Blue Cross Blue Shield Health Insurance Company
Blue Cross Blue Shield Health Insurance Company (BCBS) is one of the leading health insurance providers in the world. Over 70 years old and made up of 39 companies within itself, BCBS provides health insurance to over 100 million people. In the United States it is the largest health care company and provides insurance in all 50 states.
BCBS is represented in the U.S. as well as 170 countries worldwide making it the ideal insurance for travelers. The company offers coverage for large companies, small businesses, and individuals. More physicians and hospitals contract with BCBS then any other insurance provider in the world. With one out of every three insured Americans getting their coverage from BCBS, it is important to know what type of coverage is offered so you can decide if Blue Cross Blue Shield is right for you.
BCBS offers seven types of coverage in the U.S. They are Flexible Spending Account, Health Maintenance Organization, Health Savings Account, Health Reimbursement Arrangement, Indemnity and Traditional Coverage, Point-of-Service, and Preferred Provider Organization. Knowing a little bit about each type of coverage can help you choice which plan is right for you.
Blue Cross Blue Shield Flexible Spending Accounts (FSA)
Flexible spending accounts make it possible for qualifying members to use money before taxes are taken out in order to pay for specific medical situations. The money comes directly out of the member’s paycheck before taxes. The amount deposited is decided upon by the member. Money in a FSA can also be used for certain expenses involved with dependent care.
What BCBS does is to manage or administrate your FSA through their Blue Healthcare Bank. They manage the money deposited, help with withdraws, answer any questions that arise, advise members on eligibility and suggested amounts. This is one way to save some tax money while getting the coverage you need.
Blue Cross Blue Shield Health Maintenance Organization (HMO)
A health maintenance organization is run and administrated more like a business then a health care system. HMO’s offer comprehensive medical coverage to members. In return, members pay a monthly fee or premium to the HMO. There are coverage rules associated with HMO’s, so if you go this route, be sure to understand what the rules are and how they work.
For example, HMO’s will generally require you to see doctors in a specific geographical region or within a specific network. There are co-pays associated with HMO coverage that must be paid in order for medial services to be provided.
Blue Cross Blue Shield Health Savings Accounts (HSA)
Health Savings Accounts were approved and signed into law by President Bush in 2003. They allow individuals to save money in an account that is tax free and has advantages. The money can only be withdrawn and used for medically qualifying expenses. A health savings account is generally used along with another type of coverage such as high deductible coverage. Money can then be withdrawn from a health savings account to pay the deductible and other qualified medical expenses.
Contributions to health savings accounts can be made by individuals, by an employer, or by another person on behalf of the contributing individual. All money contributed is tax-free. Amounts that can be contributed annually change each year as they are reviewed by the US Treasury Department.
Blue Cross Blue Shield Health Reimbursement Arrangements (HRA)
A health reimbursement arrangement is set up by an employer. A predetermined amount of money is reimbursed to the employee from the employer for eligible medical situations. These situations can be for the individual employee or the employee’s family. Some eligible situations are prescriptions, co-pays, deductibles, and other out-of-pocket medical expenses.
This type of plan is usually set up by an employer who can not offer full health insurance coverage, yet still wants to provide some time of medical benefit for employees. BCBS manages this program much like it manages a FSA providing customer service, billing, withdrawal and deposit services, and answers any questions the employer or employee may have.
Blue Cross Blue Shield Indemnity and Traditional Coverage
Indemnity and traditional coverage is what most Americans think of when they hear the term “health insurance”. It is comprehensive coverage offered by an insurance company in exchange for a monthly premium. This type of coverage gives most of the control to the insured. It allows the insured to decide on providers, hospitals, clinics, specialists, and pharmacies without forcing them to work within a network.
Over 13 million people receive this type of coverage through BCBS. Although members are given freedom of choice, there are some incentives offered for choosing a BCBS provider such as reduced billing costs and faster appointment times with specialist. Indemnity and traditional coverage is the most asked for and sought after coverage by employees.
Blue Cross Blue Shield Point of Service (POS)
Point of service coverage gives members the freedom to decide on what medical services they need and then to decide if they will see a provider within the network or outside of the network. Over 4 million people receive POS coverage from Blue Cross Blue Shield.
When covered by a POS plan, everything works best when the insured chooses a preferred provider within the network as their Primary Care Physician (PCP). Then all medical needs, questions, prescriptions, and care can go through the PCP. If the need for a specialist arises, the PCP can refer the patient to any doctor within the network or outside of the network. If the insured does not go through these channels, coverage may cost more.
A POS is managed similarly to an HMO plan but gives the insured a little more freedom of choice. Whereas with an HMO the insured does not have the option of any coverage outside the network, a POS offers some type of coverage outside the network when the correct procedure is followed.
Blue Cross Blue Shield Preferred Provider Organization
A preferred provider organization (PPO) offers low cost health care to members who use health care providers that have contracted with the PPO for lower prices. This works well for providers because they know that patients will be coming their way. This works well for patients because they have a large group of qualified providers to choose from who want their business.
Over 65 million people are covered by a BCBS PPO. For members who like freedom to choose any doctor, hospital, clinic, or lab, a PPO may be too restrictive. But if you are looking for quality coverage at a reduced price, a PPO is a good choice.
Compare Blue Cross Blue Shield Health Insurance Quotes
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26 Comments to “Blue Cross Blue Shield Health Insurance Company”
Iâ€™ve had Blue Cross for 5 years, and Iâ€™ve only had one problem. They promptly took care of it for me, and their customer support was excellent. Theyâ€™ve been great for me and my family.
I have used Blue Cross Blue Shield for several years and have never had a bad experience. They have great customer service and are very reliable.
I have used Blue Cross Blue Shield for a few years and have been pleased with the availability of networks and satisfied with the plans and feasible co-payment cost. Overall, I have been pleased with the quality of service from this insurance provider.
They lose payments and deny claims even though I have proof I paid. The worst company ever, ghetto people work there, takes weeks to get a live voice.
This should be ranked as the worst insurance company. They lose payments and even after providing them proof, they deny claims. I am seeking legal action against them.
“This insurer pays medical providers so little that doctors treat members like they’re free-clinic patients.
Meanwhile Blue Cross gets $1,000 monthly now, $1,700 in 2011, in premiums.
Just what people need: to pay outrageous amounts to Blue Cross, and be treated like dirt by doctors because the payment is too low.”
“I truly hope that this message makes it to at least one person who is considering purchasing BCBS health insurance. If I can help one person avoid the headaches that have resulted from dealing with this company, it will be worth the time I took to submit this review.
BCBS is a deceptive, dishonest, manipulative company that couldn’t care less about members’ healthcare as long as they collect the premium each month. They will raise your premium and simultaneously deny more and more of the claims that they are responsible to pay. You will pay unbelievable premiums each month, and most of the claims (be it routine office visits or prescriptions) will be denied.
Trying to reach customer service is almost impossible and, when you do, you will be given a vague and nonsensical answer with no resolution. You will be left with a simple response…””no exception.”” Take my word – if you are considering BCBS as your health insurance carrier, reconsider.”
“Recently forced to transfer from BCBS to UHC (company changed)and I regret the few times I ever complained about BlueCross!! Compared to UHC, they were wonderful! Both have drawbacks but BlueCross seems to have better coverage of meds.
For example, I only paid $35/month for Lexapro and there was not a quantity limit (I was on 30mg or #45 tablets per month). With UHC, I not only have a $75 copay on it (which would be fine if I could fill it at MY pharmacy), but have to order a 3-month supply at a [email protected] $225 through MEDCOs mail order pharmacy and the max dosage they will cover is 20mg.
The only 2 complaints I have with BCBS is they had a bit too many prior authorizations required and DO NOT respond to them in a timely manner. And they do not cover compounded prescriptions (though UHC/MEDCO will try to find anything on the paperwork they can to reject your claim). With BCBS, the fact that the benefits and pharmacy plans are run by the same company seems to make a difference because, with UHC, there is no point in calling them if it has anything to do with Rxs…. you have to call Medco.
BCBS covers more providers, especially in the mental health field. I miss them and will hopefully be getting back on soon with a new job (as of now, I am on my dad’s policy). I see a LOT of negative reviews and I am not sure what type of plan they have. This is a PPO group plan. I never had any problems with them paying. I also don’t have to fill paperwork for them to pay so I am guessing different type of plan?”
“I am a small business owner and was cancelled by Horizon due to a paperwork issue. The policy was cancelled without notice or explanation. When I called to find out what happened they could not give me a reason other than “”compliance””.
It took a week to find out they canceled for a payroll form that my company does not use and did not submit for the past 6 years but now they want it. They will not re-instate now until I have been off the plan for 12 months. Sorry, I won’t be back.”
Crappy health insurance company
“They frequently lose payments. I’ve been canceled twice because of payments that cleared from my bank but never showed up in their system. During one such instance, I was told that my cancellation notice was auto generated and went out the door before they had a chance to catch it.
They then proceeded to deny coverage for a dental check-up on the basis that I was canceled. I’ve asked for a payment history multiple times to prove to them that they lost my payments. They always say it will arrive in 5-10 business days, but never does.
This company is a complete waste of time and money.”
“I was injured when a strong breeze blew the car door closed on my index finger. At the emergency room the medical staff took an X-ray, applied some super glue to the nail to attach it back to my finger, wrapped some gauze over the injury and sent us a bill for $3,500.
Blue Cross would not cover the cost stating this was an auto accident and that my auto insurance company would cover the first $2,000.
I tried to open a discussion with the Blue Cross representative at the Third Party Liability Department. I felt that this was not a car accident, and suspected my auto insurance company would agree, but at Blue Cross they’re obviously trained to just keep repeating “”no””.”
“I was rejected for insurance. I was on the phone with them and asked them why, but all they would tell me is to wait for the letter in the mail. I finally got the letter in the mail and it said, “”Unfortunately, our current underwriting guidelines prohibit us from offering coverage to any applicant who is currently a professional rodeo performer in the state of Texas.””
NEWS FLASH: I’m unemployed and a nursing student.
I called them and told them that I have no idea where they got that information. The lady on the phone put me on hold for a while to look through my application and doesn’t know what happened. No one even knows what clown wrote this letter. Apparently, all I can do is fax them an appeal stating my case: that I’m unemployed and a nursing student, NOT A FREAKING RODEO PERFORMER. It could take 60 days for them to make a decision.
I decided not to do it because first of all, I don’t have 60 days. Second of all, IF they accept me after the appeal, who knows what other kind of bullcrap they mess up. If I end up in the hospital with a broken leg, they could charge me for TWO broken legs. Screw this company.”
“How can anyone leave this company a good review? Trust me, keep them long enough and “”it”” will happen to you too. They have pre-certified a surgery for me in the past only to renege afterwards, leaving me with thousands of dollars of medical bills to pay.
Now they have denied my back surgery after I broke my back and pelvis. Several surgeons agreed it was necessary to alleviate my pain and help the bones heal due to my advanced osteoporosis but in its wisdom (and greed) BCBS denied both the surgery and my appeal. While they pay well for drugs, everyone better hope and pray nothing worse than a need for meds ever happens to you as long as you are covered by BCBS!”
“I have never been so frustrated or felt so helpless in my life!!!!
I am insured through my employer in another state and therefore am constantly filing out-of-network claims. My local BCBS office that processes our claims has an internal code that is similar to the first three letters of my account ID so my claims get sent down some rat-hole and my insurer never sees the claim.
I am out hundreds if not thousands in expenses that were never accounted for as deductible expenses. When I go onto my insurers website (where I’m supposed to be able to view all expenses and transactions), moving from page to page takes upwards of a minute … insanely slow. When I try to view an itemized accounting of expenses, I have to view each family member and dependent account individually and my pharmacy charges are managed by a completely different organization and website.
So, there’s no way to see how my annual deductible is computed nor account for all of my expenses. It’s no wonder that our country’s health care expenses are growing so fast. The people accounting for and inducing costs don’t know what the hell they’re doing and we (and our doctors) can’t do anything about it. Incompetence galore!!!!!!!!!!”
“I Love Blue Cross Blue Shield and have had them for many years. Any time I have ever had any problems, all I had to do was pick up the phone and received great customer service.
Sometimes it was just that I didn’t understand what my benefits were, but when I talked to them, they explained everything to me. Never once did I feel like they were being unreasonable or in any way deceptive.
Wouldn’t want any other company.”
Agree, Blue Cross offers great customer service. One of the best advantages of having Blue Cross and Blue Shield of North Carolina as your insurance provider is the wide range of options you have at your disposal as a patient. Altmann & Porter Insurance can help you choose from a myriad of the health plans the Blue Cross and Blue Shield of North CarolinaÂ®, both medical and dental.
“I have had BCBS for over 14 years. The company I work for asked us to change to another carrier a couple years ago and it was terrible. We have been back on BCBS but again are being asked to switch to HAP for a cost saving measure.
I am very concerned as are my co-workers because, while Blue Cross may not be perfect, it has been the best company for my family. I have peace of mind with this company that my family will be well taken care of and if I travel we are still covered. This was not the case with our other insurance.
I know that Blue Cross is more money, but I have always felt that at least I have good coverage for that money, unlike other companies that are cheaper yet deny coverage all the time.
After reading the HAP reviews and then Blue Cross reviews, I am sure I do NOT want to switch. I will keep Blue Cross if I have the option.”
“Unacceptable costumer service. Had my 2-year son listed as a 22 yr old!
I’ve been paying everything out of pocket – all medical expenses and no reimbursement!”
“I signed up with Blue Shield Network last year during the ACA time period and also qualified for a government subsidy. I selected a Bronze plan that the subsidy covered without any out of pocket expenses. I was relieved because I hadn’t sought healthcare since 1999.
This year, I have just received my premium for 2015 and it has gone up 17%. I spent three hours on the phone looking for an answer to why the premium increased so much. During the summer it was common news that insurance premiums would be increasing in the state of Michigan and it was thought that BCBS would increase on average 9.3 or 9.7%.
You can see why I was a little surprised by 17%. In the very least I wanted an explanation as to why the double-digit increase since nothing else had changed that precipitated the increase.
I was bounced back and forth several times for 2.5 hours, speaking to several representatives in different departments and no one could give me a reason outside of general thoughts and variables like age, county, income, inflation that may have triggered the increase. I still haven’t an answer and was never connected to anyone that could explain why with any authority or knowledge. Very very disappointing.
It feels very random and a very unexpected and unpleasant. Perhaps the industry needs some regulation that limits annual increases to reasonable percents based on inflation, age etc.”
“My family has had BCBS for many years and have been pretty satisfied until this year. Now they deny new prescriptions and surgeries.
With the RX they tell the doctor what medication to prescribe to their patients. With surgery, they tell the surgeon the surgery is not medically necessary, even though there is a screw puncturing a nerve that paralyzed the shoulder.
I guess BCBS think they are physicians now.”
“Many people don’t understand how Blue Cross is structured. It’s not a giant insurance company based in Chicago. It’s a group of franchisees who pay to sell health ins. as BCBS. Each state has a different franchise.
If you have BCBS in your state and travel to another state and require medical services it should be covered. If you move from your state and establish permanent residency in another state you have to convert your BCBS to that state.
Not a problem if you’re healthy. If you have anything that could be considered pre-existing even though you already have BCBS they can deny you coverage. You would be allowed to keep the coverage from your former state but at twice the price.”
“I had Blue Cross Blue Shield of North Carolina until this past January when the company I work for changed providers.
I just received a doctor invoice from July 2014, when I was still covered by Blue Cross Blue Shield, they now refuse to pay the 80% of that invoice that they are supposed to pay according to the benefits plan. They expect me to pay the total invoice.
They paid the percentage until they were collecting my money on the weekly basis, now that that stopped they decided not to pay their part.
If you have a choice DO NOT CHOSE THIS COMPANY!!!!!”
“Most of these reviews are unhelpful because they do not specify the state for which they are reviewing. BCBS is like a franchise, there are completely different owners and operators from state to state.
Thus, all the one-star reviews above may be from a certain handful of states, while all the five stars could be from a completely different handful of states.
In Virginia, Anthem BCBC seems about so-so. They often make mistakes, and usually, only catch the mistakes that require you to pay more money. Enough haggling and persistence on the phone usually solves the problem. But, many of their operators are more ignorant of their own company than they are helpful.
That said, if you pay the premiums on time, be sure to instate maternity coverage six months before you get pregnant, and stay in network, your health care will (eventually) get paid for.
We just moved to Tennessee, however, and I wish some of these reviews specified whether they were apropos of BCBC Tennessee.”
We signed up with Blue Shield specifically to use UC Davis Health Care in Sacramento, CA. UC Davis’ website says they take Blue Shield. Looked initially at Covered Cali and found the same plan on Blue Shield’s website for cheaper. Did not realize that Blue Shield Trio was completely different than other Blue Shield plans. In Sacramento, CA, the only providers you can use are with Hills Physicians Group (HMO), which is primarily out of the San Fran Bay Area; way too far to travel to see a PCP. If we had known this upfront, we would have NEVER signed up for it, especially for $800+ month, just for my husband. When his card came, they had automatically given him a PCP in another town about a 30-40 min drive from our home, one way. WTH?? Well, when I looked for him to find a PCP near us, there were like 2 accepting patients, and one doctor had the worst reviews on Health Grades, with only 2 stars— reviewers said he was only there for the cash. My husband has been to his Dr.(the other one accepting patients) 4 times since January, to get some work done from when he was uninsured prior, and he has NEVER seen his new Dr. Only PA’s. He was given a referral for a sleep study and the ONLY company (Virtuox) Hill Physicians would allow him to use, ripped him off, never did seek an approval, lied to his face and told him he was denied an approval, and did a bunch of other shady, shady stuff, including sending “results” to the Dr., when the machine never worked. There has been an investigation into them. Now, he is referred to a medical device place to get a C-PAP, and guess what? Hills Physician only has 1 in the area they consider “in network” and they also have a 2 star rating and horrible reviews on Yelp about ripping people off. Great. It’s been nearly 3 months since this whole fiasco started, and he still does not have a C-pap. If we had not paid Blue Shield the exorbitant monthly premiums, we could afford to just go out and buy a C-pap, and not waste our time with any of this BS. Definitely run, run, run far away from Blue Shield Trio. We are paying for the platinum level too, I can’t fathom how horrible the lesser plans must be. Highway robbery, it is indeed. Just sad.
One thing that I really like about Blue Cross is that they have great customer service.