Anonymous
map-marker Milan, Milan

Addiction treatment support

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full
Im disappointed and sad blue cross doesnt cover Sublocade Evidence based treatment for opioid use disorder Once month injection improves opportunity for long term recovery and reduces all cause mortality by 50 % Prevents diversion,less damage to dentition and ensures patient receives medication. Please give us all the tools available to treat this disorder.It kills over 100 k per year and WV leads the nation in OD deaths per capita.
View full review

User's recommendation: Ask for treatment

Denell Dtb
map-marker Parkersburg, West Virginia

Customer Service Runaround from BCBS West Virginia

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full
Updated by user Apr 04, 2017

They are terrible at dealing with appeals. Customer service staff is either purposely trained to frustrate you or woefully under-trained.

Original review Apr 03, 2017
I had to fill 2 prescriptions before they were out b/c my son was traveling somewhat unexpectedly. I paid full price and then called them the next day. I was told to submit a reimbursement request to Express Scripts, they would reject it and then I would get instructions to appeal. 1. 1st letter from Express Scripts gives me no option to appeal except contacting their Civil Rights Coordinator 2. Civil Right Coordinator is dismayed that there were no appeal instructions and promises to resolve by talking to Customer Service 3. 2nd letter from Express Scripts has a Q&A, where it says to call the number on the back of your card to appeal (not making this up) 4. Call number on back of card on a Friday, 2.5 hrs later and after speaking with 4 different people from BCBS in addition to 2 different people from Express Scripts, I am told I must speak with Appeals Dept at BCBS, which is closed. 5. Last BCBS person tells me he'll call me at 9:30a on Monday. 6. At 12:30p on Monday, I initiate the call as no call came at 9:30a. 7. 2.5 hrs later, after speaking with 3 different people from BCBS (only 1 was from the Friday group) and 3 different people from Express Scripts (all different people from Friday), I am told that I must submit the appeal in writing. It is important to keep in mind that EACH TIME you talk to a different person, they are asking for DOB, Address, and call back number for security purposes. This only adds to the frustration. They all ask if it is OK to leave a message as well. I will find someone in that organization to hear this story as I feel abused.
View full review
Loss:
$770
Reason of review:
Poor customer service

Preferred solution: Let the company propose a solution

Anonymous
map-marker Davis, West Virginia

Therapy Coverage Review

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full
my 82 year old mother after having Blue Cross for 50 years broke her hip and the hospital could only put her in a nursing home for one month because Blue Cross will not pay for any more time in therapy or nursing care.they sent her home with an open wound in her hip and only three weeks of therapy to walk on a broken hip
View full review
Reason of review:
Not as described/ advertised
Anonymous
map-marker Martinsburg, West Virginia

DONT DO IT! CALL YOUR STATES ATTORNEY!!!

stars-rating-full stars-rating-full stars-rating-full stars-rating-full stars-rating-full
I have had BCBS since feb. I received a letter in the mail saying I had to pay 80.52 or my insurance would be canceled. So I did. I also paid some money on the current months premium as well. I owed less than one months premium, and they canceled the insurance. When I called and spoke to three different managers, no one was willing to help me. Less than 30 days before they dropped me, I was given a possible diagnoses of breast cancer and melanoma. NO ONE at the company cared. We had also just met out family deductible as well. Whatever you do, don't do it.
View full review
Loss:
$10000

Preferred solution: Let the company propose a solution

1 comment
Guest

Yes agree call another insurance company. Sorry they gave you so much trouble don't let them eat up your positive energy.

Anonymous
map-marker Gate City, Virginia

Bluecross Blueshield of west virgina

My husband and I a need proof of insurance certificate to give to my insurance company before having surgery. We have waited a month for the certificate to arrive and then when we received it, the letter had only my daughter's name on it. A large company like this should have competent individuals doing their job. We pay a lot of money for health insurance and should receive excellent customer service. I work in an Oncology office and I see first hand how insurance companies effect our patients and it is ashamed that an incompetent individual in an insurance office can make their lives miserable. I say do YOUR *** JOB. To the companies that keep letting these individuals work for them, grow some balls and fire them when you know they are worthless. Quit paying for them to be ***, taking smoke breaks, and coffee breaks. I have to make another phone call to wait on another frickin letter when they didn't do their job the first time.
View full review
1 comment
Guest

This is supposed to be one of the best ones? Then we're in deep trouble people!

Two years ago, BCBS approved a surgery, then afterwards reneged - now I owe thousands of dollars to the hospital and surgeons (read their "disclaimer" about pre-certification and beware). Three months ago I broke my back and pelvis. The doctor wanted to perform immediate surgery to relieve the pain and help the vertebrae heal because I have severe osteoparosis. The night before surgery, the insurance company called and denied the pre-certification.

I appealed and they denied the appeal. I am still in a back brace and in severe and constant pain. Shame on you, BCBS!

I've been paying your premiums for 23 years and this is what I get? Beware, beware, beware!

Insurance Expert Talks

Exposed: Types of Insurance Scams and Fails

Mar 7, 2021

The insurance fraud: What is insurance fraud? What are the worst cases? How insurance fraud is discovered? How to protect yourself from an insurance scam? In this video, Charles R. Gallagher, an attorney, exposes the most common insurance fraud examples.

Read full article
Charles
Charles

Charles R. Gallagher, an attorney and managing partner with Gallagher & Associates. His practice focuses on insurance litigation, foreclosure defense and consumer law.

Brands Related to Highmark Blue Cross And Blue Shield Of West Virginia

Why Trust Reviews on PissedConsumer?

  • Professional auto and live moderation
  • 100% user-generated content
  • Equal opportunity and protection
  • Zero tolerance for fake reviews
  • Verified content
  • PissedConsumer is on the Inc. 5000 list

For more information read Blog article