Complaints

This profile includes complaints for CareFirst, Inc.'s headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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  CareFirst, Inc.

  PO Box 8894 Baltimore, MD 21224-0894

• 

  CareFirst, Inc.

  PO Box 14114 Lexington, KY 40512-4114

• 

  CareFirst, Inc.

  10455 Mill Run Cir Owings Mills, MD 21117-4208

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:05/09/2023

  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.

  on April 4th 2023 i went to have my taxes done. i couldn't complete them because Carefirst did not send me a 1095 tax form. so i called them 4/5/2023 and asked them to send me a form. i have not been sent a form yet. i have called them 5 times now. talked to *****- case #******-6729703, called again after several weeks got another case # ******-6766455, weeks went by, called again...case# ******-6798853.talked to ****** still i have not received a 1095 tax form for 2022. i cannot finish my taxes without it. Any help you can provide will be appreciated. My member ID # *************, group 99EE

  Business Response

  Date: 05/14/2023

  RE:    BBB File Number:    
  
  
  Dear *******:
  
  
  This letter is to acknowledge the follow-up receipt of your correspondence inquiry for ****** ******** son, **** ******** date of birth *******.

  
  
  CareFirst does not have a valid authorization on file from the complainant to provide a response to the Better Business Bureau. We will reply directly to the complainant. 
  
  
  Please be assured that we are working as quickly as possible to provide an equitable resolution.

  Business Response

  Date: 05/15/2023

  5/15/23
  
  
  Name:            **** *********
  Address          
  
  
  RE:      BBB File Number:    20033863
  
  
  Dear: Ms. ******,
  
  This letter is to acknowledge the receipt of your correspondence. 
  
  CareFirst does not have a valid authorization on file from the complainant to provide a response to the Better Business Bureau.  We will reply directly to the complainant. 
  
  Please be assured that we are working as quickly as possible to provide an equitable resolution.
  
  
  Sincerely,

  ***** *********-*****
  Senior Analyst, Executive Inquiry
  CareFirst BlueCross BlueShield
  *******************************************************>***************************************
  W ************ | F ************
  **************************

• Initial Complaint

  Date:04/28/2023

  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.

  Re: Member ID XII ******************************** failed to properly process the enrollment application for our newborn son, **** ********, DOB *************, and inappropriately terminated his coverage without notice and with no explanation.

  Business Response

  Date: 04/28/2023

  <DATE>
  
  
  Name
  Address
  
  
  RE:      BBB File Number:    
  
  
  Dear *******:
  
  This letter is to acknowledge the receipt of your correspondence. 

  Please be advised CareFirst received a duplicate inquiry for ****** ******** son, **** ******** date of birth ********
  
  CareFirst does not have a valid authorization on file from the complainant to provide a response to the Better Business Bureau.  We will reply directly to the complainant. 
  
  Please be assured that we are working as quickly as possible to provide an equitable resolution.

   

  
  
  
  Sincerely,

  
  

  Customer Answer

  Date: 05/03/2023

   
  Complaint: 19993812
  
  I am rejecting this response because: an insurance ID card has not been received for ****, and the claim for his pediatrician visit was denied despite active coverage.
  
  Sincerely,
  
  ****** ********

• Initial Complaint

  Date:04/12/2023

  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 recently reinstated my insurance with BlueChoice, because my new employer’s health plans are through them. But because I had BlueChoice several years ago with a previous employer, all my information is tied to my old company email address. That means I can’t login to my portal, because the password reset function doesn’t work, as the reset links are sent to an email I can’t access. I called BlueChoice over a month ago (~March 9th) to speak with someone about resolving this. They said due to a technical issue on their side, they couldn’t reset my password, so I should wait for them to resolve it. I waited about two weeks before calling back, and I got the same reply- they were still having technical issues. I called a third time, asked to speak to a manager and was told I could not, so my information was taken down and was supposed to have been sent to a manager. It wasn’t. My medical plan has been active for two months now, and I can’t do anything I should easily be able to do- check information about network providers, see my account balance, change my personal information, etc. I’m locked out of everything, and BlueChoice hasn’t done anything to fix this problem. I’m sure I’m not the only person experiencing this, so I would like them to fix their technical issues so I can reset my password and mailing address, so I can actually use my health services.

  Business Response

  Date: 04/19/2023

  This
  letter is to acknowledge the receipt of your correspondence.  Thank you for allowing us the opportunity to
  further review your concerns.
  
  Your
  letter has been forwarded to a CareFirst staff member to investigate and we have
  been in contact with the complainant. 
  Please be assured that we are working as quickly as possible to provide
  an equitable resolution. 

• Initial Complaint

  Date:04/12/2023

  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.

  I received out of network services upon approval of those services. I filed the claims to care first blue choice for $6580.00in September 2022. They send me a check of $2654.52 and $2526.98 to my provider. First of all they made a mistake of sending it to provider where I paid her in full and according to their guide lines I am responsible to file and receive payment. When I enquire about it than I came to know that they send part of the payment to her. I contacted my provider and asked her if she received the check. She said she never received any check. I went after CFBC to issue me the payment which they did but they send me the payment in my provider's name so I can not cash it. This check was issued on 01/26/2023. Since then I have been calling them but they never gave me an answer when I will receive the check. I am retired person and I have mortgage to pay. I am tired of calling them to get my money. Please help me to get my money. They should also compensate me for stress, tension, lies and misleading.

  Business Response

  Date: 04/19/2023

  Good Evening Heather:

   

  The inquiry is currently being reviewed, and the claim adjustment should be completed this evening. I will provide a detailed response tomorrow to include either a copy of the Explanation of Benefits or a screen print of the adjusted claim. Your patient is appreciated

  Customer Answer

  Date: 04/27/2023

  
  
  Complaint: ********
  
  
  
  I am rejecting this response because in Dec 2022 care first claims they sent the check to the provider. I complained to care first that provider never got it and I paid her in full so that check should come to me. In Jan 2023 care first sent me the check of $2526.98 in the provider's name which I could not encash (copy of the check attached). After bringing this error to Care first attention nothing has been done since January after numerous calls forcing me to go to BBB.
  
  
  
  Sincerely,
  
  
  
  ***** ********

• Initial Complaint

  Date:03/30/2023

  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 COBRA dental and vision coverage through previous employer is not ineffective (TASC is my COBRA servicer). I have been paying COBRA premium monthly and I confirmed with TASC that my dental and vision coverage through COBRA is still effective and should be effective until 8/31/2023. They sent CareFirst proof of payment/ coverage on 2/21/23. Carefirst website shows that my coverage was terminated on 11/30/22. I have been trying to resolve this issue since. I tried calling CareFirst multiple times and kept getting transferred to different departments who were not helpful. Average hold time on the phone is at least 45 minutes. I sent a message via Carefirst portal 2 weeks ago but I did not get any response. My recent dental claims were denied. I need to go back to see my dentist ASAP due to emergency. But because my coverage is showing as inactive, I cannot afford to go now and pay upfront. I only have 4 months of coverage to get my oral health taken care of. Member ID ********** group number 0H3C. I will be filing a complaint with Maryland Insurance Administration if the issue does not get resolved within 2 weeks.

  Business Response

  Date: 03/31/2023

  Good afternoon Heather, please see attached in response to BBB ********* Thank you

• Initial Complaint

  Date:03/23/2023

  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.

  Since December 2022, CareFirst ********** has been applying the incorrect subsidy amount, having the incorrect policy information on my account, and charging me random amounts that are higher than I'm supposed to be paying. I have called them at least 5 times, sent them 6 emails, and contacted ** ****** **** without a proper resolution. Every time I call they tell me they are escalating the problem but if I don't pay the premium as it's shown, my policy will be canceled--but I shouldn't worry because they'll credit me the difference. That has yet to happen. The latest bill is 3x the amount I'm supposed to be paying and I have no idea why. And if I don't pay that my policy will lapse.

  Business Response

  Date: 03/24/2023

  March 24, 2023
  
  Reference: Consumer Info: ********
  
  Dear Dispute Resolution Team:
  
  This letter is to acknowledge the receipt of your correspondence regarding the
  above referenced file.
  
  CareFirst requires a valid "Authorization Form" in order for us to
  release specific details regarding customers' complaints. Because we do not
  have that authorization on file, we will reply directly to the complainant.
  
  Please be assured that we are working as quickly as possible to provide an
  equitable resolution.
  
  
  Sincerely,
  
  Terea ********
  
  

• Initial Complaint

  Date:02/28/2023

  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.

  My husband and I both had medical coverage through CareFirst from retirement until Medicare eligible. This was a short term, self pay policy, ID #*********. Monthly premium for both of us was $1668.36. On 08/23/2022, I paid $1668.36 for our September 2022 premium. A few days later, I received a letter from CareFirst stating that we could not keep this CareFirst plan with Medicare. My husband, ******* *****, was Medicare eligible on 09/01/2022. This CareFirst letter took WEEKS to reach us because it was sent to an old address. I had notified CareFirst by telephone in mid-June 2022. We also had changed our address with the Post Office in mid-June 2022. To date, I can see via the **** app that CareFirst mail is STILL being sent to our old address, ***** ********* ****** ************* ** *****. Upon receipt of this letter, I emailed CareFirst via MyAccount asking what I should do. I received an email response on 08/28/2022 with an attachment of a Membership Change Form. I completed this form and mailed it to CareFirst on 08/29/2022.
  
  I will attach a copy of the letters that I sent to ****** *****, US House Representative of MD, CareFirst CEO, MD Insurance Administration and CareFirst, Director of Billing.

  Business Response

  Date: 03/03/2023

  March 3, 2023
  
  
  Name               ****** *****
  Address            *********
  
  
  RE:      BBB File
  Number:  ********
  
  
  Dear ******* *******
  
  This letter is to
  acknowledge the receipt of your correspondence. 
  
  CareFirst does not have
  a valid authorization on file from the complainant to provide a response to the
  Better Business Bureau.  We will reply
  directly to the complainant. 
  
  Please be assured that
  we are working as quickly as possible to provide an equitable resolution.
  
  
  Sincerely,

  Donna ***************
  CareFirst BlueCross
  BlueShield
  Senior Analyst, Executive
  Inquiry

  Customer Answer

  Date: 03/03/2023

  
  
  Better Business Bureau:
  
  
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  
  
  
  Sincerely,
  
  
  
  ****** *****

• Initial Complaint

  Date:02/15/2023

  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.

  This complaint involves dental insurance thru CareFirst blue cross blue shield.
  Date of service is 8/14/22
  Went to dentist for routine e cleaning and exam. Supposedly a check was issue in September 2022 but neithe myself of the dentist office ever received the check. I have called the dental insurance at least 5-6 times since then . I keep getting the run around. They told me they would reissue the check for 94.00 . That was in September. Never recieved reissued check so called again in Oct/Nov to be told check was never reissued. Again I was told check would be reissued now it’s mid February and told yet again today that check still has not been reissued. Apparently they haven’t bothered to assign my claim to anyone despite a half dozen phone calls- each call has been at least 2 hours long because it took 1 to 1.5 hours for someone to answer the phone . I spoke to a supervisor named Jason today and he said he would expedite claim and check should be issued within 10-15 business days but I have been told this at least 3 times already . I just want the the check for 94.00 asap. I’m tired of excuses, no legitimate explanation for delays. I have wasted at least 8-10 hours in the phone since September trying to get this resolved. They just seem to be refusing to issue a check.

  Business Response

  Date: 02/24/2023

  Thank you for the opportunity to address our member's concerns. We will respond to our member directly. 

• Initial Complaint

  Date:02/14/2023

  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 applied for a dental insurance policy with CareFirst through the ************** Health Link website on 12/30/2022. CareFirst never properly set me up with an account. I've called 10 times over the past month and a half, and keep getting the run-around. After multiple ***** minute waits, some representative answers, and tells me they've fixed the problem and to try again in 2-3 days. I've been told that 10 times. It doesn't seem to matter who I talk to - ***************** managers, technical support, billing - it's the same "the problem will be fixed in 2-3 days" and it never is. I keep getting referred to different people in a circular pattern, and nobody fixes the problem. I even tried resubmitting my application through the DC Health Link, as CareFirst suggested, and they still haven't set me up with insurance. I need dental insurance, and I need it now.

  Business Response

  Date: 02/15/2023

  Good afternoon,

  Please see attached response regarding BBB 19370193.

• Initial Complaint

  Date:02/14/2023

  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.

  With my policy with Carefirst, there was a health incentive that would be paid out every year as long as I filled out a questionnaire. I completed the survey but never received the $100 bonus. I have called Carefirst multiple times to find out why I did not receive the incentive. I have been told that a "ticket" was submitted but I never receive the check.

  Business Response

  Date: 02/15/2023

  Hello, 

  Please see attached response.