Blue Shield of CaliforniaReviews of blueshieldca.com

Submitted claim for reimbursement of durable medical equipment from In-Network provider in early July. Over course of 6 weeks spoke to three different representatives all telling me "...everything looked fine and the claim was in process." Spoke to a fourth representative a week later who told me there is no record of the claim being filed. So he had me refile online and told me "...he would watch this one personally and call me back in a couple of days to verify the claim was received and is being reviewed." No mention of expedited handling, of course. No call back, naturally so tomorrow I will start the whole follow-up process again. By the way, Blue Shield of CA has contracted with Included Health to handle customer (complaints) so that is who I have been dealing with. The claims were filed directly with Blue Shield of CA.

Can't get simple tasks done like updating ID cards. Awful customer service

Blue Shield of California Under Fire: High Prices, Poor Leadership, and Broken Promises Blue Shield of California, once seen as a trusted name in health insurance, is rapidly gaining a reputation for being one of the worst providers in the state. Thousands of Californians are speaking out against the company’s outrageous pricing, poor service, and questionable partnership with Covered California — and many are placing the blame squarely on its leadership, particularly CEO Lois Quam. Under Quam’s leadership, Blue Shield has taken a sharp turn for the worse. What should be a non-profit health insurer focused on helping people has become a bloated corporation acting more like a government bureaucracy than a customer-first healthcare provider. Premiums have skyrocketed, deductibles have soared, and access to affordable care is becoming harder to secure. Many policyholders report being priced out of their own health plans, even as they remain under Blue Shield’s supposedly affordable umbrella. Customers trying to navigate care options or get answers from the company often face long hold times, unhelpful representatives, and a system that seems designed to frustrate rather than assist. Adding insult to injury, Blue Shield’s tight relationship with Covered California — the state’s health insurance marketplace — has sparked widespread criticism. Rather than giving consumers options and lowering costs, this partnership appears to function as a pricing trap. Blue Shield premiums on Covered California are often higher than competitors, yet the system encourages users to choose them by highlighting coverage tiers or offering deceptive comparisons. It feels less like a health plan and more like a racket. Critics argue that Lois Quam has failed in her duty to lead a fair, responsible healthcare company. Instead, under her watch, Blue Shield has continued to push higher rates while delivering substandard service and squeezing families who are already struggling with medical costs. With California residents desperate for affordable, reliable care, many are asking: how much longer will this continue? Blue Shield of California needs a serious overhaul — in pricing, service, and leadership — before it loses whatever credibility it has left. If you’re currently covered by Blue Shield and feeling the pressure, you’re not alone. Thousands are calling for accountability, transparency, and real competition. It’s time for California to demand better.

Better communication , but how do you go about the Rapid rehousing program? How do you go about case management to give you the proper referrals for these programs for a CES . Vs1collections zoom call every Monday weekly. Who would I let know about this to have more better communication

They deny everything they can with zero communication and try to run out the clock to see what they can get away with not treating. I urgently need to get treatment for my condition approved, and they've made me wait for months. The communication between them and my doctor has been nonexistent, with the doctor telling me they can't get through to talk to anyone, and them saying my doctor sent what they needed but it was still denied with no rationale. I just want to get a case manager on the phone with my doctor's office to explain why I need to get this treatment approved ASAP, but they're making it impossible. I've already had to pay out of pocket for the majority of my treatment for this well-recognized condition and been shopped off to various different customer reps while I tried to solve this problem by myself. It's abject cruelty. Blue Shield, people are suffering enough. Stop adding to the suffering.

I've been assigned doctors that no longer practice in the area I am in, multiple times. The HMO service doesn't work and finding help is difficult.

Some of the medical groups they contract with, like Regal/Lakeside are absolutely awful and have no comprehension about the importance of member service or professional conduct. However, this complaint is about BlueShield's Nursing Line. Why this alleged service even exists is incomprehensible to me. Today was the 3rd time in many years that I have called the line for advice. The first thing to note is, they are not a Triage Department. In each call made to the Nursing Line, the calls each went as follows: 1. What are your symptoms? 2. How long have you experienced these? 3. You need to go to an Urgent Care facility or ER. 4. Promise me you will get there "within the hour." They must be scripted because they always respond with the samr standard replies while offeringing no help. BlueShields benefits have decreased annually for the last 3 years but the premium I pay has increased.

Called your Customer Service number (855) 836-9705 to inquire about in-network providers in northern California as I wasn't able to confirm that information on the website, and I live in SoCal. Unfortunately, your representative, Shemilia, was extremely incompetent and even sarcastic when after 45 minutes into the call, she still couldn't help me. She kept forgetting the zip code I had given her and instead kept looking around my home zip code. I explained to her several times, in different ways, what I really needed but she still was clueless (??). I've been on the phone with her for now over 1 hour and 30 minutes. She sent me 6 emails of the same exact thing and it wasn't even what I had requested. It actually looks like she is just doing it on purpose at this point. She kept using my zip instead of the one I had given her. She had no idea about what she was doing and instead of asking somebody else to help her, which I suggested her to do, she just had an attitude(!) and has kept me on hold for about 40 minutes waiting for a 'supervisor'. She seems to be enjoying the fact that she's making me wait as she tells me to wait with a slight tone of 'happiness' and while she makes me wait, she keeps sending email. SHE SHOULD NOT BE DEALING WITH CUSTOMERS. It is for this reason, that I will definitely consider going with another insurance. It is because of people like her that companies lose business. It would be so much better to have customer service individuals who are competent, trained, and who could have at least some level of intelligence to retain customers and be profitable as a business, but instead you have mediocre, unintelligent, rude and clueless people working for you. I guess you don't care about your customers or your business. I don't need this kind of experience nor treatment, especially when I pay $$$$ a month. Our entire family is insured, so I guess you'll be losing here.