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Blue Cross Blue Shield Health Insurance Review

52 Customer Comments & Reviews - see all comments
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Blue Cross Blue Shield is a health insurance company that offers a selection of insurance products for individuals, employers and families. This wellness company provides options for medicare and modern healthcare.

What’s Included with Blue Cross Blue Shield?

  • Diagnostic tests and imaging
  • Prescription drugs
  • Immediate medical attention
  • Outpatient surgery
  • Preventive care
  • Primary care visit to treat an injury or illness
  • Special visit and other practitioner office visit
  • Maternity care
  • Rehabilitation and habilitation services
  • Metal health, behavioural health, and substance abuse needs
  • Child needs (dental or eye care)

Types of Health Insurance Plans

Businesses and Organizations

Yes

Individuals and Families

Yes

Short-Term Health Insurance

Yes

Subsidiaries of Blue Cross Blue Shield:

  • CareFirst
  • Anthem
  • Premera
  • Regence
  • Highmark
  • Horizon
  • Excellus
  • Wellmark
  • Independence

Plans Reviewed

Bronze Plan

  • Overall deductible: For inpatient services, a total of $4,400 per individual must be paid for in-network providers and $8,800 for out-of-network providers. Outpatient services amount to $6,350 for every person if the client chooses a participating provider and $12,700 for non-participating providers.
  • Out-of-pocket limit: $12,000 per individual for out-of-network providers and $6,350 for in-network providers
  • No maximum annual limit for specific covered services
  • Balanced-bill charges, health care, and premiums are not included in the out-of-pocket limit
  • Other covered services: Chiropractic care, Infertility treatment, Weight loss program, and bariatric surgery

Silver Plan

  • Out-of-pocket limit: $6,000 per individual for in-network providers and $12,000 for out-of-network providers
  • No overall annual limit for some covered servicesNo other deductibles for specific services
  • Overall deductibles: A total of $1,400 per individual for in-network providers and $2,800 for out-of-network providers. Both do not apply to preventive care services.
  • Other covered services: Infertility treatment, Weight loss programs, Bariatric surgery, and Chiropractic care

Gold Plan

  • Expenses such as balanced-billed charges, health care, and premiums are not included in the out-of-pocket limit
  • Out-of-pocket limit: $5,000 per person for in-network providers and $10,200 for out-of-network providers
  • Overall deductibles: $150 per individual for participating providers and $300 for non-participating providers. Both do not apply to preventive care services.
  • No maximum annual limit and other deductibles for specific covered services
  • Other covered services: Weight loss programs, Bariatric surgery, Chiropractic care, Infertility treatment

Platinum with Dental and Vision Plan

  • Overall deductibles: None for both in-network and out-of-network providers. Does not include preventive care services.
  • No annual limit on selected covered services
  • Out-of-pocket limit: $6,000 per individual for in-network providers and $12,000 for out-of-network providers
  • Out-of-limit does not include expenses such as health care, premiums, and balanced-billed charges
  • Other covered services: Dental care for both child and adult, Infertility treatment, Routine eye care for adults, Weight loss programs, Bariatric surgery, Glasses for adults, and Chiropractic care

How Much Does It Save You?

 

Bronze

Silver

Gold

Platinum

Services

In-Network

(Your cost)

Out-of –Network

(Your cost)

In-Network

(Your cost)

Out-of –Network

(Your cost)

In-Network

(Your cost)

Out-of –Network

(Your cost)

In-Network

(Your cost)

Out-of –Network

(Your cost)

Primary Care Services

None

Not covered

$30 co-pay

Not covered

$30 co-pay

Not covered

10% co-insurance

Not covered

Diagnostic Test and Imaging

Inpatient: 40% co-insurance

Outpatient: No charge

Inpatient: 60% co-insurance

Outpatient:

No charge

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Generic Drugs

None

80% of BCBSM-approved amount for covered drugs

$15 co-pay

80% of BCBSM-approved amount for covered drugs

$15 co-pay

80% of BCBSM-approved amount for covered drugs

$15 co-pay

80% of BCBSM-approved amount for covered drugs

Specialty Drugs

None

80% of BCBSM-approved amount for covered drugs

20% for preferred coinsurance and 25% for non-preferred co-insurance

80% of BCBSM-approved amount for covered drugs

20% for preferred coinsurance and 25% for non-preferred co-insurance

80% of BCBSM-approved amount for covered drugs

20% for preferred coinsurance and 25% for non-preferred co-insurance

80% of BCBSM-approved amount for covered drugs

Outpatient Surgery

None

None

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Hospital Stay

40% co-insurance

60% co-insurance

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Prenatal and Postnatal Care

Prenatal: None

Postnatal: 40% co-insurance for inpatient and none for outpatient

60% for inpatient and none for outpatient

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Preventive Care Services

None

Not covered

None

Not covered

None

Not covered

None

Not covered

Emergency Room Service and Transportation

None

None

20% co-insurance

20% co-insurance

20% co-insurance

20% co-insurance

10% co-insurance

10% co-insurance

Urgent Care

None

None

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Rehabilitation and Habilitation Services

None

None

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Mental/Behavior Health Outpatient Service

None

None

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Mental/Behavior Health Inpatient Service

40% co-insurance

60% co-insurance

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Substance Use Disorder Outpatient Service

None

Not covered

20% co-insurance

Not covered

20% co-insurance

40% co-insurance

10% co-insurance

Not covered

Substance Use Disorder Inpatient Service

40% co-insurance

Not covered

20% co-insurance

Not covered

20% co-insurance

Not covered

10% co-insurance

Not covered

Annual Maximum Limit

Bronze

None

Silver

None

Gold

None

Platinum

None

*Only on specific covered services

Summary

Blue Cross Blue Shield is a well-established company with strong financial ratings. Wide acceptance among health professionals, comprehensive coverage and discounts on medical treatments makes Blue Cross Shield an excellent choice for health insurance.

 

 

 

 

 

 

 


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52 Customer Comments & Reviews

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sasaki.kay
10/5/2021
This is the horrible insurance. The strict networking and Nobody from insurance company informed about who was out of network of lab and imagining tests or it is the strict networking. I went to the new PCP who prescribed blood tests and imagining for the annual check ups. Cost supposed to be covered. The blood tests were done by the PCP office and they sent the blood test samples to the outside lab without letting me know which lab was sent to. Imagine office did not inform that they were out of the network. A few months later, I received the charge of $1950 for blood tests and $1330 for imagining tests. I appealed to the Blue Cross Blue Shield x3 times but all denied because of out of... Read More


kboyd1362
9/16/2021
I am on the provider end of BCBS and they are the worst! Anyone I know in the dental field hates and I mean hates dealing with this company on any level. They are terrible with providing information, they have too many varying plans which makes it hard to locate the correct one without the patient providing the insurance card. They do not provide a faxback and their portal through availity is a night mare!!! I sent in to have my Dr credentialed with BCBS Federal and the next think I know he is now not in network with any BCBS. Don't even start me on their hold times!!! I have submitted a W9 3 times to update my Dr's information and they still have failed! I'm now going to tell anyone who... Read More


trena.cortez23
8/30/2021
Customer service reps are nice and professional. My low review is for the change to dental bite wing X-ray coverage. Most dentist don’t do FMX 12 X-rays in one sitting. This coverage change is horrible because it covers every 3rd year, you can’t catch cavities early with this big 3 year gap! Bring back coverage for yearly bite wing X-rays!


R
Rachel
8/24/2021
I changed employers so I had to change insurance UNFORTUNATELY Blue Cross Blue Shield is the ONLY plan they offer..... Due to being pregnant during job change I went ahead and opted for the Gold plan (AKA most expensive) and boy was I SHOCKED to see how poor the coverage is. I am terrified to see what the lower tier coverage is. I pay $500/mo in premium just to have a $2,500 deductible. So I am out of pocket every single penny before then. If I wasn't pregnant I likely wouldn't even hit a $2,500 medical bill for the entire YEAR so paying $500/mo for literally no coverage would be ridiculous. My insurance plan at my previous employer paid for 100% of general chiropractic visits for up... Read More


sagstetter.christian
8/12/2021
Worst insurance you can get ! Unfortunately my employer offers only their plans. They hardly approve anything and low ball you wherever they can.


Jackie S
7/9/2021
I did physical therapy for about 9 months. When to my rheumatologist, place me on different pills for inflammation, shots. Finally went to Texas Bone and Joint because the pain was progressing to my back and down my leg and hips. I barely walk half of a mile. This is no way to live. All my doctor wanted to do was a scope. Finally no more pills. Just to see if I have a better quality of life. DENIED. I Appealed. DENIED THE SAME DAY. If this was a new drug to get high from it would have been approved.


edschonlau
7/6/2021
I desperately need surgery. I am 19 and already need weekly infusions because I can barely eat or drink because of severe gasteoparesis. I have been sick since 7th grade and they have tried everything besides highly invasive surgeries and nothing has helped. I was going to get the GPOEM, but insurance denied coverage. My nurses spent hours talking to them, I sent in a letter and appeal (the fax number they gave us on the appeal paperwork didn't even work). They denied it on the grounds it is an "experimental" surgery. I have read the statistics and scientific journals. Is it a new surgery? Yes. But the results have far higher success rates and lower complication rates than the only other... Read More


xmissxarielx
4/22/2021
I used to have medical through Care 1st and my coverage was much more substantial than what this company offers. Blue Cross Blue Shield does not advocate for their clients what so ever; treatment claims take a nominal amount of time to process and the employees are unfortunately not up to date with information regarding health care providers within their network. Mental health services are extremely difficult to access as well. Even my doctor(whom will remain unnamed) said this insurance company nickel and dimes their clients whenever possible. What this company does to their clients is unethical to say the least.


Debbie G
2/15/2021
Blue cross took over 4 weeks to ok my chemo. Meds. My first choice was denied even though my doctor said it would work well for me. Blue cross didn’t agree. Probably because the drug was $9000 per dose. Very disappointed they let someone with no oncology experience approve or deny chemo drugs. How do you make a cancer patient wait over 4 weeks for their Med. Someone should be held accountable.


J
Jeet
12/9/2020
I had paid costly premiums the whole year without a single claim. I had urgent care coverage at 100% in my plan. End of year I had an accident and had to go to in network urgent care for stitches. They hit me with a bill where I have to bear almost 50% of charges saying you have deductible. The worst part was when I called to question the bill, the rude human trash agent accused me of insurance fraud when they are the greedy low lives, trying to scam people. The agents are extremely rude and unprofessional. They are good only till you keep paying them and never make a claim.



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