Andrew Griffin

Review of Blue Cross and Blue Shield of ...

This rating may be altered but, as of now I have h...

This rating may be altered but, as of now I have had the worst experience in my life with this company. I do not state that lightly either.

I had a short term policy with them because I moved to the area in June and had to get insurance for my school. During my short term policy I had an MRI (that was covered) revealing a torn ACL. I put the surgery off till December due to my schoolwork and wanting to wait till I was in the winter break so that it wouldn't impact my grades. Everything appeared fine, BCBS told my surgeon's office they did not need to pre-approve my surgery and they were covering my healthcare up until now.
I renewed my policy in November or end of October and everything still seems fine. My mailed EOB's state that everything is being covered and I am paying copays at my physical therapist office. I have the surgery on Dec. 20th and pay my portion. A few days after my surgery I reapply for the new year and everything seems fine (I should have just gone with marketplace coverage).

On Jan 1 they send me an email, of course the office is closed. Jan 2 they tell me I will be denied for coverage because my knee (that, at this point believed was covered) surgery and the fact I was still receiving healthcare for it and thus was a pre-existing condition. Come Jan 8 I receive an EOB from visits to the physical therapist in november and december stating they are not covering it. I call and find out they are also probably no longer going to cover the surgery or surgeon's fee. The ONLY reason I pursued the surgery at the time I did was because it seemed like they were covering my healthcare. Turns out now, they are backpedaling. I understand that a company needs to make money. I understand that insurance companies need to make money. This though. This is a scam. If at ANY point they would have stated there was a problem I would not have pursued a 25,000 dollar surgery. I couldn't have afforded it. No, they waited to tell me till AFTER the new year that there was an issue. I am now paying cash for my physical therapy. I don't know many that have 25,000 dollars to throw at a surgery. I for sure barely have the money to pay for my physical therapy at this point (I'm a grad student. I live off my loans).

I spoke to a fantastic rep named Carmen who is doing everything in her power to aid me in getting their med director to look at this. It is pending. I will update my review once it has been finished but, at this point it's not looking good. I do not recommend them.