Complaints

This profile includes complaints for Blue Cross and Blue Shield of Massachusetts's headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  Blue Cross and Blue Shield of Massachusetts

  101 Huntington Ave Ste 1300 Boston, MA 02199-7611

• 

  Blue Cross and Blue Shield of Massachusetts

  200 High St Canton, MA 02021-3654

• 

  Blue Cross and Blue Shield of Massachusetts

  Route 128 Peabody, MA 01960

• 

  Blue Cross and Blue Shield of Massachusetts

  34 Saint Martin Dr Marlborough, MA 01752-3021

The complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.

• Initial Complaint

  Date:04/02/2025

  Type:Product Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Blue cross blue shield of Massachusetts denied medical necessary and preventative care. Claim *************** must be covered under coverage policy

  Business Response

  Date: 04/07/2025

  To whom it may concern,

  For privacy reasons, we have responded directly to our member regarding this complaint.  The member will receive a written response to their complaint in the mail shortly.

  Regards,
  Member Appeals & Grievances Program

  Customer Answer

  Date: 04/07/2025

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved. 
  
  Regards,
  
  ***** ******

• Initial Complaint

  Date:03/27/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  In November Auburn sleep med got a benefits quote for me to get a dental appliance from the dentist Dr. ******** for snoring. I was told I only need to pay the remainder of my deductable which was $48. I went to Dr. ******** paid $500 deposit and had the impressions taken. I called BC/BS to confirm coverage again 12/29 and device code ***** was covered. ******************* called and said they were having a problem with my insurance. Called BC/BS again 1/10/2025 ref # ***** was instructed to file an exception for reimbursement. Called again referance # ***** instructed to submit reimbursement form. I went to pick up the appliance at which time I paid another $500 to get the device and I was to reimburse the dental office if I recieved any money from BC/BS. Recieved $1260 check from BC/BS with explanation of benefits. Called BC/BS ref#**** was told the TOTAL due provider is $1800.$540 is patients responsibility and $1800 was owed to provider.I mailed $800 to make Dr. ******** whole as I had previously paid $1000. Dr. ******** then sent me a bill for $2060 more.I did my due dillagence and called BC/BS with my member number multiple times to make sure the mouth guard was to be covered. I went from being told that I would only pay $48 to $3060. I would never have gone through with getting a plastic mouth guard if I knew I was going to be liable for that amount. I live pay check to pay check and cannot afford even medically necessary items that strain my budget. BC/BS representitives should be held responsible for their misinformation and pateints should not have to call NUMEROUS times for an accurate quote.

  Business Response

  Date: 03/31/2025

  To Whom it may concern,
  For Privacy reasons, we have responded directly to our member regarding this complaint. The member will receive a written response to their complaint in the mail shortly.
  
  Regards,
  Member Appeals & Grievances Program

• Initial Complaint

  Date:03/20/2025

  Type:Order Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My husband began a new job on September 16, 2025. We were fortunate enough to start our insurance coverage with **** of Massachusetts on the same day. Since then, however, I have had four claims denied by them, even though we have had consistent coverage. One of those claims was related to a hospitalization that started on 9/10/24 and lasted until 9/20/24. **** was our secondary insurance from September 16 thru September 30. After multiple calls between **** and the hospital, **** decided that they are not responsible for the portion of the bill that overlapped with our coverage. The bill I received was for $4344. Given that **** was the secondary insurance at the time, their portion would be significantly lower than if they were primary, despite that, they have continued to refuse to pay. This is a lot of money. The other three of those claims were related to blood work and the incorrect diagnostic codes used by my providers. These resulted in bills ranging from $50 to over $800. In two of these cases, after multiple calls to ****, my providers and the lab (*****************), where I was not able to coordinate between three separate entities to get the bill paid, **** agreed to an adjustment and reprocessed the claims. The most recent claim for $69, they are refusing to do so and I was also told, they wouldn't do that again moving forward. I am exhausted by all these calls where I have to be the go-between and nothing gets resolved because the people who need to be speaking to one another (my providers and ****) are not doing so, nor do I have the power to make that happen. Regarding this most recent denial for $69, they sent me an appeal form, but at this point, I'm too worn down to take that step. I believe this is a part of how insurance companies make their money, deny claims and make the process to get them paid impossible. I want the coverage that we are and have been paying for and are entitled to. Each medical procedure was for medically necessary reasons.

  Business Response

  Date: 03/27/2025

  To whom it may concern,

  For privacy reasons, we have responded directly to our member regarding this complaint.  The member will receive a written response to their complaint in the mail shortly.

  Regards,
  Member Appeals & Grievances Program

  Customer Answer

  Date: 04/03/2025

  Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered. 

  I received a letter from BCBS of Massachusetts in the mail as they indicated. The letter was a written version of my complaint and the same responses I have received over the phone. They agreed that there was overlap of coverage during my hospital stay on 9/16/24-9/20/24, however, they continue to say that the hospital will need to submit a modified claim. They are again not taking the initiative to make that happen and are putting it in my hands after I already stated that I've have done everything I can do to make that happen. Again, both the hospital and BCBSMA are saying the other needs to do something differently, but no one is taking on the responsibility to make that happen. Each party is putting that on me when I am clearly without any ability to make anything happen, hence this complaint in the first place. I am not satisfied with a response that just regurgitates the details we have already covered but is now in writing. 

  [You must provide details of why you are not satisfied with this resolution.  If you do not enter a reason for your rejection, your complaint will be closed as Answered.]
  
  Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
  
  FAQ
  
  Regards,

  Heather

   

   

  Business Response

  Date: 04/16/2025

  To whom it may concern,

  BCBSMA contacted Horizon Blue Cross Blue Shield NJ who advised that the provider submitted a corrected claim to them on April 7, 2025 and Horizon Blue Cross Blue Shield NJ is in the process of entering the claim in their system.

  Regards,
  Member Appeals & Grievances Program

  Customer Answer

  Date: 04/24/2025

  Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********.

  I have checked to see if the claim status is available for me to view online and it is not. Other than the response on 4/16/25, there have been no further updates, so I reject this response to keep the complaint open. Once I know the claim status, that will determine next steps.

  Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
  
  FAQ
  
  Regards,

  Heather

   

   

• Initial Complaint

  Date:02/21/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  Hello,I have been disputing a lab bill for 2 years now with no resolution. The date of service was 2/16/2023 with a patient balance of $98.64 and the issue has not been resolved despite countless attempts from the doctor, the lab - Quest diagnostics, and member services team from ****. I have spoken to the doctors office and the they have told me that the request was submitted to quest with all preventative billing codes. As per the policy at the time of the service, all preventative labwork is covered at 100% with no requirements for the deductible or coinsurance being met. I have been told by **** after over a year of back and forth that they will be manually issuing a payment to Quest diagnostics on my behalf as a courtesy to resolve the issue. This has never happened, and no matter who I speak to, they point the finger at another party and claim that they are the ones who are at fault for not processing the claim or paperwork correctly. I am requesting that blue cross blue shield step in and resolve this issue as this has dragged on so long that it has been sent to collections and we are now being harassed for payment. It is not my responsibility to bear the burden of cost for these tests as far as I understand, and I am not willing to just pay the bill because the various parties cannot provide an explanation as to what went wrong here. You may review my internal correspondence with Shaolin ***** from BCBSMA, who has been very helpful throughout the process Patient: ***** ******* - BCBS account holder - ***** ******* - Member ID ************

  Business Response

  Date: 02/27/2025

  To whom it may concern,

  For privacy reasons, we have responded directly to our member regarding this complaint.  The member will receive a written response to their complaint in the mail shortly.

  Regards,
  Member Appeals & Grievances Program

• Initial Complaint

  Date:02/14/2025

  Type:Service or Repair Issues
  Status:

  UnresolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I submitted two claims for reimbursement for out of pocket travel on 11/26/24 for two different travel periods. The claim status indicates paid. Neither claim has an EOB showing a picture of a check mailed. When I inquired of status because I have not received reimbursement for either they say they paid both on 1/2/24. I informed the company on 1/16/24 I did not recrive either check. They told me I have to wait 30 days before its missing to request them to track. I informed them on 1/31/25. I still have not received and that its strange that two different checks have never arrived and there is nowhere EOB with copy of check. They tell me it takes 30 more days for them to put in check tracer and re process for payment. They have not contacted me to indicate they are mailing new checks. They owe me over $2000 that I have been waiting almost 3 months since submitting for payment. The process of waiting and waiting when I indicate not received is not fair when they can easily research in bank if check cashed. I am an accountant so I know how its done. I want my refund immediately as i dont believe they ever sent the two checks in the first place. Have them show proof with an EOB that shows copy of check they sent and two pieces of mail don't coincidentally not get delivered. Their customer ********************** is horrible. Their policies are unreasonable. My policy number is R6G995601784. Please redact this number.

  Business Response

  Date: 02/14/2025

  BBB, this does not appear to be a BCBSMA member. Member currently has a dental plan only with BCBSMA and references an ID# of ************ that is not a BCBSMA ID #. Please redirect the member to their correct BCBS plan.

  Customer Answer

  Date: 02/15/2025

  Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered. 

  please see attached explanation of benefits related to my claim and plan. It clearly states to refer to ************************************. Phone number **************. When you log on to that website it shows the exact phone number and address that matches this business I selected to complain about  
  

  I cut contact info from website noted on claim attached (see below)  
  

  
  Blue Benefit Administrators of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association.
  Registered Marks of the Blue Cross and Blue Shield Association.
  2025 Blue Benefit Administrators of Massachusetts
  ****************************************************************************************************************;| ************ (BLUE) | TTY Number Dial 711

  Please ask them to properly address the complaint or explain why my explanation of benefits with the member id for medical would direct me to and have their contact info if not correct company  

  additionally i have since been informed that although they accepted my appeal acknowledging claim was incorrectly processed as an in network claim (see network discount) and that I do not owe the lrovider.  This is a provider who is not in network and that I paid provider and should not be processed with network discounts for out if network claim. They also did not inform me in writing denying my appeal with their explanation why they believe the claim was processed correctly as is required by insurance law.  

   
  Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
  
  FAQ
  
  Regards,

  ********

   

   

• Initial Complaint

  Date:02/10/2025

  Type:Service or Repair Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  On February 4, 2025 I got an email from the hospital stating they need my insurance information. I called Blue Cross and Blue Shield of Ma asking about my insurance. They stated that my policy had been cancelled as of February 1, 2025 for non Payment. I told them that I called in January and asked them if I owed anything and they said yes I owed the January payment. I offered to pay it online and they stated they could not do that. I then told them to send me a bill. I never received that bill or the February bill. I asked to speak to a supervisor and she also stated she could reinstate the policy because I had been notified. She stated that many letters and emails had been sent advising me of the cancelation. I never received any of the letter or any email notification. You can have access to my email account. I did due diligence I called the company and tried to pay the bill on line. I asked them to send me a bill, but I never heard from them again by mail or email. I did receive a letter from Blue Cross and Blue Shield today February 10, 2025 and the letter was dated February 3, 2025 stating that I owed the January payment if they did not receive it my policy would be cancelled. I was always going to pay the premium. I do not feel my policy should have cancelled. I would like it reinstated. Something need to be done so this does not happen to anyone else. Sincerely, ******** Suzanne ********

  Customer Answer

  Date: 02/21/2025

  I have not heard from the business in response to my complaint.

  Business Response

  Date: 03/03/2025

  Upon receiving the members complaint, Blue Cross Blue Shield of Massachusetts (BCBSMA) ********************* reviewed the members account in its entirety and responded with the following details: No payments were received for the months of December 2024 and January 2025. The plan
  submitted this as an involuntary disenrollment. The plan confirmed member payment options/premium bill preferences were correct . Member has been informed they remain disenrolled from our plan. The member was notified via letter on 2/18/25 16:00

  Customer Answer

  Date: 03/04/2025

  Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.  

  Blue Cross and Blue Shield did not address my complaints.  They never sent a bill when I asked for one and never sent a bill for February. I did receive a cancellation notice, but it was dated February 3, 2025 after the policy had cancelled in February 1, 2025.  They were required by law to send me notice of cancellation in writing which they never did.  When I tried to speak with them they said there was nothing they could do even putting blame on the ********************* I have to say I get the rest of my bills. I also could not pay on line because they said they do not do that. That is why I asked for a bill to be send which was never sent.   

  
  Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
  
  FAQ
  
  Regards,

  ******** *******

   

   

• Initial Complaint

  Date:01/27/2025

  Type:Product Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I asked for a quote and was told that I can not get the quote until I commit to add a person to our policy. I spoke to several people and was refused a supervisor. I actually have a name and email of a person. I wrote them and was given a return to email telling me to call member services. I have asked for a customer complaint number and can get through. I would like a corporate supervisor to call me back.

  Business Response

  Date: 02/14/2025

  To whom it may concern,

  For privacy reasons, we have responded directly to our member regarding this complaint.  The member will receive a written response to their complaint in the mail shortly.

  Regards,
  Member Appeals & Grievances Program

• Initial Complaint

  Date:01/02/2025

  Type:Billing Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  BCBS MA **** $980.33 a month for another person's insurance premiums from my bank account. I am a client of BCBS MA and have an individual plan with them; I have had no issues with my own plan, but I was being charged for premiums for someone named ********* T ******* in addition to my own premiums. These appeared as two separate charges on my bank account; a correct one for me, and another for $980.33 a month for ********* T *******.Charges occurred in September, October, and November. I was able to dispute and reverse the December charge, but **** has not refunded me for the three prior charges, totaling $2940.99 of fraudulent bank draws, despite numerous calls to customer *********************** and promises to fix it.

  Business Response

  Date: 01/17/2025

  To whom it may concern,

  For privacy reasons, we are responding directly to our member regarding this complaint.  The member will receive a written response to their complaint in the mail shortly.

  Regards,
  Member Appeals & Grievances Program

• Initial Complaint

  Date:12/10/2024

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I was a victim of an assault and battery in 2021 while Blue Cross was my health insurance provider.The case is now in civil litigation, and I am looking to access my old medical records for use in court. Blue ********************** has told me they have these archived, but will not release them to me. They have also blocked me from their customer ********************** portal and blocked my number from the customer ********************** hotline. I am simply requesting to view the details of MY medical claims.There is no action be taken against ****, but I need the medical records - or atleast the names of the providers I saw to treat my injuries so that I can use them as proof of medical costs.

  Business Response

  Date: 01/03/2025

  To whom it may concern,

  For privacy reasons, we have responded directly to our member regarding this complaint.  The member will receive a written response to their complaint in the mail shortly.

  Regards,
  Member Appeals & Grievances Program

• Initial Complaint

  Date:12/03/2024

  Type:Service or Repair Issues
  Status:

  ResolvedMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  When I was hired by my current employer the wrong *** of a dependent was giving to **** of MA - this has since been rectified by my employer. For over a month BCBS of MA has NOT updated this information. My dependent has been attending medical appointments and is now receiving bills for the care he received because **** of MA has not updated this information and his ************ Physician cannot give him a referral for the care he is receiving because the *** does not match what BCBS has on file (INCORRECT). When I contacted **** member services they said it has been updated - when the ****************** contacted Provider Services they said the *** was incorrect and there was nothing they can do. Does **** not share a computer system between Provider and Member Services? I'm not sure what kind of circus they are running but because of their incompetency we are now receiving a bill which we will not be paying for as we pay for insurance. There is no point in paying a monthly premium if they will not get their act together and cover medical services. I am looking for BCBS to update my dependents *** and stop sending bills!

  Business Response

  Date: 01/03/2025

  To whom it may concern,

  For privacy reasons, we have responded directly to our member regarding this complaint.  The member will receive a written response to their complaint in the mail shortly.

  Regards,
  Member Appeals & Grievances Program

  Customer Answer

  Date: 01/06/2025

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved. 
  
  Regards,
  
  *********************