Capital BlueCross Reviews | capitalbluemedicare.com @ PissedConsumer

Dorotha Sxe

Monroe, North Carolina

Poor customer service

Feb 26, 2024

I called customer service to see why virtual care was charging me $65 for an appointment when it should only be 15. I was told that their system is having issues and there is nothing that they can do. I informed her that I could not afford that or urgent Care. There's no offer of any other help just accept the situation.

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William W Fdp

Cancel coverage

Dec 17, 2023

Staff In November 2023 I signed up for one of your benefit plans(forgot which one) I found a better plan that same day I contacted customer and spoke to Michelle I asked to cancel my policy I waited a week and called again I spoke to Crystal and again asked to cancel policy She said original call was in my file and she would forward this request to the proper dept Today(12/17) I receive an email to register with the company I am registered with another company and would like this policy (if it exists) canceled THX William R Walsh 455 Garland Circle Lancaster PA 17602

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Preferred solution: Deliver product or service ordered

Anonymous

Guest-4101799

Harrisburg, Pennsylvania

Dental Coverage - they now do their own and its horrible

Oct 25, 2022

2.0

I've been going to Marinak & Glosser Dentists in Camp Hill (now Glossner & McElwee) for the last 22 years. Never have they NOT accepted my dental insurance - even when I had subpar dental insurance through a nonprofit employer - until now.

The practice has chosen to not participate in the Capital Dental plan due to poor customer service, slow reimbursement, and low reimbursement rate. The practice tried to make a go of continuing to accept Capital Dental out of loyalty to their patients, but when it came down to employing a full time person to sit on hold all day as they tried to call customer service to track down claims, they made the business decision to terminate the relationship. Calls were dropped and hold times were ridiculous. As someone who works for Capital Blue Cross, I am beyond disgruntled.

I had to pay over $300 out of pocket at my family's 2-person dental check up on 10/21 because the practice no longer wishes to participate with Capital Dental. Even worse, as I try to locate a new dentist, the search function turns up many providers currently not accepting new patients. I'm stuck in a catch-22.

Really great job "going the extra mile" for your dental members. Just go back to outsourcing to United Concordia or Delta Dental.

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User's recommendation: When pricing, don't forget to consider dental coverage

George D Beo

Not like you have a choice.

Jan 03, 2020

1.3

Got a call from CVS saying that they needed more info about my insurance, even though they'd been covering my prescription for the past 6 months. Turns out, CapBlue rejected it. After sitting on hold for an hour, my representative Brian began stammering about the pharmacy not being in the extended medication network. He provided me with a list of in network pharmacies, and mine was right...there... he then told me he has "no idea why it was rejected" but I should just go to one that is in network. In essence, get the prescription written again and resubmitted somewhere else, after going a week without them already. "I have no idea, it should be approved" was the answer I got. "Call the pharmacy," he says, "and give us a call back, we're here for you 24 hours a day." Pharmacy offers to fill it for full price. I call back - "Our business hours are 9-8pm, call back during that time." Waste of my time, horrible and incompetent customer service reps, and I'm still unmedicated. Only provider my employer offers, so I can't even "take my business elsewhere" and they know it.

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Cons:

Lack of ability to find answers for my plan

Reason of review:

Poor customer service

Preferred solution: Let the company propose a solution

K W Zav

Kind of ok

Jan 06, 2020

3.9

To be honest, all health insurance sucks - but when I had a real unexpected crisis and faced catastrophic bills, they weren't so bad. And there customer service was much nicer to me than with other insurance companies I've been with. So until universal healthcare and no deductibles or coinsurance, I give them a 4.

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Charlotte K Cfo

Susquehanna, Pennsylvania

More Of A Bizarre Charity Than A Health Insurance Company

Jun 02, 2019

We'll be contacting them yet again tomorrow. The latest denial was for something I've been prescribed for a decade, for R.A.. They're getting more creative. This one is for ' non-compliance ' although they flatly refuse to tell the doc what in blazes that means. IMO what it means is a last-ditch effort to have the customer write the check for coverage and have enough left over to also pay for your prescriptions. Like idiots, we DO pay for some out of pocket and why? Because I need them. It's beginning to feel like we're writing a check to some bizarre charity supporting poor, needy CEO's. Prescriptions seem denied as a knee-jerk reaction, there's never a reason or cause. We shopped very, very carefully for this plan and bought a nicely expensive comprehensive plan. Although staff answering phones are pleasant and seem to try to help, you're routed around for HOURS and hours and hours you'll never get back. I do feel we were lied to and wince when we see ads - they're all about how cozy is the relationship with the customer. Sure. With our check books. Seriously. It feels like a genuine scam and sure has all the identifying features. 1. Make a lot of huge promises. 2. Fail to meet them. 3. You write checks for a product that doesn't exist. 4. Someone is getting wealthy somewhere behind the whole thing. All that's missing is that bridge in NYC.

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Loss:

$700

Reason of review:

Not as described/ advertised

Preferred solution: Let the company propose a solution

Jeffrey A Eag

Prescription not getting filled

Feb 16, 2019

2.3

Have been trying for 2 days to get my blood pressure medication filled. It got denied at my local pharmacy so Capital Blue said I would need to go to CVS. Drove to the closest CVS. Denied again. Called the doctor, he called Capital Blue and resubmitted the prescription under their requirements. Denied again. Called Capital Blue and they put me on hold. Came back and said they will contact CVS to get it filled. Waited on hold for 15 minutes. They came back and said they are unable to make outgoing calls at this time. Put me on hold. Waited 15 minutes and I hung up. So far going on 3 days without my blood pressure medicine. Worst service every. I guess as long as they get my monthly payment, they feel they don't need to help.

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Reason of review:

Poor customer service

Dana T Jjp

The worst at the the highest $$$

Jun 25, 2018

1.5

We pay $2300/mont for a family of 4, no pre-existings. They cover nothing! Everytime we go to any doctor, specialist I get bills! I need to see an ortho, which there are about 75 in my area, no they want me to travel 45 minutes to someone I never heard of! To have lab work done they expect me to call to see where to go every time because everyone keeps dropping them! Do any providers accept Cap Blue Cross?? $27,600 a year and out of pockets up to $20,000! We’d be better off if we were poor and got free healthcare! Any suggestions on different plans?

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Reason of review:

Pricing issue

Anonymous

Guest-1223300

Wouldnt cover diagnostic mammogram, denied appeal

Mar 31, 2018

Two time breast cancer survivor, instructed by oncologists to always have a diagnostic mammogram. Never had a problem tilll l had this lousy insurance. Now stuck with all the bills.

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Reason of review:

Bad quality

Anonymous

Guest-1063296

Harrisburg, Pennsylvania

Prescriptions

Jun 19, 2017

1.0

Our doctors give us medications and how much they want us to take because they are the doctors not insurance companies so why is capital blue undermining our doctors by giving us a quantity limit! why should anyone pay for insurance when all they do is refuse to pay for what we need! what our " DOCTORS" say we need!! Constantly changing our policies and trying to get out of paying for our medical needs! Who are you to say we will only pay for half your prescription and less then half on some.So i guess we all should only pay half of our insurance bills RIGHT!! Its only fair!!!Enough is enough insurance companies are crooks and think they can do what they want whenever they want even think there above the doctors now, well I say we should all join together and stop this from happening any longer by not paying them a dime!! If it were not for us and our money they would be obsolete!! One more thing it says your doctor can authorize a request well *** they already did when they signed the prescription in the first place!!!!!

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Cons:

Constant changes to policy

Reason of review:

quantity limit on presriptions

Preferred solution: keep it like it was instead of trying to get out of paying your share all the time

2 comments

Machele Imf

Jun 19, 2017

Commenting on a complaint that is devoid of specifics is impossible, eg., drug name, number of pills requested and authorized by the insurance company and their reasons for doing what you said they did, etc. A generalized complaint about insurance companies is common, but they do have reasons for what they do and if you called them they would have told you.

Helpful

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Anonymous

Guest-891086

Hanover, Pennsylvania

Coverage issues

Jul 29, 2016

This is by far the worse insurance we have ever had! Do not choose if you have any health issues at all. This was the first insurance company that has denied treatments for my son with Crohn's disease in the last eight years. Not reliable. No consistency with their coverage and co payments, one time it is covered, next time it is not. I have called to talk to talk to a service representative several times and was told they would look into the issues and never called back, happened 3 times and issues are still not solved. I have called to see if services will be covered and no one is able to tell me, if they can't tell me who am I supposed to ask. It is a complete joke that might be funny if it were not costing me thousands.

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Reason of review:

Bad quality

Anonymous

Guest-717469

Hershey, Pennsylvania

Disgusted with Capital Blue Harrisburg PA

Oct 15, 2015

I have a Medical Advantage Plan with Blue Cross - Senior Blue PPO. It is offered to retired teachers. I am so disgusted with getting passed around to find out answers to simple questions. I simply want to know co-pays for 2016 for 2 medications. I am given incorrect information and different answers for the same question. It is a whole afternoon affair to get an answer and my co-pays for this year never matched the information I was sent from Capital Blue. I will be changing during the open enrollment period so I don't have to deal with the incompetence of this company. They need to have the info available for my plan and train their employees how to find it.

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Cons:

Lack of ability to find answers for my plan

Reason of review:

Getting accurate info

Christobal Fnq |

Allentown, Pennsylvania

Capital Bluecross - Blood Pressure Medication Review from Allentown, Pennsylvania

May 16, 2015

Updated by user Jun 15, 2015

Nothing has been resolved!!!!!!! This is causing a lot of stress and anxiety for my husband and I. I have never dealt with such a company:-\

Original review May 16, 2015

I've been having problems with my account since October. After I made 25 phone calls for a total of 6 hours and 57 seconds, I find out our account is suspended. Eevidently, they found an error dating back to December 2014. So without notice or even a May invoice, boom we're cancelled. When my husband went for his 2 blood pressure prescriptions on 5/14, that is when we found out highmark cancelled us.

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Reason of review:

Poor customer service

1 comment

Guest-986626

May 20, 2015

SAME problem with this company. ''Automated Bill Pay'' and some confusion with the routing number… so why not call their customer ??

NOPE. JUST DROPPED ME WITH NO LETTER FOR 15 DAYS !!!!

There is no supervisor to talk to, and cannot switch because they have the government behind them now. I can't wait to switch next year.

I am livid with them, as had all kinds of tests scheduled and had NO IDEA I WAS EVEN CANCELLED !!!!!

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