I never thought I would reach the point where I would be telling people to run the other way from BlueCross. Yet here I am: after 6 years as a BlueCross subscriber, I recommend getting any other coverage available to you. Which is saying a lot, given that they have one of the largest networks of health care providers and offer some of the most extensive PPO plans around. To be fair to BlueCross, the first two years were great. The customer service people were helpful, the prescription coverage was excellent, and claims were approved and paid in about two weeks.
About three years ago something changed, and everything positive about the company disappeared into the ether. Customer service became just like every other company: a complete crap shoot. The prescription coverage became worse and worse, until my out-of-pocket cost for my daily medication had eventually increased twenty-fold. And, most frustrating of all, BlueCross began to make errors on every single claim I submitted. The process for being reimbursed for covered services became a nightmare of calling again and again, providing the same information over and over (provider name, diagnostic, medical license and tax identification numbers), and endless resubmitting.
Honestly, I would have continued to live with all of that had BlueCross not started, in November of last year, to deny me coverage based on an internal BlueCross employee error. In October, I switched from my COBRA coverage to paying as an individual subscriber for the same plan. At the time, I had to demonstrate that I’d had continuous coverage for the previous 4 years in order to remove the standard waiting period for coverage of preexisting conditions, which I did. Hunky dory, everything’s fine, we truck along with the same frustrations already enumerated above. In November, someone at BlueCross did something — trust me, if I could get a clearer or more specific explanation out of them, I’d share it — that changed my starting date of coverage and activated a waiting period. I promptly received a nonsensical bill from them and my claims starting being denied. I called, they told me I needed to get a statement from them and fax it back to them — major errors resulting in the wrongful denial of service can apparently be made but not corrected internally at BlueCross — and then they would remove it. I did so, they did so, hunky dory, right? WRONG. Despite being assured over the past six months by a half dozen customer service agents and managers that the waiting period has been removed, it is in fact still active, and my claims are still being wrongfully denied. As of today, I’ve been waiting two weeks for a return call confirming that it’s been corrected. I’m not holding my breath.
I, of course, have done what any sane person would do in this situation: changed my insurance company and filed a complaint with the Better Business Bureau. Next up: the Maryland Insurance Administration. I’ll keep you posted.
