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Insurance Companies

Blue Cross & Blue Shield of Minnesota

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Complaints

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

Customer Complaints Summary

46 total complaints in the last 3 years.
20 complaints closed in the last 12 months.

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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:03/31/2025
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.
Our company has decided to use Blue Cross Blue Shield of Minnesota for insurance starting in November 2024. I have been using ****** as a stomach medication because nothing else works for me. Since November, I have been calling them to see if I could get this medication approved. They finally approved ****** as a non-formulary medication in February. However, every time I check with my pharmacist, I find out it would cost me $625 to obtain this medication. I called customer service several times to understand why the cost was so high. To be precise, I called six times, and five of those times, their response was that they would need to investigate the matter and would call me back. Today, I finally found out that the $625 charge is a penalty for using a non-generic medication. Now, I need to go through another process to request that they forgive this $625 penalty, which is essentially the same as getting approval for ******. The previous process to get approval to use ****** was not sufficient. I believe this is all just a delay tactic to avoid covering the medication. It has now been four months since our company switched to Blue Cross Blue Shield of Minnesota, and they are asking my doctor to submit another appeal so they can process my request for forgiveness of the penalty for using non-generic drugs. How does this help with our medical costs? All we seem to do is paperwork for them to deny our requests. We end up spending days calling and waiting for answers.
Business Response
Date: 04/11/2025
Good afternoon:
A Member Experience Specialist in our *************************** left a voice mail for our member on April 10, 2025, regarding their concerns involving the generic penalty being applied towards their prescription, ******. The prescription ****** is a non-formulary, non-covered medication. Their plan requires a generic for this medication (**********************) which is a tier 2 generic drug for coverage under this plan. Although a prior authorization was approved for the ******, this approval does not override the generic drug cost. As of today (April 11, 2025), we have not received a formal appeal from our member or their provider to review this request further (their provider submitted a formulary exception request, which was closed out, as there is a prior authorization already in place for this medication). Our Member Experience Specialist advised in their voice mail that a complaint form would be needed in order to have the generic penalty reviewed. The Specialist left their phone number for our member so they may provide their email address to email the complaint form to be completed. Our member may also locate the complaint and appeal form on our website at: *************************************************************************************************
Thank you for contacting us regarding your concerns. Have a good day.
Customer Answer
Date: 04/13/2025
I am rejecting this response because:
This seems to be yet another denial or delaying tactic used by Blue Cross Blue Shield to avoid paying for the medication. My provider has filed an appeal as instructed by the customer service department, but that appeal was denied. Now they are asking me to fill out a form, which I suspect will also be denied. This feels like a clear attempt to delay the process. I have been working on this issue since November 2024, and now, after all this time, **** is telling me that I need to submit a form myself, which contradicts the information provided by customer service during our previous conversation.
Initial Complaint
Date:03/26/2025
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 asked for what was company data. Twice maybe more, they sent me copies of my bills and data. Nothing related to what I asked. Nothing. My personal info was unnecessarily put at risk multiple times. The request was in writing. Plain as day. My data was put at risk multiple times. Unnecessarily. Please provide 1 year of free credit monitoring.
Business Response
Date: 03/26/2025
We have responded to the member directly via a letter to address his complaints and concerns.
Customer Answer
Date: 03/27/2025
I am rejecting this response because:

No. My data was put at risk unnecessarily multiple times. I have asked for free credit monitoring. They rejected it. They responded but did not take accountability. They sent multiple packages to me with personal data that was not requested. Please provide free credit monitoring. My requests were clear. Instead the company chose to put my data at risk by not sending anything related to my request. Please take accountability and provide free credit monitoring.
Business Response
Date: 03/31/2025
We have responded to the member directly via email to address his complaints and concerns.
Initial Complaint
Date:01/14/2025
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.
When my wife, *****, and I were in need of a new C-pap device, Blue **********************/Blue Shield representatives told us that we each had the option to either rent a new one or purchase it outright. We both have severe sleep apnea, and so purchasing seemed the obvious choice, since its very likely that we will both need to use one for the rest of our lives.However, Apria insisted that Blue Cross/Blue Shield requires that renting one was our only option. When I told them that we had each purchased two units previously, they were firm in denying our **********, is **** telling its clients one thing and telling ***** a completely different story?Furthermore, Apria told us that **** denied our claims, due to non-compliance. What is THAT all about? Does **** have some secret policy that it keeps hidden from its clients?**** representatives told us that they did not deny our claims, but that ***** stopped submitting them after just three months, forcing us to pay exorbitant amounts out-of-pocket. Were they acting upon this secret **** policy?
Business Response
Date: 01/15/2025
Good morning and thank you for your inquiry. We will respond to our member directly.
Customer Answer
Date: 01/22/2025
I am rejecting this response because:
It has been more than a week since I filed my complaint, and Blue Cross/Blue Shield said they would contact me directly. I have not received anything from them -- no email, no phone call, no letter.
I want them to contact Apria and give me a no-nonsense account of why my wife ***** and I have been so grossly over-charged, and why Apria insists that BCBS required us to rent our C-PAP units when we have each purchased two units previously. Also I want BCBS to explain why our claims were denied for "non-compliance" after just three months.

Business Response
Date: 01/23/2025
The response letter was sent to the member via **** on 1.23.2025.

Thanks
Customer Answer
Date: 01/31/2025
As of 1/31/25, I have NOT received a letter (or any other form of communication) from Blue Cross / Blue Shield of Minnesota in response to my inquiry to them.

They claim they sent a letter on 1/23/25 -- more than a week ago -- which has yet to show up in our mail box.

I would request that they communicate with me through my e-mail -- which would more easily facilitate a dialogue if I have any need for clarification or have any follow-up questions.

Thank you.
Initial Complaint
Date:12/27/2024
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.
In July 2024, I applied for health care through my local county, I was given two healthcare accounts by mistake. One was Bluecross Blueshield, I did not use this coverage, but a bill was sent at the end of July. I then called BlueCross Blueshield upon receiving this bill of $250 at the end of July to cancel my coverage, as I did not use them. Then in August I received a bill of $500, I then called to cancel again . It is now December and I have a bill of $1500 sent to me, even though every month I have been cancelling this account. I need assistance in getting this $1500 charge removed and this coverage cancelled, so far when I have called to address this I am being ignored. And I fully expect another bill to be sent with the charges continuing to go up month after month for a healthcare coverage I am not using.
Business Response
Date: 12/31/2024
Hello:
Thank you for your concern. We will reach out to you directly to respond to your concerns.
Initial Complaint
Date:12/19/2024
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 received a rejection in December 2023 Again I didnt have a physical. I had shots and prescriptions for travel which is covered under the policy. Same page. Page 45. Look at the bullet literally below. I didnt have a physical. I had shots and medications for travel. That is covered. It was literally 1 bullet below. You applied the wrong bullet. Please send the following. I still havent received it. 1 Who was the ** *** rejected the claim? Their board specialty and license number as well. 2 Materials that were relied on to make the determination. 3 Are they licensed in **?4 Proof the ** making the determination has maintained registration in mn and proof they have met all continuing education requirements. 5 Aggregate treatment at which similar treatments are denied or approved by the ** being used for peer review. 6 any other notes You probably have to send this via ****. **** ****
Business Response
Date: 12/23/2024
Thank you for your concern. We will reach out to you directly to respond to your concerns.
Customer Answer
Date: 12/23/2024
I am rejecting this response because:

Please send the data. Last time you said you sent it, you didnt. Please send the data. Also note you noted the wrong bullet on the rejection. You cited physical. It was the travel shot and prescription 1 bullet below.
Business Response
Date: 12/27/2024
A letter dated 12/23/2024 was sent to the member addressing his additional information.
Customer Answer
Date: 12/30/2024
I am rejecting this response because:

I cant trust your letters. I dont know what quality it is and it hasnt been received. I will approve when I have read it and it has the requested information. There is a bunch of medical information that was requested. I wont approve until I have received it and approved it. Otherwise it will be escalated to state ag, mn **** commerce and opm.
Initial Complaint
Date:10/29/2024
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.
We requested access to the BC network on April 16, 2024 as an outpatient mental health business. I checked on 5/17/24 and was asked to wait until 45 days had passed so I waited until 6/28/24 at which time it was indicated they had the information. I then emailed and spoke with a representative at the beginning of July who said she was not sure why there was a hold up but she would escalate the case and since it was BC who had the issue she would make a note of it and the contract would backdate. I again waited the 45 days and sent an email on 9/28/24 asking about the case and was again told the application would be escalated. The contract arrived October 18, 2024. This took 6 months when it should have taken 3 months at the most. Patients had to be seen during this time as they were current patients of the providers who followed them to their new business. I have been on the phone all afternoon and the service representatives who have tried to help do not seem to understand what I am asking, ie we are mental health and they directed me to dental/chiropractic. They have given me five incorrect phone numbers where I have waited on hold and then spoken with people who could not help me as it wasn't their area *********** representatives are not trained properly. This is not acceptable. I would like a phone call to find out what happened. ************
Business Response
Date: 11/11/2024
This concern has been sent to our Network Managment area for review and response.
Initial Complaint
Date:10/08/2024
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.
We have Anthem Blue Cross which has all its claims go through the local Minnesota Blue Cross Blue Shield office. Our son is scheduled for surgery at **** on October 30th for Vertebral body tethering to correct his scoliosis. Blue Cross is saying the surgery doesn't need prior authorization but won't give Mayo an answer on if the surgery will be paid for after they submit and says they will look at the claim after the surgery and make a decision. We've called trying to get a firm yes or no answer in writing, but they are refusing to give a firm answer and keep saying it doesn't require prior authorization so they don't have to guarantee it will be paid. Because of their answer, we will have to pay the $100,000+ surgery out of pocket ahead of time and then pray they cover it, but if they don't, we are out that much money. Insurance companies shouldn't be allowed to not give an official approval or denial on an expensive surgery.
Business Response
Date: 10/10/2024
Good morning,
This is not a Minnesota member, and the PA requirements are made by this member plan. which they state is Anthem. The member would need to contact Anthem.
Thank you
Initial Complaint
Date:09/23/2024
Type:Order 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.
Denied my surgery saying it's experimental. Surgery has been performed since 2007. Had the hiatal surgery twice Doctor wants to do a different procedure which he thinks would prevent cancer forming in my esophagus. They keep deny it. Even after appeal. doctor believes the Linx Surgery would prevent further problems. Blue Cross Blue Shield MN don't care about someone's health.
Business Response
Date: 09/24/2024
Good morning,
We did review an appeal for Mr. ******* which was upheld, and an outcome letter of the determination and optional next steps was mailed on September 16, 2024.
The requested surgery is considered investigative per our medical policy: ****************************************************************************************************************************************************
Mr. ******* has the right to request a corporate appeal review, or he can file for an external appeal.
Thank you
Initial Complaint
Date:09/23/2024
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 am currently credentialed with **** as a provider with my *** Type 1 under my employers NPI Type 2. I am opening a clinic and am trying to contract the business *** Type 2 and recredential me with the new clinic with my NPI Type 1.I received confirmation that all my information was received on July 1st. It stated ***** days for a timeline. Friday will be 90 days. I would typically wait, however, the last email I received (Friday 9/20) said it was in que and I should check back in a "few weeks".I was careful to start this process with enough time per **** reported timelines. Over 60% of my caseload is **** members. These clients will have a disruption in services and be without mental health care (and are high-risk) when I transition. There are not clinicians to transfer them to and most if not, all will stay with me through the transition to a new clinic.I am concerns about the significant wait to get contracted and credentialed with ****. They are been fabulous and easy to work with over the last decade that I have been credentialed.I have followed the emailing guidelines at 30 and 45 days each time getting a response that it is in que and I am to keep waiting.The descripted problem in short is that I have been unable to get contracted and there is no customer service for me to reach out to via phone as the require a "provider number" to attempt to resolve the issue. I am seeking assistance to move the process along to get my *** 2 contracted and my *** 1 credentialed - to preserve services for my clients.
Business Response
Date: 09/24/2024
Good afternoon, this has been forwarded to our credentialing department and they will contact the provider.
Initial Complaint
Date:09/17/2024
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.
We applied for medical insurance with **** on May 28, 2024, for covering beginning **** 1, 2024. All paperwork was submitted on time through a third party ********************* Broker, ***** **********. When we didn't receive anything from **** by mid-****, ***** reached out to ****. They we slow to respond and by the time a connection was made, **** was over and we never received proof of insurance coverage (our daughter on the plan was unable to make a needed appt at a clinic due to no proof of coverage). ***** was then told by a **** representative that there was a mistake on their end and the application hadn't been submitted properly. At the time, ***** requested the application be submitted for July 1, 2024 instead and the payment we had made be applied to July instead. It then took until mid-July to receive any confirmation from **** with ID cards and a policy number. Shortly after, **** began sending invoices for the July premium. When we called to complain, they said they still show a start date for **** 1, 2024. We were told we would need to file an appeal, which we did. Six weeks later, their appeal result states that we still owe for both **** + July. This is not only unprofessional and extremely unfair, but also fraudulent to force payment without services rendered. They put us in a vulnerable position as a family to go without coverage for a month. We have since moved out of state. We sent a request for cancellation on July 30, 2024 via email as their representative instructed via phone. I called afterwards to confirm receipt and had to send it again. Then when submitting the appeal on August 15, 2024, they are referring to that as notice of cancellation instead of the email. Super disorganized business resulting in dangerous practices for the consumer! Please help or advise. They are still wanting $1,300+ payment for one month of coverage that was never provided. We are concerned they will take us to collection or mar our credit score. Thank you!
Business Response
Date: 09/18/2024
Good morning,
After reviewing concerns, we are able to cancel the coverage from 6.1.24-7.1.24, however there are 2 claims in June that were processed and those will be recouped.
If the member is ok with that, we can cancel the coverage from 6.1.24-7.1.24.
Thank you

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Blue Cross & Blue Shield of Minnesota is NOT a BBB Accredited Business.