Complaints

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

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• 

  Premera Blue Cross

  PO Box 91102 Seattle, WA 98111

• 

  Premera Blue Cross

  PO Box 91102 Seattle, WA 98111-9202

• 

  Premera Blue Cross

  7001 220th St SW Bldg 1 Mountlake Terrace, WA 98043-2160

• 

  Premera Blue Cross

  PO Box 327 Seattle, WA 98111-0327

• 

  Premera Blue Cross

  7001 220th St SW Mountlake Terrace, WA 98043-2160

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:05/25/2023

  Type:Sales and Advertising 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.

  Jan 16 I injured my shoulder and had a appointment with my orthopedic the 19. Moving forward from this was horrible because my insurance is blue cross but really I had paid for nothing the company began to deny my claims and any process moving forward. Basically trying to time out what insurance was paid via my work. Now I lost my job/career due to the injury and this insurance if that's what we're calling it gave me little to no coverage denying that they even had a claim while we have written denials prior. Long story short I got injured lost my job due to failure to receive medical treatment cause I had no representation or coverage for the insurance I paid for. Now I have no insurance cause they like to time it out on top and a basically useless shoulder.

  Business Response

  Date: 06/19/2023

  Dear Resolutions Specialist:

  
  Thank you for your inquiry received in our office on May 25, 2023. You have forwarded a complaint for our review and
  response.
  

  Insufficient information was provided in order for us to review this complaint and provide a detailed response. We
  encourage ********* to follow up with Premera Blue Cross (Premera) directly so that we can assist them.
  

  In general, we are unable to provide any information about any person who is or may have been our member without
  proper authorization. We responded directly to the person who submitted the complaint to your office.
  

  Please note health benefit plans are not subject to review or oversight by the Better Business Bureau. We respectfully
  request that this complaint be removed against Premera Blue Cross of Washington.
  

  If you have any questions, please contact **************** at **************.
  

  Sincerely,
  

  ****************, Appeals Specialist
  Complaints and Appeals Department
  

  Customer Answer

  Date: 06/27/2023

   
  Complaint: 20106180
  
  I am rejecting this response because:
  I was denied over and over with calling daily during the issues and nobody would give any answers or reason for denial. I dont expect anything from you guys I just hope that the public can know what to expect can happen trusting the wrong company. I don't have a copier to scan my documents either if we have another option to copy but seriously left me with a torn tendon and rotator cuff.
  Sincerely,
  
  *******************************

• Initial Complaint

  Date:04/26/2023

  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.

  Premera Blue Cross Lists Confusing, Misleading information, causing extra financial burden to members I'm seeking for billing adjustment as I was heavily mislead by the false information on Premera's official website and benefit details. I'm a Premera Blue Cross member with a standard plan from my employers. On Premera's official website, it states that I've services of Massage Therapy(Inpatient, Outpatient, Professional). For Outpatient massage therapy, it's 90% covered. I've been visiting my massage therapists with the expectation of that coverage. However, recently the claims got declined as Premera believes the massage I went to only belongs to professional/alternative care, which only has 18 visits per year. While calling Premera's customer service, they replied that only massage service offered by providers other than massage therapists are considered "Outpatient". This is completely misleading or false information. (1) How would member distinguish the difference when there is no explanation on the official website or benefit details' page? (2) How could members foresee massage therapy is not covered under "Massage Therapy(Outpatient)" when it's worded this way? I'm requesting bill adjustment for my 3 massage visits on Apr 7th, 16th and 23rd.

  Business Response

  Date: 06/01/2023

  See attached response

• Initial Complaint

  Date:03/27/2023

  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 am a health care provider with my own business. I have been contracted with Premera for about 15 years. Last March, I was asked by them to recredential on one health port which is a platform that they ask us to communicate all billing issues with. I did this on time, I have the proof (although it took me a month to get it from one health port). They state that since I didnt email them to let them know that I recredentialed on the platform that they asked me to recredential and they took away my providership. All my patients with premera I felt I could not charge for so I lost tons of income and the patients lost their continued care. I went to the Washington state commissioners office to make a formal complaint. I sent them my recredentialling proof. Premera stood by their lie that I didnt recredential in time even though the proof was presented to them. They put me through h*** asking me to recredential again and jump through all these hoops for nothing. They are conducting criminal activity at their clients and providers expenses. They do not believe in healthcare, they believe in ripping off everyone else. The Washington state commissioners office stated that there is nothing they can do. I am outraged that there is nothing to protect the public from these criminal cartells called insurance companies.

  Business Response

  Date: 05/08/2023

  See attached response

  Customer Answer

  Date: 05/08/2023

   
  Complaint: 19860741
  
  I am rejecting this response because: They sent me a letter saying that I never recredentialed in time which is not true from the document I provided to them, you and the Washington commissioners office.  The Washington ******************** stated on my last discussion with them, that there are basically no laws to protect providers or consumers from the criminal activities of the insurance companies.  I would love to see our systems hold these companies responsible for their lies and criminal activities to hold my payments and disregard the health care of their customers. 
  
  Sincerely,
  
  *****************************

• Initial Complaint

  Date:03/09/2023

  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.

  On October 17, 2022, I had a stroke. Through testing in the hospital and follow-*** with my cardiologist, neurologist, and hematologist it was discovered that I had a large Grade 5 ***. This large *** allowed a blood clot to pass through to my brain. My cardiologist and the cardiac specialist told me I needed a procedure to close the *** and Premera immediately denied it. My specialist asked for a peer-to-peer review, and immediately after it was denied. We appealed and submitted all medical records and notes from the onset of the stroke to now and it was immediately denied. Premera first denied the claim stating that I DID NOT HAVE A STROKE, then during the peer-to-peer, they claimed again I didnt have an actual stroke. When we appealed they changed their mind and are now saying that they believe I had a real stroke BUT I have a genetic mutation that causes clotting. Regardless of the reason for my clot, the *** IS THE REASON I had a stroke and it is the reason I WILL have another stroke if it is not closed. Both *****************, the neurologist, and Hematologist all agree I am at high risk until the *** is closed. If I have another stroke and it does not kill me I will be severely mentally and physically impaired. This *** closure is guaranteed to block any clots from entering my brain preventing another stroke from happening, regardless of what causes the clots. Any other course of action is NOT guaranteed and places me at high risk. It also guarantees that I will have to stay on life-altering medications that will negatively impact me for as long as I am alive. I have a large Grade 5 *** that 100% allows clots to enter my brain how can Premera deny this LIFE-SAVING PROCEDURE to close it? Every single one of my doctors says this is not only necessary but that it needs to be done immediately. Premera is making excuses so they do not have to pay the claim. This is effectively a DEATH SENTENCE for me or worse.

  Business Response

  Date: 03/30/2023

  Thank you for your inquiry received in our office on March 9, 2023. You have forwarded a complaint for our
  review and response.

  
  We are unable to provide any information about any person who is or may have been our member without
  proper authorization. We responded directly to the person who submitted the complaint to your office.
  

  Please note health benefit plans are not subject to review or oversight by the Better Business Bureau. We
  respectfully request that this complaint be removed against Premera Blue Cross of Washington.
  

  If you have any questions, please contact **************** at **************.
  

  Sincerely,
  

  ****************, Appeals Specialist
  Complaints and Appeals Department
  

  Customer Answer

  Date: 04/04/2023

   
  Complaint: 19563156
  
  I am rejecting this response because:

   

  You should NOT remove unfavorable information simply because the company doesn't like to hear the truth.  Premera's decision was ultimately overturned buy an independent review however only after weeks of stress and worry. Consumer's have a right to know that Premera lies in order to avoid paying claims until forced to comply.

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

• Initial Complaint

  Date:03/03/2023

  Type:Service or Repair Issues
  Status:

  UnresolvedMore 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 son (***********************) has been taking a specialty medication called "OralAir" that is on the list of covered medicines through my health insurance with Premera. He has been taking the medication for last 2 years and Premera has been covering it. Only CVS Specialty pharmacy carries this medication.Starting 2023, CVS Specialty is "out of network" for my Premera plan. None of the in-nertwork pharmacies carry this specialty medication. I have been on call daily for 2-3 hrs with Premera trying to have them provide an override for this medication. Every day they tell me something and don't follow up next day.My son has been without medication (which is covered) for last 10 days.

  Business Response

  Date: 03/31/2023

  Regarding: BBB Case Number 230660000068

  
  Dear Resolutions Specialist

  Thank you for your inquiry received in our office on March 6, 2023. You have forwarded a complaint for our review and
  response.
  

  We are unable to provide any information about any person who is or may have been our member without proper
  authorization. We responded directly to the person who submitted the complaint to your office.

  
  Please note health benefit plans are not subject to review or oversight by the Better Business Bureau. We respectfully
  request that this complaint be removed against Premera Blue Cross of Washington.

  
  If you have any questions, please contact **************** at ************.
  

  Sincerely,
  ******************, Appeals Specialist
  Complaint and Appeals Department
  

  Customer Answer

  Date: 04/04/2023

   
  Complaint: 19536118
  
  I am rejecting this response because:

  I have spent countless hours with multiple departments and employees at Premera. While Premera assigned a single person of contact with a direct number for me to reach out to, the issue has still not been resolved. They sent me a 30 day supply of the medication, and my son went without medication for 2 weeks and had some related health issues.

  The complaint is still valid and final resolution of the issue of not allowing a pharmacy to refill an approved medication under the plan is still true.
  
  Sincerely,
  
  *************************

• Initial Complaint

  Date:02/15/2023

  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.

  Premera retroactively uncovered several of my prenatal appointments/lab tests, etc, some which are over a year old, without telling me why. They also retroactively uncovered my newborn sons coverage of his birth and medical appointments stating that they had accidentally billed it like the deductible had been met and it hadn't at the time of previous billing, although now it has for sure been met.Unfortunately, I already been billed and paid off what they originally sent which they do not take into account when working with the provider, so you get charged for things you already paid. When I try to contact them regarding my own account, I was on hold for nearly two hours each day I tried to contact them with no avail. I have filed a complaint with the insurance commissioner as well and will not remove this until they adjust the balance and refund what I have already spent.

  Business Response

  Date: 03/28/2023

  
  Thank you for your inquiry received in our office on February 27, 2023. You have forwarded a complaint for our review
  and response.

  
  We are unable to provide any information about any person who is or may have been our member without proper
  authorization. We responded directly to the person who submitted the complaint to your office.

  
  Please note health benefit plans are not subject to review or oversight by the Better Business Bureau. We respectfully
  request that this complaint be removed against Prem *** Blue Cross of Washington.

  
  If you have any questions, please contact **************** at ************ .
  

  Sincerely,
  

  ******************
  Complaint and Appeals Department
  

• Initial Complaint

  Date:02/14/2023

  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.

  This company is taking premiums from my deceased mothers account. They do not answer the phone ever. I waited on hold a total of three hours over a two day period. I have to close an account that is 70 years old just to keep them from stealing from a dead woman's account.

  Business Response

  Date: 03/27/2023

  Please see attached. 

• Initial Complaint

  Date:02/02/2023

  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 am a medical billing specialist. My job often involves contacting insurance companies to resolve claims. Premera's hold times to call customer service is over 2 hours long. This is absolutely ridiculous. They need to be held to a higher standard.

  Business Response

  Date: 02/28/2023

  Dear Resolutions Specialist:
  

  Thank you for your inquiry received in our office on February 2, 2023. You have forwarded a complaint for our review
  

  and response.
  

  We are unable to provide any information about any person who is or may have been our member without proper
  authorization. We responded directly to the person who submitted the complaint to your office.
  

  Please note health benefit plans are not subject to review or oversight by the Better Business Bureau. We respectfully
  request that this complaint be removed against Premera Blue Cross (Premera).
  

  If you have any questions, please contact **************** at ***************.
  

  Sincerely,
  

  ****************, Appeals Specialist
  Complaints and Appeals Department
  Enclosures
  
  

• Initial Complaint

  Date:01/19/2023

  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.

  Premera retroactively uncovered several of my physical therapy sessions without telling me why, then when i call them at 9 am they leave me on hold for upwards of hours. They also have the worst hold music, that im convinced is solely there to make me frustrated and hang up so they dont have to talk to me. I have a chronic medical condition that requires physical therapy, or surgery, but premera will not cover either the surgery if I dont commit to other forms of help. I will never remove this complaint until they turn the terrible hold music off/give the option to, because if youre going to leave people on hold for hours atleast give them the option not to hear the same s***** quality song over and over for hours.

  Business Response

  Date: 02/06/2023

  Regarding: BBB Case Number 18839961

  
  Dear Resolutions Specialist:

  Thank you for your inquiry received in our office on January 20, 2023. You have forwarded a complaint for our review
  and response.
  

  We are unable to provide any information about any person who is or may have been our member without proper
  authorization. We responded directly to the person who submitted the complaint to your office.
  

  Please note health benefit plans are not subject to review or oversight by the Better Business Bureau. We respectfully
  request that this complaint be removed against Premera Blue Cross of Washington.
  

  If you have any questions, please contact **************** at ************.
  

  Sincerely,
  

  ******************
  Complaint and Appeals Department

  Customer Answer

  Date: 02/06/2023

   
  Complaint: 18839961
  
  I am rejecting this response because: i was on hold for too long. Fix your phone hold. I was on hold on for super long and then got no information. 
  
  Sincerely,
  
  *************************

  Business Response

  Date: 03/08/2023

  Please see attached 

• Initial Complaint

  Date:01/07/2023

  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.

  I've been covered by Lifewise (Premera affliate, I believe) since March 2022. In that time, I had my coverage dropped for no fault of my own, and without my knowledge. I continued to receive health care, and this was (finally resolved) and my healthcare was retroactively reinstated. In the meantime, however, I received many letters from providers attempting to collect payment for my visits, tests. etc. Now that Lifewise is on the hook to pay these providers for services I received, they have magically materialized some secondary insurance plan (******) that I supposedly have in addition to theirs -- which I NEVER signed up for. I found out about this randomly on 1/3/2023, when I called due to the pile of EOBs I received stating Amount Paid by Health Plan = $0.THIS. IS. FRAUD.In all of the MANY times I've been on the phone with Lifewise, this is -- suspiciously -- the first time any secondary plan was ever mentioned to me. In January!What am I paying my insurance premium for? They have now denied all my claims for 2022, and are stating they are paying $0. They're now "questioning eligibility" because of this supposed 2nd insurance, under someone's name I don't even recognize.This is completely fraudulent. I continue to get bills from 3/29/2022, even on up to 12/22/2022, adding up to thousands of dollars for very basic visits that my plan with Lifewise SHOULD COVER. The last visit dated 12/22/2022 was a simple ER visit, which should have cost me a copay and nothing more. Yet, here I am, with a bill for over $1000 for it. This is as good as having ZERO insurance. Lifewise needs to get rid of this secondary ****** insurance, go back through ALL claims for 2022, and re-adjust what I owe to reflect the correct coverage. I should owe a deductible of $750, then copays for visits, and nothing more.

  Business Response

  Date: 02/06/2023

  Regarding: BBB Case Number 18702710

  
  Dear Resolutions Specialist
  

  We have reviewed your request
  

  Thank you for your inquiry received in our office on January 7, 2023. You have forwarded a complaint
  for our review and response.
  

  We are unable to provide any information about any person who is or may have been our member
  without proper authorization. We responded directly to the person who submitted the complaint to your
  office.
  

  Please note health benefit plans are not subject to review or oversight by the Better Business Bureau.

  We respectfully request that this complaint be removed against LifeWise Health Plan of Washington.

  If you have any questions, please contact **************** at **************.
  

  Sincerely,
  

  ****************, Appeals Specialist
  

  Complaints and Appeals Department
  Enclosures

  Customer Answer

  Date: 02/15/2023

   
  Complaint: 18702710
  
  I am rejecting this response because: Lifewise doesn't get to hide behind HIPAA on this one. All they had to do was ask me for a release of information -- very simple. I have a legitimate complaint spanning almost the entirety of 2022 that has yet to be resolved in any way.

  Consumers such as myself have to have an avenue to get these complaints resolved -- otherwise these huge bureaucratic entities (with TONS of control over people's lives) have no oversight.

  NO other kind of provider gets to say "I'm sorry oversight agency, I don't have any authorization on file to speak with you about this customer's complaint, so therefore it's not correct and needs to be removed." This is illogical, and is just an attempt by Lifewise to delegitimize my complaint. 

  This insurance company has made the last year of my life an unmitigated disaster of bills upon bills upon bills. Damage has been done to MY credit, through NO fault of my own. And they have a responsibility to ANSWER MY COMPLAINT in a reasonable way.  

  Sincerely,

  
  *********************