ComplaintsforBlue Cross and Blue Shield of North Carolina
Health Insurance
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Complaint Details
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Initial Complaint
05/28/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Resolved
On 4/29/24 I signed up for insurance with BCBS of NC to start in May using the government ************ I was approved, issued an account at ********************** NC, sent medical cards via mail, made my initial premium payment, signed up for their online platform called Blue Connect. Received a bill for ***** Logged on to Blue Connect on 5/23 to pay but there was no option on my online account. Called customer service for Blue Connect and spoke to *******. She said they would fix this plus email me a link to make the payment. Never received the email. The next morning 5/24, I tried to log onto Blue Connect but couldn't. Called Blue Connect, they were baffled but my acct was inactive. Called BCBS of NC ***************** The female sounding rep mumbled a name. First she said that my account was past due and that my first paymt was applied to April. impossible because, I was covered by different insurance company as I only moved to ** at the very end of April. I couldn't be double covered in April. Correspondence from BCBS NC shows that my coverage began in May. BCBS patched me to gov ************ Gov determined that 2 acts were opened in error, told BCBS how to fix immediately but BSBC rep was non responsive even when she was instructed exactly how to fix. *** forced to escalate the issue. *** rep asked BCBS to email.me a card NOW to the active acct, then left call. The email contained the old inactive card. When I asked BCBS why they sent me that and why she didn't comply with Gov instructions to fix my issue immediately, she said that I "needed to be nice to her." At no time was I rude to her. She could have fixed my issue but instead allowed the problem to persist and Gov forced to file an escalation. After 2hrs, 8 min, still have an inactive acct, no access to my paid insurance and a rep who did nothing for me, refused to follow the Gov *********** reps instructions to immediately correct the error or even allow me to pay my June premium.Business response
05/28/2024
BlueCross NC will contact the complainant directly regarding their concerns.Customer response
05/31/2024
Better Business Bureau:
I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
Sincerely,
***********************Initial Complaint
05/16/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
Enrolled in ********* Was approved. Tried for 2 months to get ******************** card sent To local DSS. Could never get anybody on the phone.Business response
05/16/2024
BlueCross NC will contact the complainant directly regarding their concerns.Initial Complaint
04/26/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
My mom (*************************) passed away August 10, 2023. She had a supplemental health insurance policy with BCBC of NC. Her estate is due a refund check (approximately $225) for the month of August after she passed. I have contacted customer service at ********************** 7 times (10/5/23, 12/13/23, 2/1/24, 2/22/24, 2/27/24, 3/22/24, 4/26/24) since my mom passed asking about the status of the check. Every time I am told that the request is being sent over to be processed. When I asked if there is a manger/supervisor I can talk to about it I am told no. Can the BBB please help me with this issue?Business response
04/26/2024
Thank you for the referral. We will reach out to our member and address any questions or concerns.Initial Complaint
04/09/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I am a retired Federal employee and have health insurance through the Blue Cross/BS insurance company of North Carolina Federal employee program. At the end of Dec 2023 I filed a claim for a hearing aid replacement which is covered by my policy. BC/BS processed that claim in early Jan 2024, approved it and listed on line my Explanation of Benefits that at charge of $1499.99 was paid on Jan 19, 2024. But I never received an EOB in the mail or a check for that amount' After a near month delay I phoned BC/BS and told them no check . They said they would investigate that but no check ever came. After numerous calls every week or two I kept getting told that they would cancel the lost check and send me a new one. But one never came. I talked with BC/BS personnel for more than 15 times and each time told its being processed , or the check is in the mail. After contacting the ************** of OPM that agency contacted BC/BS about this and a new insurance employee contacted me- from an ****** of ******** Satisfaction- and said the issue was being resolved and I would soon have a check. That was near the end of March. After more than 2 weeks of that I was told yesterday that they are still working the problem but replacing a lost check is very difficult and time consuming. Now it is nearly 90 days since they had approved my claim and nearly 60 days since I first reported it but this "difficult " problem of a lost check seems to be impossible by BC/BS to resolve. They seem to be the most incompetent, uncoordinated company with a minimal amount of concern for their customers when problems occur. For weeks and weeks and by numerous employees I have been told that the problem is being resolved and my check is on the way- but to date- April 9, 2024 I have yet to receive it or told when to expect it. Pure management incompetence at the highest level.Business response
04/09/2024
Thank you for the referral. Since 3/26/24, we have been in communication with this member regarding this issue. We will reach out to our
member and continue to address any questions or concerns.Customer response
04/10/2024
Complaint: 21552033
I am rejecting this response because: The issue has NOT been resolved. The claim has not been paid yet. This is the same response I have been getting for weeks that "the problem is being handled and the check is in the mail. "
When I receive a check for the approved claim then I would consider this issue resolved but that is NOT YET the case.
Sincerely,
***********************Business response
04/10/2024
Thank you for the referral. We will reach out to our member and address any questions
or concerns.Initial Complaint
04/05/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
BCBS showed in network for a provider that I went to, and a few months later I received a bill that stated the provider was out of network. I had to file an appeal to make sure that I am not paying $800 for bloodwork. I have sent the appeal in twice and BCBS says that they do not see it. I have called Blue cross so many times and on the phone for hours. And the issue is never resolved!Business response
04/08/2024
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
03/22/2024
- Complaint Type:
- Order Issues
- Status:
- Answered
My policy with them ended on 12/31/2023. I did NOT renew any policy. My Agent has already told them, that I did not renew. I did not pay my first premium for 2024 because I did NOT renew my policy. They continue to send me a bill every month with a new total. There have been ZERO claims filed with them under my name in 2024 because: 1. I cancelled my policy verbally to my agent. 2. My agent cancelled my policy electronically to BCBSNC. 3. I have NOT paid any premiums for 2024. I have tried multiple times to contact them over the phone, but all I get is the amount OWED for a policy I no longer have!Business response
03/22/2024
Thank you for the referral. We will reach out to our member and address any questions or concerns.Initial Complaint
03/21/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I found out, through Cover ** *********** on March 18, 2024, that I was receiving healthcare coverage through Anthem Administrators ** since July 2022. I was not aware, nor did I consent to this coverage through Anthem Administrators **. In addition, I have NEVER lived nor been employed in the *********** at any point in my life. It does not make sense that I have been a full-time student at *** since 2020 that has been receiving coverage through ** ******** AND be receiving benefits through another policy based in **. I have contacted Anthem in VA and ** and have not received any resolution (resolution being termination of this policy and filing a personal incident report) to this problem. Currently, this policy shows as active under my social security number and prevents me from receiving my ******** benefits in VA.Business response
03/21/2024
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
03/13/2024
- Complaint Type:
- Product Issues
- Status:
- Answered
My policy when renewing on the marketplace back in December of 2023 never went into effect. I sent BCBS a message on 12/6 asking what else I needed to do to ensure I made the open enrollment window. I was told it would take 2-4 weeks to update and then I could pay my premium to start the policy. *** comes around and my new policy still isnt showing. I follow up again on 1/14 and am told I need to pay the premium for my old policy that auto renewed , which was not suppose to happen, prior to my new policy rate taking effect. I make the payment in full and when the next bill cycle comes Im being charged the price as the prior month (double what my policy should cost per my new policy). I call BCBS and am told to contact marketplace. I do this and marketplace confirms my new policy was showing on there end. I tell BCBS this and they tell me to continue to wait for it to hit their system. I follow up again on 2/12 and BCBS acknowledges my new rate in writing and tells me they are opening a ticket to have it corrected. Im told this should take 1 week. I follow up the next week and am put on hold for 45 minutes before the rep comes back and states they will need to escalate this to management and that I should be getting a refund and should see my new rate within the week. I am told they would follow up around 5pm the next day to confirm, this never happened. I wait a week and call back again as no change in my policy has occurred. The rep stays on the line with me for over an hour and the final resolve is its been escalated to management and my new rate and refund will take 24 hours to process. This doesnt happen and I follow up again. I am told by the rep to STOP FOLLOWING UP as it restarts the process on their end to fix it! I wait another week and STILL my policy rate has not been updated, no refund issued, and the app is showing me delinquent on my monthly payment for March. I sent another message yesterday and have yet to receive a responseBusiness response
03/13/2024
Thank you for the referral. We will reach out to our member and address any questions or concerns.Initial Complaint
02/16/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I have *****'s my doctor put in for my infusion order on feb 5th. I have been getting sicker with stomach pains more often, BCBS took my rumicaid away for another infusion med because it was to expensive. what i have been on now is not working. I was supposed to of had my infusion two weeks ago. my husband contacted the insurance company just to be told it would be between 48 hours up to 15 days. he asked when it will be given to me, was told by the employee of BCBS that if a doctor put in a emergency order it would be 48 hours up to 15 days. for the past week i have not been able to hold much down, smells of food just make me sicker, all this because of wanting to save money. still waiting on BCBS of ** to contact me on when i can get my infusion.Business response
02/19/2024
BlueCross ** will contact the complainant directly regarding their concerns.Initial Complaint
02/12/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
2/2/24. I went to fill my medicine and found out my health insurance was canceled. I called bcbsnc ************ was on phone for 2 hours. Got disconnected. All these calls I can prove on my phone bill. Called back that night, the ** rep put my issue as ***** for some reason. Didnt make since. The switched me to another ** rep for him to tell me the previous person shouldnt have done that. The issue is bcbs cashed my money. They said I never paid it which makes no since cause I added dental insurance and that was paid the exact same time and posted to my bank. . So bcbs cancel my policy for no reason. I called back 2/5 2/7 2/9. Each time 2+ hours. I sent them an email of my bank where both health and dental posted. Mean time I have canceled 2 doctors appointments and am now 7 days out of my medication. Just was on hold for 37 minutes when ** rep hung up. Called back got a nice lady that put me through to a supervisor **** ***. She said she waiting on whoever to ok that they did take my money. Which I wont hear anything til Monday 2/13 and that is if someone has looked at the bank statement. I have another doc appointment Tuesday 2/14. If they are not gonna reinstate my policy I want my 100.14$ back and cancel my dental. I will never ever have bcbs againBusiness response
02/12/2024
BlueCross ** will contact the complainant directly regarding their concerns.
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Customer Complaints Summary
110 total complaints in the last 3 years.
28 complaints closed in the last 12 months.