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Review fromSedrick C
Date: 07/31/2025
1 starI was supposed to have a procedure done for varicose veins months ago and still haven't had it done. When the doctor did a pre certification, blue cross denied it twice claiming that the procedure is not medically necessary. He then appealed it, and they still denied it as well. I am still beyond angry and it's not right at all and I'm way beyond depressed and want to go back to work so bad. Why put people through this frustration blue cross?
Blue Cross And Blue Shield Of Alabama
Date: 08/01/2025
August 1, 2025 Mr. ******* X** X** Name of Patient:Mr. ******* Contract Number:BEG888888888 Complaint Number: ***** ******************* are responding to your complaint to the Better Business Bureau concerning surgery for varicose veins. Based on our research, the requested procedure was denied due to your submitted medical records show that you have a contraindication. In medicine, this is a condition that serves as a reason not to take a certain medical treatment due to the harm that it may cause. It has been reviewed twice by two different physicians and the denial has been upheld based on this contraindication in your records. We regret any hardship this has caused. **************************Review fromKelly C
Date: 04/14/2025
1 starMy husband was suppose to have a life saving surgery last week. We have waited for this appointment with a surgeon and surgery date for a month. Seen doctor on Tuesday, doc says I can do it on Thursday. Approval is sent expedited to insurance BCBS of Alabama. He has been unable to work for a month. Pre -op is done we are ready, Wednesday night we get a call from the surgeon nurse that she has called BCBS of Alabama several times that day with an expedited request for surgery approval and no answers. Now the nurse reviewer at the insurance company that has my husbands file is gone for the day and we have to cancel surgery. This is unacceptable!!!!!He needs HEART surgery. No it was not an emergency but it was expedited. To tell me they processed in the order they are received is unacceptable. Their should be an order. Vital organ importance, surgery date importance, etc. When the nurse finally looked at his case it was approved within an hour the next day. This should have been taken care of on last Wednesday not the day of his surgery. Now we sit here and wait another week. Had this been a their family member it would have. When you work in the healthcare industry you need to look at each case as if it were your family and how would you want that person taken care of. I hope BCBS of Alabama will do better.I don't want to hear the approval was sent in a short amount of time because many approvals are sent with a short notice that is why it was expedited.Blue Cross And Blue Shield Of Alabama
Date: 04/17/2025
April 17, 2025 Mrs. ******** X** X** Name of Patient:Mr. ******** Contract Number:COP888888888 Complaint Number: ***** ********************* are responding to your complaint concerning your husbands surgery.Based on our review, we received the request for a precertification on April 8, 2025. The information submitted contained an unlisted procedure code, which caused us to have to request additional information. We spoke with ****** at the providers office on April 10, 2025. She explained that the unlisted procedure code was what they planned to use based on what they were doing. She also stated that the surgery had been rescheduled and she would provide us with the new scheduled date. She called on April 15, 2025, and advised the surgery had been rescheduled for April 16, 2025. Certification was given under certification number **********. We attempted to call the member to advise of the approval, but no one answered and the mailbox was full. We appreciate the opportunity to respond, and we hope this addresses your concerns. **************************Review fromGregg R
Date: 04/02/2025
1 starI'd give BCBS Alabama no stars if I could, as stated by others they deny coverage that a doctor orders, deny claims, don't show all your claims on their website, and don't credit out of pocket expenses properly against deductible nor max out of pocket. They are rated the worst for denials.Review fromDarrell B
Date: 03/18/2025
1 starWARNING!!! ?? CHECK VERY CLOSE TO YOUR BCBS OUT POCKET COSTS! You have been warned! BCBS OF ALABAMA DONT CARE if people stay ALIVE. BCBS of Alabama is illegally using funds from my co-pay card from a drug manufacturer, but not applying it to the patients deductibles. This is blatant fraud! This is also price gouging. Double charging!THIS IS DISCRIMINATION AGAINST PEOPLE WITH RARE BLEEDING DISORDERS!My wife, ******, has a very rare bleeding disorder FXIII (13) takes the drug Tretten a Tier 5 drug. This cost of this drug is $57,000 per month. There are only two drugs that treat her condition and they are both this expensive. This is a lifesaving drug. She had a brain bleed in 2005 and was only given a 10% chance of survival. Since 2020 we had zero issues with getting this drug and the copay card being applied to our deductible. This year, 2025, BCBS of Alabama changed without our knowledge, requiring that a speciality drug have a $3700 deductible and 25% co-insurance of the $57,000 drug. We cant afford this. NOVO the manufacturer of the drug gave us a co-pay card of $12,000 to apply to our out of pocket cost and deductibles but each month BCBS of Alabama is getting the funds from the co-pay assistance card but NOT applying it to our deductibles. Your attention to this matter is urgent as we have been on the phone with BCBS of Alabama for two weeks, the speciality pharmacy and her medical team at ********** in *********, Tn. with no resolution!! This is very urgent and is life threatening!PLEASE urge you Alabama politicians to support H.R. 830/S.1375 This Bill was Introduced in the House 2/06/2023 HELP ENSURE LOWER PATIENT COPAYS ACT OR THE HELP ACT!Thank you! Trying to stay alive in Alabama **************** *****Review fromAmir K
Date: 01/31/2025
1 starThis insurance is not good if you end up needing anything more than a routine doctor's visit. It's ok for in-network doctor visits and prescriptions. But if the doctors recommends a procedure as the case was for me they become substandard. My doctor recommended a procedure and sent them a request for a "Pre-Authorization" as they normally do. After a few months the response from the insurance was neither a YES or a NO. The response was if the procedure is necessary I should go ahead and follow my doctor's advice. Once they get the bill from the doctor then the insurance will evaluate whether it's covered or not!So they really don't have a "Pre-Authorization" process but rather a "Post-Authorization" process!At least this was the case for me. Since my procedure was not of an emergency type (luckily), I waited and had it done the following year using a reputable insurance.Blue Cross And Blue Shield Of Alabama
Date: 02/03/2025
February 3, 2025 Mr. ********* X** X** Name of Subscriber: ********************** Number: PPA888888888 BBB Case Number: ***** ********************* are responding to your complaint concerning prior approval/predetermination. Due to the vast amount of request, we receive on a daily basis, we cannot review every member's procedure prior to it being done. Certain procedures do require a predetermination be done prior to the service, while most do not. In cases where a predetermination is not required, Blue Cross and Blue Shield of Alabama provides available resources to check coverage ahead of a procedure being rendered. Our medical policy is available online for providers to review to see if their patient meets the criteria for coverage. Providers also have access to a member's benefits online. You can also obtain the Current Procedure Terminology (CPT) code and diagnosis codes from your provider and call our *************************** and check eligibility.We regret any hardship this may have caused. Sincerely, ****************Review fromBrianna W
Date: 01/09/2025
5 starsI want to give huge appreciation to ***** with Blue Cross Alabama. I have been locked out of my online account for 2 going on 2 1/2 years and nobody has ever given me the extensive amount of help that ***** did. She escalated my issue up and kept me posted and nobody with them has done that before. Again thank you *****! These 5 stars are for you and you only.Blue Cross And Blue Shield Of Alabama
Date: 01/10/2025
January 10, 2025 Ms. **** X** X** Name of Patient: ***************** Number: BEG88888888 ************** We are responding to your comments concerning *****.Thank you so much for taking the time to acknowledge the work done by *****. We certainly try to provide excellent customer service each and every time. We always here the bad but rarely the good. We will make sure ***** is made aware of your comments.Please let us know if we may be of further assistance. **************************Review fromDonnie A
Date: 11/29/2024
1 starIm very disappointed with BCBH High performance plan my doctors will be out of network in January grandview hospital is out network as well thats where my doctors are at very disappointed how can a insurance company tell me what hospital and what doctors I can and cant see me another thing I just had two ankle ligament surgerys on each ankle and BCBH is refusing to pay for PT days and they are refusing to pay for orthotics and my orthopedic surgeon told them that I need more pt and I need orthotics but **** said they will pay for custom ankle braces I dont braces **** is horrible insurance company them dont care about what someone needs them only wants tell you what you need or who you can and cant see bye BCBH I will be switching to someone else here very soon I will never have yall ever againBlue Cross And Blue Shield Of Alabama
Date: 12/02/2024
December 2, 2024 Mr. ***** X** Complaint Number: ***** ***************** are responding to your complaint from the Better Business Bureau concerning the High Performance Plan.The High Performance Plan does have limitations. However, there are other Blue Cross Plans that you may choose from that do not have these limitations. You may contact ************** or our website, ******************************, for other options.We hope this information is helpful. Please let us know if we may be of further assistance.Sincerely,Customer ServiceReview fromKevin M
Date: 10/01/2024
1 starbcBS execs and board members should be ashamed of themselves. I can't even get my insulin and CGM using my "insurance". One of my insulins isn't covered by bcBS at all, so I have to use the mfr discount card to make is somewhat affordable. My CGM (continuous glucose monitor) cost 3 times more with bcBS, than with the mfr discount card, which is still unaffordable. I look down my list of claims, and out the last 30, bcBS only paid any amount on 4 claims. I know this is the plan that I signed up for, but this is the best offered by my employer. bcBS should be ashamed to sell this anyone, let alone call it ***************** I've had bcBS my whole life - 46 yrs, and it didn't use to be like this. What they do should be illegal. bcBS used to be the best, but that is definitely not the case anymore. Very disappointed! No stars have been awarded, I forced to select one star only bc it made me.Blue Cross And Blue Shield Of Alabama
Date: 10/04/2024
October 4, 2024 Mr.. ********* x** ***, AL ***** Name of Patient:Mr. ********* Contract Number:PPA*****8888 Review ID Number:61097 ********************* are responding to your complaint concerning your benefits for insulin and a glucose monitor.We have reviewed your employers benefit plan and based on the guidelines of that plan, there is an in-network deductible of $8,450 per calendar year. Drugs purchased at a participating pharmacy are considered at 100 percent, subject to a $20 copayment for a Tier 1 drug, 100 percent, subject to a $35 copayment for a Tier 2 drug, 100 percent, subject to the in-network deductible for a Tier 3 drug and 100 percent, subject to the in-network deductible for a Tier 4 drug.We have reviewed your claims for 2024 and the reason no payment is being made is because they are applying to the deductible. At this time, you have met $3,177.38 of the in-network deductible. Our records show that a claim for insulin that was filled on October 1, 2024, paid with a $20 copayment.The claims are processing correctly under the guidelines of the contract. However, we do understand your frustration.Sincerely,Customer ServiceReview fromAbigail J
Date: 05/17/2024
1 starThis is the worst most diabolical insurance company I've ever had the misfortune to have to use through my company, whose HQ are based in Alabama but half the employees sit outside of it. I've had endless issues with BCBS of Alabama in a way I havent with any prior insurance carrier. I've never run into these issues despite a prior tonsillectomy, two knee surgeries, and a prior pregnancy that ended in an emergency C-section with an extended hospital stay for myself and my baby (NICU). I reached out to BCBS about a$1,200 medical test that I'd been denied for because it said I needed preauthorization and because I didnt have that, it wasnt covered. For transparency, it was for genetic testing for the baby. This was something that was covered by my last companys insurance, so I believed this to be something covered by the maternity care portion of our insurance as routine standard of care, which for them it is! Ive gone back to push BCBS because this also wasnt applied against my deductible, though it was applied against the deductible of another co worker who also happens to be pregnant on a similar timeline. When I inquired about how to know what I would need preauthorization on, BCBS told me that the only way to know if a service requires precertification is to get the procedure and diagnosis codes that would be filed to insurance from the performing provider, and then contact insurance to provide the codes, who can then check the codes and advise if a precertification is required. This seems like a highly unnecessary burden to be placed on us as a policyholder, despite what our contract stipulates. When I went back to BCBS asking them to rerun the claim so it could be applied against my deductible, since my provider stated that they've never had this test require preauthorization and that's why it wasn't used, BCBS denied me. I am not sure what I am paying for with this insurance company because they barely cover anything anyway.Blue Cross And Blue Shield Of Alabama
Date: 05/21/2024
May 21, 2024 ************************* X** Contract Number: PPA888888888Patient Name: *************************** Number: 265-0296326 Date(s) of Service: January 19, 2024 Complaint ID Number: ***** Dear *********************,We are responding to your complaint concerning the denial of claim number 265-0296326 for date of service January 19, 2024. Blue Cross and Blue Shield of Alabama is only the administrator of the benefits your company has chosen for their employees. Under the guidelines of the groups policy, genetic testing requires precertification. This information is listed in your employee online benefit booklet found on page 16 under the category ******************* Benefits, Physician Benefits, ************* Services. Based on the group's benefits, if no precertification is obtained, there are no benefits available. This means that no amount of the charge(s) is eligible to apply to the deductible or to be paid. We hope this info is helpful.Sincerely,Customer ServiceReview fromTyson J
Date: 05/15/2024
1 starIf a zero star was available I'd give it. About 4 weeks ago I had blood work done. Before I meet with my doctor to go over the results I got a letter from BCBS of Alabama telling me I was diabetic and how to best treat it. Two weeks after I received that letter I had a doctor's *********** and we went over the results where he informed me that my blood sugar was over 200 and A1c was 8. It's been trending on that direction over the past year. Blue Cross Blue shield of Alabama denied my ability to fill the medication. I love when insurance companies dictate my medical care. If I was a meth addict needing methadone or suboxone strips no problem. But life saving medication nah.. nevermind high blood sugar can cause a heart attack, you can go blind, lose your limbs.. nah.. But you need some Adderall no problem. I called BCBS today. I was told they don't look at my previous records when determining this. So I asked if thats the case and BCBS doesn't look at previous records then how can they decline people with preexisting conditions? The guy with BCBS said that is a good question. I know when I was a cash paying patient one of my medications cost $99.00 to fill. With insurance I pay my copay but the pharmacy submits ****** to insurance. I asked about the discrepancy and was told "that's the bcbs negotiated price". So BCBS negotiated double the price. That's one h*** of a negotiation.. BCBS shouldn't dictate healthcare. Women say abortions should be between a woman and her doctor. No woman who is pro choice says "it's between a woman, her insurance provider, and her doctor". It's a disgrace. Unfortunately BCBS of Alabama has a monopoly in Alabama. ZERO STARS!!Blue Cross And Blue Shield Of Alabama
Date: 05/16/2024
May 16, 2024 Name of Member:****************** Dear ******************:We are responding to your customer review concerning your medication request.However, we are unable to locate a contract number for you based on the information provided. We would like to discuss the issue with you further to see how we can help and assist you concerning your medication. Please contact the number on the back on your insurance card for further assistance. This will help us better address your concerns.We hope this information is helpful. **************************
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