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Blue Cross Blue Shield Federal Employee ProgramThis business is NOT BBB Accredited.
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Complaints
Customer Complaints Summary
- 67 total complaints in the last 3 years.
- 18 complaints closed in the last 12 months.
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Submit a ComplaintThe 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:03/19/2023
Type:Service or Repair IssuesStatus:UnansweredMore 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 utilized tele health services to make appointments with my primary care provider, I even went through a preferred clinic. Now Blue Cross and Blue shield have denied two claims for tele health appointments, stating the clinic choose the wrong location to file the claims (I have no understanding of how it is to be filed, I dont work for insurance) so instead of talking to the clinic, they complete denied the entire claim and put the bill on me, they did not cover any portion of the insurance claim. The amount I pay into insurance a month, this should not be an issue for me to resolve. Dates of appointment are 3/06/2023 and 3/13/2023.Initial Complaint
Date:03/13/2023
Type:Service or Repair IssuesStatus:UnansweredMore 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.
Hello, I had a hip surgery October 5th 2022, my plan was that once I met my deductible I was to pay 30% and BCBS was to pay 70% which was the way it went and it was fine. Then starting in late December 2022 I began receiving payment requests from providers stating that they refunded BCBS payment and I needed to pay. I contacted BCBS multiple times about this and they said it was because I was covered under my fathers plan under empire BCBS which was false, I was the sponsor on the *** BCBS plan and it has always been my primary. I was never eligible to be covered under my fathers plan. It has been nearly two months and providers are still contacting me for payment. *** BCBS has had ample time to fix their mistake and contact all the providers but they have not. They have failed to provide me updates and I am worried that the medical bills, which I am not responsible for, will end up in collections because of BCBS mistake and failure to rectify it.Initial Complaint
Date:02/18/2023
Type:Service or Repair IssuesStatus:UnansweredMore 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 livid with FEP Blue of *******. I happened to go to ******** in ******* for blood work recommended from physician. I asked at ******** if they took FEP Blue before getting the blood drawn. They told me, yes, and took my insurance information. Lo and behold, was shocked to find out FEP Blue in ******* didn't cover afterwards!!! I would have gone to Quest if I have known this but have used ******** in other states with FEP Blue. Let me remind you, FEP Blue covers ******** in nearly all 48 continental states except *******!!!!! ******** is a national company, and so is FEP Blue!!!! This is discrimination against the customer!!!! When I called ******** when I was shocked at my bill, they told me to disregard the bill since the error occurred with the nurse telling you that they took FEP Blue!!!! Now, ********, of course, denies that conversation which I should have recorded it. Why can't FEP Blue show compassion and pay the bill!!!! I think FEP Blue in ******* needs to get rid of the big shots ****** of ********** Executives, etc.), who show no compassion here!!!!Initial Complaint
Date:02/07/2023
Type:Service or Repair IssuesStatus:UnansweredMore 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 a hard time contacting the right customer service representative. I get transferred 7-8 times before Im hung up on. Whenever I need assistance, I need to find a way to figure it out myself. I had an open wound on my hand for a month before I was able to find out how to take care of it myself. **************** is absolutely terrible. 0/10000 I now needed assistance getting medical massages covered, as the provider also couldnt contact anyone and was on hold for an hour.Initial Complaint
Date:01/27/2023
Type:Service or Repair IssuesStatus:UnansweredMore 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.
For year ending December 31, 2022, Blue Cross Blue Shield Federal Employee Program drastically changed its reimbursement for out of network providers. There was no warning or notification issued to policy holders and the change happened on June 10, 2022. The policy is effective for an entire year at a time and can only be changed during an open enrollment period, which is usually in December of the same year. The explanation provided by BCBS Fed is that they simply changed the plan allowance for services mid year and they were not required to notify policy holders. I use out of network providers for mental health care. In ********, it is very difficult to find a provider with in-network benefits and the quality of out of network providers far outstrips in-network providers, despite this. Out of network providers generally charge a cash amount and you submit for reimbursement at the end of the year. This is a common practice in **. This year, I was surprised to find this change and stand to lose about $15,000 that would have otherwise been covered by the plan - as it had been in 2021.Initial Complaint
Date:01/10/2023
Type:Customer Service IssuesStatus:UnansweredMore 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 for BlueCross BlueShield Federal Employee Program ***************** as a new **** employee during open enrollment in December 2022. My coverage started in December 2022. As of today, January 10, 2023, I didn't receive my member ID card so I cannot use health benefits not even sign for the MyBlue website. I tried to contact BBS customer service today and stay one hour on phone. It is impossible to reach an agent via the phone. I cannot use my benefits 3+ weeks after my coverage started because I don't know my member ID. It is unacceptable. I paying for the benefits from my paycheck and cannot use it. I should be reimbursed for these 3 weeks I cannot use my benefits.Initial Complaint
Date:12/20/2022
Type:Product IssuesStatus:UnansweredMore 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.
We are writing to file a complaint regarding the poor service provided by Blue Shield regarding processing of our claim #************ for Covid test kits in the amount of $235.18 on 01/12/2022 to 01/19/2022. Blue Shield received this claim on 2/17/2022 and processed the claim on 4/30/2022. Since the processing of the claim on 4/30/2022, we have made multiple calls to their customer service number (see timeline below). 5/13/2022photos of original claim forms with receipts attached sent to Blue Shield via myblue patient portal 5/13/2022call to Blue Shield. The representative told us she checked and that Blue Shield received the receipts. She further stated that the check would be processed in ***** days to the primary contractor with an explanation of benefits 6/272022 @ 9:50am PSTcall to Blue Shield. The representative (********) read through the notes of the previous call. She stated as of today, the payment on the claim was still pending. She said the previous representative sent everything over to be processed on the 20th and that she (********) would send an email to see if the payment can be expedited and hopefully the payment can be done this week8/9/2022 @ 1:05pm PSTcall to Blue Shield. The representative stated there was no change in status. Said there were system issues in June and that many of those checks are being processed now12/16/2022 @10:00am PSTcall to Blue Shield. I went over with the representative (*****) the calls made to date with Blue Shield. She said she would send a request to expedite the payment which I reminded her was made previously by ******** on the 6/27/2022 call.As exhibited by the timeline above, it has been more than 10 months since Blue Shield received the claim (with receipts stapled to the claim) for reimbursement for Covid test kits. During this time, weve followed up with a number of phone calls and are still waiting for reimbursement.Initial Complaint
Date:12/07/2022
Type:Product IssuesStatus:UnansweredMore 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 Blue Cross ********* FEP. The only way for me to get reimbursed for out-of-network treatment is to print a claims form, fill it out, and mail it in. Then hope that it is received and processed timely. I have searched other programs, and even BCBS state websites, and all of them have the ability to receive claims online. For whatever reason, BCBS FEP makes it as hard as possible to file a claim, which I think is a huge disservice to federal workers. Strangely, they allow claims to be processed online only if you received overseas care. This as been going on for years and in 2022, we should be able to submit claims onlineInitial Complaint
Date:11/26/2022
Type:Service or Repair IssuesStatus:UnansweredMore 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 beyond frustrated with Blue Cross Blue Shield Federal. My husband transferred from the *********** to *** in Oct 2021. Due to lack of communication between the *********** HR and BCBS, my husband was still in the system as working for the ***********; however, no premium was being paid for coverage. My husband reached out to BCBS to inform them on what was going on, that he transferred from the *********** to *** and that both HRs are extremely slow as to updating information. BCBS did nothing, we kept getting the run around from different reps to the point I just give up on BCBS. I took it upon myself to start coverage for my family since I work at *** as well. I started a family policy and was paying a family premium; however, BCBS was only providing coverage for me a self only but I was paying for a family premium on the *** end. I reach out to BCBS again and told them what was going on. They again did nothing. I reach back out to my HR (***) and finally got someone to look into this. I was credited back my overpayment of my premium, policy cancelled and moved to my husband policy for family. Present day, November 26th, I go online to make an appointment because I have not been feeling well. I was told by the system that my insurance has expired in Jan 2022. At this point Im confused so I go to BCBS website and see that Im not even on my husband policy as a member. So I have had no coverage under my husband policy since Jan 2022 and I cant go see my regular doctor because Im not covered. My husband has been paying a premium for family and Im not even included. Im beyond ****** and Im sick on top of this. BSBC has really failed me. As a federal employee and disabled veteran this is an outrage and shame on BCBS for providing service to families in this terrible manner. I have to get out of bed and try to go get care when I could of easily did telehealth and get seen from the comfort of my bed. Thanks for the inconvenience.Initial Complaint
Date:11/01/2022
Type:Service or Repair IssuesStatus:UnansweredMore 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 $219.14 out of pocket for my mediation, Ovidrel, on 9/20/22 due to it being time sensitive to take this medication while I waited on the prior authorization to be approved. I had checked my benefit plan prior to having my doctors office submit the PA (prior authorization) form to ensure coverage. I received a letter dated 9/22/22 that the PA was approved and I requested reimbursement for my out-of-pocket cost. I was informed the reimbursement was denied due to me picking up the medication on 9/20/22 and not within the PA date range starting on 9/22/22. I spoke with a FEP BCBC pharmacy representative on 10/24/22 and 10/25/22 that informed me the doctors office can call BCBC FEP (he provided the number for the doctors office to call) to have that PA form back dated to 9/20/22. My nurse, *****, called on 10/25/22 to update them on backdating the date. ***** called me back that same day to inform me she spoke with my insurance and they said they will process the back date and did not give her a turnaround time. I called my insurance today, 11/1/22 for follow-up and was informed they are not able to back date a PA form. *** completed all steps per conversation and guidance from FEP Blue representatives and now informed they cant backdate the PA form. *** made multiple calls and talked to different representatives on 11/1/22 with no resolution to the miscommunication on FEP Blues end. I picked up this same medication in 2020 and completed the same process with no issues and was able to be reimbursed for my out-of-pocket cost. I would like to be reimbursed for my out-of-pocket costs as I and my doctors office has followed all the steps outlined by FEP Blue representatives.
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