Customer Answer

  Date: 03/31/2025

  
  Better Business Bureau:
  I discovered this complaint should be directed at OPtum Rx with whom Bluecross Blue shield claims to not be affiliated.
  
  Sincerely,
  
  ******* *********