Complaints

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

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  Blue Cross and Blue Shield of Illinois

  300 E Randolph St Chicago, IL 60601-5099

• 

  Blue Cross and Blue Shield of Illinois

  PO Box 1364 Chicago, IL 60690-1364

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:07/03/2025

  Type:Billing 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 6/26/25, I turned off Automatic payment on my ****** account bc I was drafted twice in May for my payment. I made a manual payment for my premium of $695.46 (shown on their website and in my bank account statement attached). I then turned automatic payment back on for the July payment. The website stated the next payment would not come out until 7/31/25. 7/1/25 comes around and I am charged $695.46 again for my July premium, which I already paid on 6/26/25. I called BCBSIL on 7/1/25 at 10:59 am CST and told them what happened. The guy on the phone did some research into the account and told me a refund would be processed and would be deposited in 1-2 days. This is on a recorded line, so they have that call as well. I get up today and call to check on the status of the refund because of something odd I saw I my account. They tell me that it will be 10 days before it is approved and processed. I told them no your representative told me 1-2 days. They refuse to expedite my refund even though their representative told me 1-2 days on a RECORDED line. They mess up and I am the one who is screwed. My account is now over drawn because of them, and my mortgage is going to be late because of them and their s**** up and refusal to honor what they say. I will be looking for new insurance because this is the second time they have done this to me and refuse to make it right in a timely manner. WORST COMPANY EVER!

  Business Response

  Date: 07/18/2025

  
  
  
  
  
  
  July 18, 2025
  
  
  Better Business Bureau of Chicago & Northern Illinois, **** ************************
  Suite 2000
  *************************************
  
  
  
  RE:  Record ID: *********
  Member: ******* ****** File #: 23552480
  
  To Whom it May Concern:
  This letter is in response to Stefine Rayners inquiry, submitted to your office and received by 
  Blue Cross and Blue Shield of Illinois, a Division of *******************************, a ************************************** an Independent Licensee of the Blue Cross and Blue Shield Association, on 
  July 4, 2025.
  
  Due to the Protected Health Information involved in the response of this inquiry a letter will be 
  sent directly to Mrs. ***************** strive to deliver excellent service and appreciate being made aware of instances in which 
  improvement is possible. If you require additional information, please do not hesitate to contact 
  us in the future.
  Sincerely,
  ***** *. U312279
  Senior ********************************************************************************************************************************************************************************************************************************************************************************************** of *******************************, a ***************************** an Independent 
  Licensee of the Blue Cross and Blue Shield Association.
  
  

  Customer Answer

  Date: 07/18/2025

   
  Complaint: 23552480
  
  I am rejecting this response because:
  I called again today 7/18/25 because I still have not received my refund that i was told on 7/3/25 was now going to take 10 days from time of submission on 7/1/25. It is now day 13 (I did not count the 4th or any weekend days).. I called and was now told it will take 14 days because it requires a level 2 approval or some BS. I had this same problem in June with them taking a second charge fro me for my premium. That one didn't require a second approval and i got my money back on the 10th day. So why is this one different? So they are now making up policies as they go. They claim they take these accusations seriously, yet no one is making it right for me for their lack of correct information. I have been told three different things by three different people. ON RECORDED LINES! No one is trained properly and is making the customer suffer because of their lack of training. They screwed up, they lied and told me misinformation. That is NOT MY FAULT. I should NOT be made to suffer and run my credit cards up because they have almost $700 of my money that i needed for my bills. I have lost my dental and vision bc the money they took was for that payment. This is absolutely not ok.  I should have been refunded my $695. three days ago,  actually should have been back on the 3rd bc i was told 1-2 days when I called the first time! And now with no communication AGAIN I am being I given the run around on money they took from me. I will not accept ANY action except a refund of the money that was not supposed to be taken in the first place.
  
  ******* ******

  Business Response

  Date: 07/25/2025

  A response was mailed to the member today.

• Initial Complaint

  Date:06/05/2025

  Type:Customer Service Issues
  Status:

  ResolvedMore 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 applied for BCBS OAP State of Illinois insurance during open enrollment, and today 6/5/2025 around 10:00 AM, I called BCBS to confirm my application. The gentleman I spoke with at **** asked me several personal questions (name, phone number, address, zip code etc.), and I answered each one. Afterward, he informed me that I would need to talk to the employer department and said he would transfer me. This was frustrating because I had initially asked him my specific question, but instead, he asked for my personal information and then transferred me without addressing my concern.The number he transferred me to informed me that they were not the employer department and said they would transfer me to the employer department. The third number I was connected to stated that the employer department does not exist. This entire process was very frustrating. Who can I contact at **** OAP to confirm that my application was submitted and received? Can someone at BCBS contact me at **************? Please, call me. Thank you.

  Business Response

  Date: 06/12/2025

  We have responded directly to the member. Thank you. 

• Initial Complaint

  Date:06/02/2025

  Type:Customer Service Issues
  Status:

  ResolvedMore 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 clinical psychologist and in January 2025 completed the application and signed the contract to join the network. A week later I received multiple emails saying I was a new appointment to the network and had effective dates for the plans I wanted to be in network in. I also received mail later with the same information. I have recently started my private practice and want to enroll in the *** through Availity but when I go to submit, it basically states my information is not in the payer's system. I have attested in Availity and CAQH; recently, I received 2 checks for claims sent for services provided from the ****. I have called MULTIPLE numbers over the course of at least 3 days as well as sent multiple emails and NO ONE has been able to help me because it's not their department and the provider service number is COMPLETELY automated. I would like to resolve the issue soon and need to talk to a person to do so but again, no one is available to help figure out why I am not in the system but have approval that I am as well as payment from them. It has been frustrating because of the time spent to have no help in an important issue (I think it would be good that if I'm in their network I should be recognized in their system) and I need an actual person to discuss this with and resolve this. It is the most common health insurance in the state, especially among providers, so I'm not sure why there is no person of contact to be able to actually talk to when an issue like this comes up.

  Business Response

  Date: 06/09/2025

  Please see attached response to complaint.

• Initial Complaint

  Date:05/30/2025

  Type:Order Issues
  Status:

  ResolvedMore 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.

  Have used this insurance provider with MyBlue Plus since 1/1/2025. All the providers they give are inaccurate. ********************* only practices with nursing homes and not as a PCP I can see. I cannot visit an ************************** the one they provided at 1700 W ******* no longer exists and no others are available.

  Business Response

  Date: 06/05/2025

  Please see the attached response.

• Initial Complaint

  Date:05/27/2025

  Type:Billing 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 visited *********** ****** for a hernia. Turned out to be 10 hernias. She recommended surgery and advised me that it would be extensive and would required several days in the hospital. She advised me she would make sure insurance carrier would have what they needed as this situation is often messed up in billing. She stated this again on March 11th in pre-op. She fixed 10 hernias in addition to removing intestinal adhesion to my stomach lining. After surgery went late they moved me up to a room to stay. I left a couple days later and received a bill from Blue Cross Blue Shield for $72,326.38. My out of pocket maximum is $5500 which is what I was quoted by both the surgeon as well as the hospital. Blue Cross has denied paying for the hospital stay indicating the services were not warranted. Despite the recommendation of my surgeon from the beginning. No one from the hospital ever notified me that the stay was not covered nor visited me in my room to let me know that the costs being incurred were on me. My surgeon has written a letter in defense of her prescribed path of treatment that hospitalization was required. They continue to deny the coverage.

  Business Response

  Date: 05/30/2025

  Please see our attached response letter.

  Customer Answer

  Date: 05/30/2025

   
  Complaint: 23381755
  
  I am rejecting this response because: a letter will take more than the 7 days allowed to receive thus making my compalint invalid. This game will only cause additional filings and escalation of the matter. My email and phone number are available in my records and i can be contacted directly or to my **** state of Colorado dispute as well.  
  
  Sincerely,
  
  **** ****

  Business Response

  Date: 06/10/2025

  Please see the attached response letter. A letter will be sent directly to **** **** before the end of day on Wednesday, June 11, 2025, to the preferred email and mailing address we have on file.

  Customer Answer

  Date: 06/11/2025

   
  Complaint: 23381755
  
  I am rejecting this response because: there was no new  information provided. 
  
  Sincerely,
  
  **** ****

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

• Initial Complaint

  Date:05/16/2025

  Type:Customer Service Issues
  Status:

  ResolvedMore 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.

  Im currently shopping for insurance, and I called Blue Cross and Blue Shield of Illinois for information about their infertility benefits. The person I spoke to was unable to provide any information at all. The answer to their infertility benefits? She provided the definition of infertility only and said she didnt have the information on their infertility benefits. When I asked to speak to a supervisor, she put me on hold and returned with other information which was helpful, but did not answer my specific question. For instance, she said that Blue Cross and Blue Shield of Illinois OAP covers 100% infertility and IVF benefits, but I highly doubt it, since most insurance do not cover 100% IVF. When I inquired what specifically they cover for IVF, she was unable to answer and gave me a website for additional information. I went to the website and the answers to my questions are not there. Id like a breakdown of IVF benefits or some type of information to help me in deciding which insurance to elect. Thank you.

  Business Response

  Date: 05/29/2025

  Responding to member.

  Customer Answer

  Date: 06/01/2025

   
  Better Business Bureau:
  
  Blue Cross Blue Shield Illinois responded to the BBB complaint by providing a link to their *************** Policy, which isnt helpful to me since my policy isnt a small group plan. I work for a large university. A few days ago, feeling frustrated, I called my benefits representative at the university. They arranged a conference call with a representative from Blue Cross Blue Shield Illinois, who was able to answer many of my questions about the *** benefits under the Blue Cross Blue Shield Illinois AOP.
  
  Today, I still have a few more questions, but aside from the one person at Blue Cross Blue Shield Illinois (the one my employer made a  conference call with), getting information from them has been such a challenge. Im hoping my embryo transfer works under *************** so I wont have to deal with Blue Cross Blue Shield Illinois for ***, as I can only imagine it would be a nightmare.
  
  Sincerely,
  
  D

• Initial Complaint

  Date:05/13/2025

  Type:Order 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.

  I am filing this complaint to document a pattern of medically inappropriate care denials by Blue Cross Blue Shield of Illinois (BCBSIL) and to request resolution for a recent claim denial that was unjustly rejected.Over the past year, I have experienced multiple denials of care for physician-prescribed treatments. In each case, the care was medically appropriate, ***-approved, and supported by a clinical diagnosisbut BCBSIL denied coverage based on narrow documentation requirements that failed to reflect real-world care delivery or clinical discretion.Most recently, ****** denied coverage for a low-cost topical medication, **********, prescribed to treat a documented condition. The insurer claimed that necessary supporting diagnoses were not includedeven though my provider has confirmed they were submittedand dismissed the treatment plan because past use of an oral medication was not verifiable, despite the fact that those records are from providers in other states and health systems no longer accessible to me. My current provider made an informed decision to prescribe this treatment based on my full medical history and current condition.******* repeated denials rely heavily on inflexible prior authorization policies and overly narrow interpretations of "medical necessity," often requiring documentation that is unreasonable to obtain or completely irrelevant to a members present-day care.These practices place the burden on patients to navigate outdated systems, repeat prior treatments, and exhaust appealsnot to ensure better care, but to reduce the insurers payout responsibilities. It is unethical, and it erodes trust in both the provider and the employer-sponsored plan.

  Business Response

  Date: 05/14/2025

  Thank you for your inquiry. We are reviewing the case and will reach out to the member directly with a resolution.

  Customer Answer

  Date: 05/15/2025

   
  Complaint: 23325659
  
  I am rejecting this response because BCBSIL has not reached out to me as indicated on their reply to the BBB.
  
  Sincerely,
  
  ***** ********

• Initial Complaint

  Date:05/13/2025

  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.

  This is the third time **** had canceled my appointment to get a sleep study after it was previously approved and scheduled. It takes 2 - 3 days and 5 - 6 phone calls between the pulmonary doctor, sleep center, and insurance company to schedule an appointment. The sleep center will not schedule an appointment without prior insurance authorization. They are usually booked 2 or months in advance. I had approval and scheduled an appointment with the sleep center back in late March/early April for my appointment next week. I get a call from the sleep center today that the insurance has canceled/not approved my appointment and I have to appeal to get it scheduled. So after waiting 2 months, I get the rug pulled out from under me a week before the appointment. Now I have to start the process all over again and then try to get another appointment scheduled in two months or more when I should be going next week. This is very frustrating. This seems to be a delay/deny tactic to frustrate the patients to get them to give up and not get the treatment so the insurance company can save money and to pay for the treatment. Why do they deny the treatment after it was previously approved before scheduling the appointment?

  Business Response

  Date: 05/28/2025

  Thank you for your inquiry. We are reviewing the case and will reach out to the member directly with a resolution.

  Customer Answer

  Date: 06/05/2025

   
  Complaint: 23321741
  
  I am rejecting this response because: 

  This complaint has not been resolved.  I have still not gotten approval for a sleep study that was canceled last month.  

  
  

  My contact at BCBS has tried to gas light me that the sleep center canceled the appointment when I in fact talked to the nurse at my doctors and they explained that it was BCBS.  My doctor contacted me last Thursday and was to follow up with BCBS with the appeal, and I have not yet heard back from BCBS.  The original order for the sleep study was written correctly, BCBS is just using delay and stall tactics and making my doctor do more paperwork and delaying my treatment. 

  
  

  BCBS representative is trying to talk me into a lower level sleep apnea machine than the one that is needed to properly treat my condition.  She is unaware and uninformed on this subject and does not know the different devices available for this condition and is trying to suggest a cheaper alternative that is not as effective.  I can't believe that they do not know more about sleep issues as many people have them.  

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

• Initial Complaint

  Date:05/09/2025

  Type:Billing 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'm currently involved in a billing dispute with ***** over two recent medical claims that have been rejected on the basis that my orthopedic provider is not in network. Complicating this matter is that my benefits administrator is Teamcare and I am unable to speak directly to BC/BS about this. I am trying to find out from ********** whether or not my provider is in network. I provided screenshots to Teamcare from the BC/BS of Illinois website showing both my actual doctor as well as the practice (************************) as being in network. Teamcare, just being the administrator, was unable to tell me whether or not said doctor was in the network and forwarded me to the BC/BS medical provider number. Upon calling the number several times I was unable to get a clear answer from BC/BS as the number was routed to a call center that had a significant language barrier. I would like for a representative of BC/BS of Illinois to contact me and verify the network status of my medical provider because at the moment I am unable to return for follow up treatment. 

  Business Response

  Date: 05/30/2025

  This letter is in response to ****** ****** inquiry, submitted to your office and received by Blue Cross and Blue Shield of Illinois, a Division of *******************************, a ***************************** an Independent Licensee of the Blue Cross and Blue Shield Association, on May 10, 2025.
  
  Due to the Protected Health Information involved in the response of this inquiry a letter will be sent directly to Mr. **************** strive to deliver excellent service and appreciate being made aware of instances in which improvement is possible. If you require additional information, please do not hesitate to contact us in the future.
  
  
  Sincerely,
  
  ***** *. U312688
  
  Sr. Inquiry Specialist
  Blue Cross and Blue Shield of Illinois 

  Customer Answer

  Date: 06/06/2025

   
  Complaint: 23307350
  
  I am rejecting this response because:
  

  You have not sent me a letter or given me a way to verify whether or not my doctor is in network or not.  

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

  Business Response

  Date: 06/17/2025

  Hi There,

  BCBSIL mailed the response letter to the member on June 17, 2025. Please allow time for mail to arrive.

  BCBSIL did not have an email address on file for the member to submit the response electronically.

  Sincerely,

  
  ****** *. U430912
  Inquiry Specialist
  Blue Cross Blue Shield of Illinois

   

• Initial Complaint

  Date:05/06/2025

  Type:Billing 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.

  The problem with my insurance (Blue Cross Blue Shield of Illinois) started after I had surgery on February 14, 2025 in *******, **********. I chose the performing surgeon as he was the ONLY In-Network doctor with **** that was local and specialized in the care I needed (there was one other local Washington doctor but he wasn't even In-Network with **** at all so I couldn't go to him). When I got the bill, I was surprised to find the total for the medical services was double of what I expected. **** said the surgeon was categorized under Tier 2, and even though they didn't offer a Tier 1 doctor (or even another doctor at all for me to choose from) that was In-Network, I would be stuck with paying the $6000 out of pocket maximum instead of the $3000 maximum I had planned for. On March 28, 2025, I appealed what was determined. I asked **** to make an exception as they didn't offer ANY alternative choices to the doctor I went to. On May 5, 2025 the appeal was denied by ****. This is unacceptable to me. **** can't just only offer one In-Network Tier 2 doctor, no Tier 1 doctors, and then think it's okay to bill me according to the Tier 2 coverage. That's operating in bad faith. There's only one doctor? That doctor needs to be made Tier 1. Not Tier 2. I have attached three files. One is showing the only doctor in the **** database as In-Network, the second is showing the bill as determined by ****, and the last is showing the denial by ****. The denial misunderstood the problem and didn't even address their conduct. I've attached three files. The first shows the only doctor in the **** database that I ended up going to, the second is the bill as **** thinks it is, and the last is the denial (they took from March 28, ****** to May 5, 2025 to respond) by **** that misunderstood the problem/didn't address it.

  Business Response

  Date: 05/09/2025

  Attached is our BBB response.

  Customer Answer

  Date: 05/15/2025

   
  Complaint: 23296714
  

  I tried to be fair. I didnt take any action because I wanted to give Blue Cross Blue Shield ample opportunity to respond to my complaint against them. On May 11, 2025 I received a letter (dated May 9, 2025) from *******, an Inquiry Specialist with ****, who stated a response would be sent directly to me due to protected health information.
  
  Unfortunately, no such response has come as of May 15, 2025. Not in the mail. Not in the Blue Cross Blue Shield online messaging system. Not one phone call has been left for me or emails sent my way. If they truly meant to send a response, Im puzzled why they havent reached out to me in the allotted time. Many of these methods would have given me a response nearly instantaneously from when they could have sent it. Im puzzled why they didnt specify in the letter which method of delivery (mail, email, phone, etc.) they would even use. It would have helped.
  
  Unfortunately, theres no more time to wait. I have to respond or risk having this Better Business Bureau complaint closed from lack of activity. Unfortunately, I have to reject BCBSs inaction/oversight to provide a satisfactory response any response to bring this complicated and stressful issue to a close. I have attached a copy of the initial/vague letter by ***** *. Theres no solution or detailed response at all in it. No rebuttal or argument. Its a letter void of any substance, unfortunately. Thats why I have to reject the non-response. Please see attached. Thank you.
  
  Sincerely,
  ******* Frutos 

  Business Response

  Date: 05/19/2025

  See attached.

  Customer Answer

  Date: 05/19/2025

   
  Complaint: 23296714
  
  I am rejecting this response because:

  I didn't receive the response in the mail. They have my personal information. They can message me securely in the **** messaging online system. OR I grant them permission to reveal the contents of the letter (claimed to have been sent May 14, 2025) right here in the Better Business Bureau system, so we can come to an amicable and speedy solution to this issue.

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