Complaints

• Initial Complaint

  01/20/2025

  Complaint Type:

  Sales and Advertising Issues

  Status:

  Resolved

  More info

  Please remove my address from all Blue Cross and Blue Shield paper mail advertisement mailing lists. I do not wish to receive these advertisement flyers in the mail. I have attached pictures of the letter I received.

  Business response

  01/21/2025

  Blue Cross NC will contact the complainant directly regarding their concerns.

  Customer response

  01/22/2025

   
  Complaint: 22830883
  
  I am rejecting this response because:

  Blue Cross did not address my concerns. The message they sent me told me to call somebody named ******** but she was not available. I don't understand why I have to call somebody at all, it's a waste of time. 
  Please just remove me from your mailing list so I will stop receiving **** advertisements from Blue cross. I'm not interested in any promotions or health alerts.
  
  Sincerely,
  
  **** *******

  Business response

  01/23/2025

  BlueCross NC has spoken with the complainant directly regarding their concerns. It has been identified that this is a Blue Cross of Texas member concern. The member will communicate with their states Blue Cross on the issue. 

  Customer response

  01/24/2025

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.

  Sorry, I submitted the complaint to wrong subsidiary, my complaint was about Blue cross of Texas.
  
  Sincerely,
  
  **** *******

• Initial Complaint

  01/16/2025

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  Several BCBS employees misled and misinformed me about my insurance benefit coverage. When I was pregnant, I reached out to my insurer to confirm if a Labor Doula was covered. I provided them with the necessary procedure codes and was assured that this service was indeed covered under my plan. Based on their information, I hired a doula to support me through my prenatal care and eventual labor and delivery.I began the process of filing my claim in July 2023 for reimbursement. However, upon calling to check the status of my claim, I was told that since the services hadn't been rendered yet, they couldn't process my claim at that time. I was instructed to wait until after my child was born in ************ and refile the claim then.After delivering my child, I promptly prepared all the required documents and refiled my claim. To my shock and dismay, I was informed that my claim was now outside the statute of limitations for review. Heartbroken and furious, I appealed their decision and explained that I had followed the "proper protocol" as advised by their employees. Despite this, my appeal was denied.BCBS promotes itself as a company dedicated to supporting a healthy lifestyle and caring for its customers, but my experience tells a different story. Insurers beware: think twice before choosing this company to handle your medical coverage needs. I am extremely disappointed and angry at how I was treated during such a vulnerable time in my life.

  Business response

  01/17/2025

   BlueCross NC will contact the complainant directly regarding their concerns.

  Customer response

  01/20/2025

   
  Complaint: 22816500
  
  I am rejecting this response because: BCBS is still reviewing my claim and conducting their internal investigation. No further resolution has been provided.
  
  Sincerely,
  
  Daemesha *******

• Initial Complaint

  01/16/2025

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  In 2024, I enrolled in Experience Health NC ******** Advantage HMO, managed by Blue Cross Blue Shield. An allowance of $500 was available for dental preventive care. I visited the dentist in January '24, charged $342, paid. I then sent in a request for reimbursement and received a check for $342. This left $158 of the $500 to be requested for reimbursement. July 16, '24, I visited the dentist again for a cleaning and an exam. I was charged $167, paid. I then sent in a request for the remaining $158. I called customer service in September, "...be patient...", October, "behind in processing", November, I filed a grievance. December, I receive a letter that another 90 days is needed to evaluate my request. It has been SEVEN(7) MONTHS, and I have not been reimbursed. The letter was sent by a ******** *********** appeals analyst) ************, Experience Health, Claims Depart, ****************************. I have called several times and left messages, but there has been no response. I know of no reason the request for reimbursement should be denied. If so, what is the reason?

  Business response

  01/16/2025

  BlueCross NC will contact the complainant directly regarding their concerns.

  Customer response

  01/16/2025

   
  Complaint: 22819471
  
  I am rejecting this response because:  There has been no action to reimburse me for the dentist visit when there was money still remaining in the amount to be used for preventive care.  There has been no action that I have experienced other than to tell me to be patient, wait, etc...
  
  Sincerely,
  
  ****** ****

• Initial Complaint

  01/14/2025

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  Promised me a gym membership when I signed up for this health insurance through ********. I've yet to get my free gym membership. I have called several times trying to resolve the issue and nobody cares to resolve the issue. I had to cancel my gym membership at the planet fitness because the card they give me and told me to pay for my gym membership with this card it declines. I was with another insurance provider and I told them before I signed up. I don't want to lose my planet fitness fitness gym membership. I wasn't sure that I would not lose my gym membership and I can use this card that they sent me to pay for said gym membership. This is sadly not the case. I just want the gym membership I was promised along with the other benefits of the insurance program I was promised.

  Business response

  01/14/2025

   BlueCross NC will contact the complainant directly regarding their concerns.

• Initial Complaint

  01/09/2025

  Complaint Type:

  Order Issues

  Status:

  Resolved

  More info

  *************** was my primary ********* that ended on December 31, 2024 . On, and after Thursday, January 2, 2025. I decided to have the pharmacist fill Wegovy, Promethezine, ********** and Heslthy Blue refuse to cover any medicine but not until ***** ********* was over. I had to call Healthy Blue to make sure that they knew that my primary ********* was not my primary anymore and Healthy Blue was my primary ********* and so Healthy Blue . I sent in a termination letter to Heslthy Blue from ***** as well as ***** faxing the termination letter to the fax number ********** and my doctor also sent the prior authorization for Wegovy discussing why I needed it . I have not been able to get my meds as I am sick wihtout. Paying with my food money since I do not have money. I need the $24.04 for the ********** and ************ refunded to me. I am attaching the receipt. I also want ***** taken off as my primary and healthy blue actually paying for my meds and services. I need Wegovy approved.

  Business response

  01/09/2025

  Thank you for the referral. We will reach out to our member and address any questions or concerns.

  Customer response

  01/09/2025

   
  Complaint: 22786359
  
  I am rejecting this response because: I was contacted by BCBS and  left a message that I am not an insurance member even though  I am an NC BCBS ********************** member and gave them my Member ID. ********************** *** then hung up on me and threatened not to pay for any meds. I am not sure what is happening. No one should be mistreated this way. I cant afford  my meds and my insurance is behaving fraudulently.

  
  Sincerely,
  
  ****** B. *******

  Business response

  01/10/2025

  Thank you for the referral. We will reach out to our member and address any questions or concerns.

  Customer response

  01/10/2025

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ****** B. *******

• Initial Complaint

  10/17/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My father suffered a stroke in 2023. My mother and I have filed claims with BCBS and were clearly told these would be covered. Over the last 8 months the process has been going in circles processing and re-processing, one claim approved, others not sure what is happening. When speaking with customer service we were told these already should have been approved and paid. Somebody needs to look into these and finalize these claims properly because we are wasting months and hours speaking to customer service. My father is ********* ************. Subscriber ID ************.

  Business response

  10/17/2024

  Thank you for the referral. We will reach out to our member and address any questions or concerns.

• Initial Complaint

  10/02/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  My mother passed away on March 29, 2024. I called BCBS to stop bank drafts April 16th and to request a refund for the premium collected in April. Two premiums were collected on 4/5/2024: $****** and $291.00. They said they would stop all bank drafts and refund money. Check received from BCBS for ****** in mom's name. 5/7/2024 BCBS withdrew $291.00 premium. Called BCBS in *** and they apologized and said they would refund money and stop automatic bank draft. I asked them to issue checks in my name. Put Letter of Testamentary in mail per their request. 6/5/2024 BCBS withdrew $299.00 premium. I called BCBS and they said they did not receive letter of Testamentary in mail. They said I could fax it over. I faxed the letter to them. They also advised that I stop payment to them through my bank. 6/21/24 I paid a fee of $31.00 to stop payment to BCBS to my bank. 7/8/2024 Called BCBS. They said they received the Letter of Testamentary. They said I should be receiving a refund for part of March, all of ****** *** and June. Case number ******** was opened. 8/1/2024 Called BCBS to check the status of refund. I was on phone for 2.5 hours after being transferred multiple times and hung up on 2 times with no resolution. 8/7/2024 I called BCBS. They state that 2 checks have been issued in the amounts of $650.60 and $249.16 that day. 9/5/2024 I called BCBS to check the status of checks. They said they should have been expedited. I was put on hold and then disconnected while on hold. I called back. BCBS said it should take 30 days from 8/8/2024. I should wait until Monday and call back if I did not receive checks. 10/1/2024 Called BCBS to check status of checks. They said they could not tell me anything because their system was updating. They would call me back tomorrow.

  Business response

  10/02/2024

  
  BlueCross NC will contact the complainant directly regarding their concerns.

  Customer response

  10/02/2024

   
  Complaint: 22366408
  
  I am rejecting this response because:  My complaint is against BCBS not this company.
  
  Sincerely,
  
  ******* ****

• Initial Complaint

  09/18/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  Blue Cross Blue Shield has approved payment directly to me, for an ambulance ride that occurred 03/22/2024 in ****************. Since April, when they approved the claim and payment for the claim. I have been waiting for the check in the mail. i have called a total of 4 different times since April in regards to this issue. They have said that they have "voided and reissued" the check twice, but do not know why it is not getting to me. it is now September 18th... nearly 6 months later.. no payment has been received. And when asked if there can be an investigation into why i am not receiving these checks, they answer was no. We can only keep voiding and reissuing the check. At this point there seems to be issues within the company with regards to sending reimbursement to clients. I asked if there were alternative ways to submitting the money , ie. digital or to my bank. The answer is no. just a check. When asked what will happen if i still do receive a check in 30 days, the answer was we will void and reissue. How can this be escalated for investigation? or can there be alternative modes of delivery when clearly one is failing?

  Business response

  09/18/2024

  BlueCross NC will contact the complainant directly regarding their concerns.

• Initial Complaint

  09/17/2024

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  This bill was paid and we are still getting letters stating that we owe them money.I called and spoke to ******* and she left a phone message stating that it was taken care of in august.I received a letter dated September 11, stating that this is still pending and this is the 3rd notice,We wrote a letter and included a copy of the check that was cashed. Nothing seems to be addressed.We paid the amount owed in June!Please help sort this out.

  Business response

  09/17/2024

  BlueCross NC will contact the complainant directly regarding their concerns.

  Customer response

  09/17/2024

   
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ***************************

• Initial Complaint

  08/27/2024

  Complaint Type:

  Product Issues

  Status:

  Answered

  More info

  I cancelled my health insurance in January 2024. I had already paid my bill for February so I was issued a refund of $157.21. They suppose to send me a check but it never arrived. I called back after 30 days like they told me to and they cancelled the check and reissued another one. That check also never arrived. This process was repeated several times. I moved throughout this process and updated my new address before I moved to assure there were no issues. The representative did not change my address. I have been on the phone with customer service over 20 times now each time being tied up on the phone for over two hours. Thats a lot of time wasted on the phone. I am extremely upset. I want my money back. It is now almost 8 months later and I still do not have my check. I have talked to two different **********s as well. I have 7 different reference numbers about my case. The first ********** said they tried to send me one electronically and said it went through. And they closed my case. It did not go through. I got in touch with another ********** named ****** who is now in charge of my case. We got on the phone with my bank and my credit card company to verify that the check did not go through. She assured me this time everything was processed correctly and that I would get my check just like the rest of the people said. I still do not have my money. If this was the other way around debt collectors would be after me. I am so frustrated with this company. For a multi million dollar company cant refund a $157.21 check for a middle class working person. Its ridiculous and unacceptable. Here is the latest reference number that will get you in touch with ****** who is now in charge of my case. She has been nice about the situation but ultimately has not gotten my money to me. Please help. ****** (In charge of my case)50885511 (Most recent)************** (Phone number)Reference #s past 8 months ******** ******** ******** ******** ******** *******

  Business response

  08/30/2024

  BlueCross NC will contact the complainant directly regarding their concerns.

*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. ↩