Complaints

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

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• 

  Anthem Blue Cross and Blue Shield

  One Liberty Plaza New York, NY 10006-1404

• 

  Anthem Blue Cross and Blue Shield

  622 Third Avenue - 28th Floor New York, NY 10017

• 

  Anthem Blue Cross and Blue Shield

  11 West 42nd Street New York, NY 10036

• 

  Anthem Blue Cross and Blue Shield

  P.O. Box 5059 Middletown, NY 10940

• 

  Anthem Blue Cross and Blue Shield

  P. O. Box 11800, Mail Drop R5D Albany, NY 12211-0800

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:07/02/2025

  Type:Service or Repair 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.

  Our Son ***** ********* was born on *************. Coverage on my health insurance was in place and was canceled effective July 1, 2024. For the claims surrounding the birth of ***** who was a covered dependent, Anthem denied multiple claims saying coverage was not in force for those dates of service. We have 2 member service representatives ON A RECORDED LINE admitting that coverage was indeed IN FORCE. But every time we appeal the company keeps their decision final. This is criminal. This is FRAUD and legal action will be pursued unless Anthem decides to correct course and honor the policy and coverage according to the terms and conditions of the plan in force.

  Business Response

  Date: 07/16/2025

  Dear Palesa Nkholise:    
  
  We have reviewed your complaint, dated July 2, 2025, filed on behalf of member ****** *********. The complaint regards the effective date of the members newborn child. 
  
  The member was effective on a small group Anthem Balanced PPO 500/10%/2800 Rx Copay plan through July 1, 2024.  The members complaint states her child ***** ********* was born on ************* and the claims associated with his birth have not been covered by Anthem.  
  
  I confirmed Anthems records do not reflect active coverage for ***** ********* for June 2024.  The coverage was supplied by a small group employer, *********, which is a self-funded group, so any changes to the members eligibility must be submitted to Anthem by the employer group.  The member is encouraged to contact the employer group at ************** to request the submission of updated eligibility information for ***** *********. 
  
  Anthem received an appeal request regarding this denial on April 23, 2025; the appeal request was reviewed as Anthem Case Number *****************  An appeal determination was mailed to the member on June 16, 2025 advising the appeal request was denied because ***** ********* did not have active coverage on the plan for June 2024.  As noted above, the employer group must submit eligibility information for ***** ********** for June 2024 before the claims can be adjusted for benefit consideration.  
  
  Thank you for bringing your concerns to our attention. Please contact me directly if you have any additional questions or concerns.
  
  

• Initial Complaint

  Date:06/12/2025

  Type:Sales and Advertising 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 changed my Anthem BC/BS insurance plan in January 2025 to an Anthem plan with a lower premium. I had been signed up for autopay, which I was told would continue after the change and that the new lower premium would be automatically updated in Anthem's billing system. In February 2025, Anthem withdrew the same higher premium that they had been withdrawing from my account prior to the change. The overcharge was for $769.98. I contacted them immediately and requested that they refund the money digitally back to my account which was the method by which they took the money. They agreed. Weeks later, after not receiving the refund, I contacted them again. I was told a paper check was issued on 2/15/2025 and that they had closed the ticket. I explained I had not received the check and had previously been told it would be issued digitally, which was the method in which I wanted the refund. They said they could not change the method of the refund but that a new check would be issued within 14 days. This cycled has repeated several times since February. In April they sent me a letter stating they were resending the check but again I have still not received it. I have attached the letter here. I followed up with them again but they will not provide a direct line to billing so I am forced to call or email customer service who then sends their billing department a request for refund. the billing department typically responds back that they will address the issue within 5-10 business days. It's been four months since they deducted the almost $800 from my account without my consent. When I last contact them, they issued a statement saying they wanted to set up a three way call with my bank and me, which is absurd. I am not asking for anything unreasonable. I want Anthem to refund the money they took without authorization. I have attached this last correspondence and can provide more. My account number is ************.

  Business Response

  Date: 06/12/2025

  Member authorization is needed in order to address the members concerns.

  Thanks,

  ***** 

• Initial Complaint

  Date:06/12/2025

  Type:Product 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.

  This business is pretending to be something else. Tried to get money from me and now keeps harassing and bothering me

  Business Response

  Date: 06/12/2025

  Good afternoon, 

  We were unable to locate the member in our system.  Please provide the members identification number, including the three-character prefix.  This information may be found on the members health plan identification card.

  
  Thank you, 
  ******** *.
  

  
  

• Initial Complaint

  Date:05/23/2025

  Type:Service or Repair 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.

  ****** ****** runs in my family and I recently found out a great aunt and cousin have ****** ****** causing genes. A genetic counsellor reviewed my family history and recommended testing for the ****** ****** genes and told me it was covered by my insurance. I got an explanation of benefits saying my insurance paid nothing and I will owe $3,000. I disputed and was told the provider did not submit the claim right at first. I got a new explanation of benefits saying I would owe $1,700. Then I got another one ********** would owe $4,800, $1,800 more than when I first disputed! They are claiming the testing was not medically necessary which is absurd when you look at my risk. Its clear they did not even speak to the doctor at all or look at any documentation.

  Business Response

  Date: 05/27/2025

  We are unable to locate the member in our system. Please provide the member identification number complete with the three-letter prefix. This can be located on the member's identification card.
  
  

  Customer Answer

  Date: 05/28/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

  [Your Answer Here]

   

  *************  

   

   

  In order for the BBB to appropriately process your response, you MUST answer the question above.

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

  Customer Answer

  Date: 06/20/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********* and have determined that my complaint has NOT been resolved because:
  
  Blue cross did not resolve my complaint. They literally did nothing. I already gave them all of my information. They have my information on file. They are playing stupid. Tell them I will be getting a lawyer. 
  
   
  
   
  
   
  
  In order for the BBB to appropriately process your response, you MUST answer the question above.
  
  
  Sincerely,
  
  ******** *****

  Business Response

  Date: 06/23/2025

  Until the member returns the authorization form giving the BBB permission to act on her behalf, we cannot address the members concerns. 
  
  Thanks,
  
  *****

• Initial Complaint

  Date:05/16/2025

  Type:Service or Repair 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 paid them for dental insurance, but they are not providing me with coverage that I have paid for.

  Business Response

  Date: 06/09/2025

  Dear Better Business Bureau,  
  
  
  This is written in response to the complaint sent to the ******** Better Business Bureau regarding the members coverage. 
  
  Our records show that the member has single coverage under a New York Individual Family Risk dental plan purchased through the Exchange/Market Place, under group numbe* ******. This plan was effective May 1, 2025. Our NAIC number is ***** and the state situs is ********. Please note that for a copy of the members application, you would need to contact the Exchange or entity in which the member enrolled.
  
  Upon review of the members complaint, we understand that the member is stating I paid them for dental insurance, but they are not providing me with coverage that I have paid for.
  
  According to our records, the member does have active dental coverage. We recommend that the member view their benefit booklet as that shows what is covered. They can also contact ***************** Please note we were unable to upload any documents to the BBB portal. We do not show any claims on file from May 1, 2025 through todays date. 
  
  We hope this information has been of assistance to you.
  

• Initial Complaint

  Date:04/29/2025

  Type:Sales and Advertising 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 had to have an emergency appendectomy in November of 2022. The insurance company has not paid on the procedure. I previously filed a complaint against ************** and that completed the release of records for the insurance company. It has now been another six months and anthem has not resolved the claim. I am not sure what I need to do. I have called and emailed numerous times with no resolution. I just need help or direction on how to get this claim resolved. Neither Anthem or Mosaic are responding.

  Business Response

  Date: 04/29/2025

  We are unable to locate the member in our system. Please provide the member identification number complete with the three-letter prefix. This can be located on the member's identification card.
  
  

  Thanks,

  ***** *.

  Customer Answer

  Date: 05/16/2025

  Member Id #*********

  Group# **********

  claim#***********

  Business Response

  Date: 05/28/2025

  Please be advised that member authorization is needed prior to us being able to address the members concerns. Refer to attached letter.
  
  

• Initial Complaint

  Date:04/23/2025

  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 called blue cross blue shield on December 20, 2024 and told them I was canceling my insurance effective January 1, 2025 as I had moved from ******* to ******* and I had new insurance in ******* starting on January 1, 2025. They told me it was cancelled effective January 1, 2025.I have been charged and they have auto charged my credit card for insurance payments for January, February, March and April in the amount of $3,322.34/month for a total since January 1 of $13,289.36. When I called to indicate that they have charged me for a policy that I canceled on December 20, 2024, the representative indicated that she can only go back 60 days to retro-cancel. She wanted me to say on the phone that this was my first call in regards to the 2025 policy so that it was recorded with them. I told her no, this was not my first call with them regarding the 2025 policy and I asked her to go back and pull the recording from the call on 12/20/24 where I specifically called to cancel a 2025 policy. She agreed that it was noted that I had called to cancel but that they have an automatic renewal policy. So even though I had called to cancel, they renewed my policy without my ********** this point, Anthem Blue Cross owes me $13,289.36 and I believe they should give me additional compensation for the interest on that money that they took from me without my permission as well as pay me for the 2 hours I spent online and on the phone with them today trying to get this resolved and any additional time I need to spend in the future. The issue is still not resolved and the agent on the line said she will submit for approval and get back to **** believe what they are doing is illegal and criminal. They are effective stealing from people that have canceled a policy with them knowing that it was canceled but indicating that they have an auto renewal which I dont understand if you cancel a policy effective 1/1/25 on 12/20/24 why they would think that they can auto renew.

  Business Response

  Date: 04/23/2025

  We are unable to locate the member in our system. Please provide the member identification number complete with the three-letter prefix. This can be located on the member's identification card.
  
  

  Thanks 

  Customer Answer

  Date: 04/23/2025

  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID# ********, and have determined that my complaint has NOT been resolved because:

  my account id with them was

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

   

  [Your Answer Here]

   

   

   

   

  In order for the BBB to appropriately process your response, you MUST answer the question above.

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

  Business Response

  Date: 04/24/2025

  Please be advised that member authorization is needed prior to us being able to address the members concerns. Refer to attached letter.

   

  Thanks,

  *****

• Initial Complaint

  Date:04/18/2025

  Type:Service or Repair 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 signed up for their medical insurance based on their website and a prior call that my provider would be covered. My coverage started February 1st and on the 3rd I was sent a notice by ******* that my ** was outside coverage. I called same day to confirm. The reprehensive said that my ** was in a strange state showing up on the website but in the system he was out of coverage. I asked if anything could be done she said she wasn't sure so I asked to cancel my plan and I'd go back to COBRA. she called the next day and just said if I gave a ** note I would be considered in network. I went to the ** she requested. when I called back every representee i talked to said that it didn't happen. and that I couldn't get coverage. I requested a manager and after 3-5 days of calling I finally got a hold of one and they told me they squared away my account and it would be covered.The clams seemed to go through. months later they all got denied and when I called the manager again said that they had no record of this and it was out of network and I couldn't get a claim.they told me to try and file a different type of clam but the time they said it will take will fall outside the time to challenge this further.

  Business Response

  Date: 04/21/2025

  Please be advised that member authorization is needed before we can address the members concerns. Refer to the attached letter.

  Thanks,

  ***** 

• Initial Complaint

  Date:04/18/2025

  Type:Service or Repair 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 have ez scripts with my Blue cross Blue shield ************* my co pay for my ******** was always ***** now they have upped my copay to ****** they have changed thier story about the dose and daily supply. I called a few times to get a resolution and were told 3 different things. They do not want to pay for this medication. Now my health is at risk with not having on my system. They said that ********* used a coupon. I have spoken to ********* and the ***** copay was always the same amount. I am very upset about this.

  Business Response

  Date: 04/18/2025

  We are unable to locate the member in our system. Please provide the member identification number complete with the three-letter prefix. This can be located on the member's identification card.
  
  

  Thanks,

  ***** 

• Initial Complaint

  Date:04/10/2025

  Type:Service or Repair 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 Dec 28, 2024,I walked in at ******* MyCare *** ********************* on *************** in ******* ** for my routine preventive care test..Before that i been going to another location still in ******* and my insurance have always covered those ********** they are not paying the office visit charge which i dont even understand why..i keep getting the run around..my insurance which is through my employer is telling me they paid it and the clinic should not have billed me...i need this taking care of and my member ID is ************

  Business Response

  Date: 04/10/2025

  Please be advised that member authorization is needed before we can address the members concerns. Refer to attached letter.

  Thanks

  *****