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Business Profile

Medical Plans

CareFirst, Inc.

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Medical Plans.

Complaints

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

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CareFirst, Inc. has 3 locations, listed below.

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    Customer Complaints Summary

    • 135 total complaints in the last 3 years.
    • 41 complaints closed in the last 12 months.

    If you've experienced an issue

    Submit a Complaint

    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.

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    Complaint status

    Complaint type

    • Initial Complaint

      Date:03/03/2025

      Type:Service or Repair Issues
      Status:
      Unresolved
      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.
      Our company's claims for one of our therapists keep being rejected as OON, because the incorrect coverage termination date was entered. We called CareFirst on November 1, 2024 to file a termination date of February 4, 2025. Whoever did this incorrectly listed the termination date as November 1, 2024, and thus all of those therapist's claims for the next four months have been wrongly rejected. This incorrect listing also violated CareFirst's own policy, which states that termination of coverage requires 90 days' notice.We have called CareFirst multiple times about this over the past few months, and each time we have been assured that it would be resolved promptly, only for the payments to continually be rejected. Most notably, we spoke with **** (case #********), who told us that she escalated the reinstatement up the chain and it should be resolved within 5-6 business days. That was at the beginning of this month; we have not heard anything since, and this continues to be an ongoing issue.The last time we called about this, we waited on hold for hours until we were finally given the phone number for the credentialing team; we were told we were being transferred there, only for the call to fail. When we called back, there was no option to speak to a person, only an offer to leave a voicemail after another hour on hold. This has been a complete waste of time and an incredibly frustrating experience. CareFirst's treatment of the people it relies on to do business is abhorrent.

      Business Response

      Date: 03/06/2025

      Please see response. Thank you. 

      Customer Answer

      Date: 03/12/2025

      You marked this as resolved. It is not. I have still not heard anything from the company itself. They promised to contact me "within 24 business hours" of their response and they haven't. Why would you mark it as resolved if I have not indicated that it is? Just another useless thing for CareFirst to hide behind while it continues its path of destruction. Thanks for absolutely nothing.

    • Initial Complaint

      Date:02/28/2025

      Type:Billing Issues
      Status:
      Answered
      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 tier exception but the insurance company denied this request without providing any reason why. i've been without my medicine for weeks! as of 2025, the co-pay went from $60 to over $600 for 1 month's supply of my zepbound. i don't ever recall being informed this was going to happen! the tier exception would take my co-pay down to $75 per month. i explained the hardship of not being able to afford the huge price increase, but the insurance company never provided any explaination or assistance.please call or email me and explain exactly what i need to do to be approved for the tier exception please!

      Business Response

      Date: 03/04/2025

      3/4/25

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

      Dispute Resolution Specialist
      ********************************************************************************
      Phone: **************

      Complaint ID: ********

      Dear Dispute Resolution Team:

      This letter responds to your inquiry of 2/28/25, in which you requested an investigation of allegations raised by the complainant, ******** Dattoli ********.

      CareFirst BlueCross BlueShield and CareFirst BlueChoice (CareFirst) cannot respond to this inquiry using a public forum due to privacy regulations.

      CareFirst will contact the complainant within 24 business hours of this response and work directly with that party to resolve the issue at hand.

      Thank you for the opportunity to address your inquiry. If you have questions or concerns regarding the information provided in this letter, you may contact me at **************.

      Customer Answer

      Date: 03/26/2025

      I have been trying to reach **** again. I re-filed my tier exception request and spent a great deal of time as well as my doctor's time to submit this paperwork.  **** again denied the paperwork, even after I did exactly as they had instructed me to do.  They also failed to provide a reason why this happened. I was told the ******** was not eligible for a tier exception as of 3-1-25, however **** failed to inform me of this rule before I jumped through all the hoops they told me to do.  this is greatly unfair and unethical for this company to cause ongoing problems for a patient as well as the doctor and staff. Please ask **** to call me so I can learn more information about how to handle this.  Thank you.

      Customer Answer

      Date: 03/27/2025

      Im still waiting to hear from Bcbs 

      Business Response

      Date: 04/01/2025

      BBB RESPONSE:

      4/1/25

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

      Dispute Resolution Specialist
      ********************************************************************************
      Phone: **************

      Complaint ID: ********

      Dear Dispute Resolution Team:

      This letter responds to your follow-up inquiry of 3/28/25, in which you requested an investigation of allegations raised by the complainant, ******** Dattoli ********.

      CareFirst BlueCross BlueShield and CareFirst BlueChoice (CareFirst) cannot respond to this inquiry using a public forum due to privacy regulations.

      CareFirst will contact the complainant within 24 business hours of this response and work directly with that party to resolve the issue at hand.

      Thank you for the opportunity to address your inquiry. If you have questions or concerns regarding the information provided in this letter, you may contact me at **************.

      Customer Answer

      Date: 04/06/2025

      I have not received a phone call back from the business, can you please ask someone to call me ASAP? Or if they can send an email. Im not able to reach anyone to help me at ****. Please !

      Business Response

      Date: 04/08/2025

      4/8/25

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

      Dispute Resolution Specialist
      ********************************************************************************
      Phone: **************

      Complaint ID: ********

      Dear Dispute Resolution Team:

      This letter responds to your follow-up inquiry of 4/7/25, in which you requested an investigation of allegations raised by the complainant, ******** Dattoli ********.

      CareFirst BlueCross BlueShield and CareFirst BlueChoice (CareFirst) cannot respond to this inquiry using a public forum due to privacy regulations.

      CareFirst will contact the complainant within 24 business hours of this response and work directly with that party to resolve the issue at hand.

      Thank you for the opportunity to address your inquiry. If you have questions or concerns regarding the information provided in this letter, you may contact me at **************.

    • Initial Complaint

      Date:02/18/2025

      Type:Billing Issues
      Status:
      Answered
      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 July of 2024, I switched employers meaning I would be switching from Care First BCBS to another provider. My employer at the time did their part and updated my file with the new fiscal year information, ensuring that my insurance would be set to expire on 7/31/2024. CareFirst, not understanding how it works I presume, still has it set to 7/1/2024 and is giving me the runaround on changing the date. I have since called CareFirst NUMEROUS times, including on a recorded line with my previous employer who also agreed that the date should be changed and that they sent the right paperwork stating this. CareFirst continues to drag their feet and point their fingers at who should be changing it while my claims are tied up and Im being billed for things I shouldnt be. I have screenshots showing the overcharges and the comments left from CareFirst on the claims and them still not changing it despite promising to do so. It also doesnt help that you can never login to see your account information. What will it take? How much money do I have to lose?

      Business Response

      Date: 02/20/2025

      Hello *******, please see our response attached.  

    • Initial Complaint

      Date:02/10/2025

      Type:Billing Issues
      Status:
      Answered
      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 receive CareFirst insurance through my employer. They are illegally refusing to reimburse me for two regular dental visits for my daughter (****** **********) totaling $990 (Case Numbers ************ and ************). They paid these claims normally until last year and now claim that the no longer need to.

      Business Response

      Date: 02/13/2025

      2/13/25

      BBB LETTER:

      ******* ******
      Dispute Resolution Specialist
      ********************************************************************************
      Phone: **************

      Complaint ID: ********

      Dear Dispute Resolution Team:

      This letter responds to your inquiry of 2/10/25, in which you requested an investigation of allegations raised by the complainant, ***** **********.

      CareFirst BlueCross BlueShield and CareFirst BlueChoice (CareFirst) cannot respond to this inquiry using a public forum due to privacy regulations.

      CareFirst will contact the complainant within 24 business hours of this response and work directly with that party to resolve the issue at hand.

      Thank you for the opportunity to address your inquiry. If you have questions or concerns regarding the information provided in this letter, you may contact me at **************.

       

      ***** *********-*****

      Executive Inquiry Analyst

    • Initial Complaint

      Date:02/06/2025

      Type:Billing Issues
      Status:
      Answered
      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 am filing a complaint against CareFirst Blue Cross Blue Shield due to an unauthorized charge after my confirmed disenrollment.I was enrolled in a CareFirst health insurance plan throughout 2024. However, as of 2025, I no longer needed this coverage and switched to another provider. I ensured my disenrollment through Maryland Health Connection and confirmed it again on January 15, 2025. Despite this, on February 3, 2025, I was charged $605.82 for a plan I had already canceled.Upon contacting CareFirst, I was informed that they had never received my disenrollment request from Maryland Health Connection and that my plan remained active. This is despite my Maryland Health Connection portal confirming that I am not enrolled in any coverage and having the same confirmation through the Carefirst portal until Feb 5, 2025 (The website just got updated with wrong information right after I contacted them).I have already submitted a case review request with Maryland Health Connection, but CareFirst continues to claim that my plan was not canceled on their end. I request that CareFirst:1. Acknowledge my disenrollment for the entirety of 2025, including January.2. Issue a full refund of the $605.82 premium wrongfully deducted from my account.3. Ensure that disenrollment communications between Maryland Health Connection and CareFirst are handled properly in the future to prevent similar issues for other customers.4. Provide a fair settlement for the inconvenience caused by this administrative error, including the time and stress involved in resolving this issue.I believe this is an unfair and improper charge, and I seek a resolution as soon as possible. I appreciate your help holding CareFirst accountable for its administrative error.Attachments: 1. Copy of CareFirst bill 2. Screenshot of Maryland Health Connection portal showing no active coverage 3. Screenshot of Carefirst portal showing no active coverage I appreciate your prompt attention to this matter.

      Business Response

      Date: 02/07/2025

      Hello *******, please see CareFirst response to complaint attached. 

    • Initial Complaint

      Date:01/29/2025

      Type:Customer Service Issues
      Status:
      Answered
      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 had insurance through my employer at ***************** that was canceled March 31st, 2024 because I was no longer a full time employee at that job. I recently purchased a BlueCross insurance plan through Maryland Health Connection. I was unable to get my payments in for ******* by ******* 1st due to not having my account set up. I called, payments for ******* were made ******* 14th. I have the confirmation numbers:# ******** for my health insurance payment for ******* and #******** for my dental insurance payment. I spent most of the day on ******* 14th speaking to representatives over the phone and was able to get my **************** card sent to me via mail. Now I have my card and Im being hung up on over the Technical Support Line ************. I also just paid for February Health and Dental, confirmation numbers are Health #N50020019 and Dental #N50020020. I dont understand why Im having so much trouble accessing the portal for my new plan information. Ive received mail, emails and plenty of links to access the my health portal and MyAccount and keep getting sent to Technical Support and just in a loop. *** also started support messages REF: ********* and C25-0002825278. Its been almost 3 weeks with no resolution. Im tired. I just want to be able to log in and pay my bill more easily and see my information updated. I also transitioned and had my name changed on my plan from *****************. I can provide materials and documents for support if need be to verify my information.

      Business Response

      Date: 02/03/2025

      Hello *******, please see CareFirst response to BBB22868895 attached. Thank you. 

    • Initial Complaint

      Date:01/28/2025

      Type:Customer Service Issues
      Status:
      Answered
      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 needs urgent care and the provider said they cannot verify insurance without a card. My husband couldnt get care today because you have not mailed us our cards, even though we are currently supposed to be covered. This should be illegal.Please mail us our cards immediately, or send me a digital card. I cannot log into my account through the app without my card numbers. I am very disappointed that my husband needed care today and cannot get it until our cards come. His health is in jeopardy, right now, until we receive our insurance cards. Youve known about our coverage starting on 1/12/25 for MONTHS, yet no cards yet.

      Business Response

      Date: 01/27/2025

      Good afternoon, 

      Based on the additional document loaded to this case on January 24, it appears that the member's coverage is through our federal employee program.  The request is being forwarded to that area for handling.

      Thank you, 

      ******** *.

      Customer Answer

      Date: 01/27/2025

      Better Business Bureau:

      I have reviewed the offer and/or response made by the business in reference to complaint ID ********, and have determined that this proposed action has not yet resolved my complaint.  For your reference, details of the offer I reviewed appear below.

      We still do not have our insurance cards - until we do this complaint should remain open. 

      Regards,

      ****** ****




      Business Response

      Date: 01/28/2025

      Good afternoon, 

      This is not an Anthem Blue Cross Blue Shield member.  It appears the member is covered under CareFirst FEP Blue Cross Blue Shield. 

      Thank you, 

      ******** *.

       

      Customer Answer

      Date: 01/28/2025

      Better Business Bureau:

      The insurance cards arrived today. They say FEP Blue BCBC on them. I dont understand how that is different from regular BCBC. 

      I have reviewed the offer made by the business in reference to complaint ID ********, and find that this resolution would be satisfactory to me. I will wait for the business to perform this action and, if it does, will consider this complaint resolved. If the company does not perform as promised I can get back to you at: *********************************************************************************.

      Regards,

      ****** ****



      Business Response

      Date: 02/04/2025

      Please review the attached response. 

    • Initial Complaint

      Date:01/23/2025

      Type:Billing Issues
      Status:
      Answered
      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.
      went to ********** in network for flu like symptoms prior to being seen the billing agent informed me that they were a in-network provider and the policy i had had no copay and would bill insurance the insurance company hs denied claim putting me on hook for bill and i told them before being seen i had no money so the insurance need to eat the bill for lying to billing person

      Business Response

      Date: 01/28/2025

      BBB LETTER:

      ******* ******
      Dispute Resolution Specialist
      ********************************************************************************
      Phone: **************

      Complaint ID: ********

      Dear Dispute Resolution Team:

      This letter responds to your inquiry of 1/24/25, in which you requested an investigation of allegations raised by the complainant.

      CareFirst BlueCross BlueShield and CareFirst BlueChoice (CareFirst) cannot respond to this inquiry using a public forum due to privacy regulations.

      CareFirst will contact the complainant within 24 business hours of this response and work directly with that party to resolve the issue at hand.

      Thank you for the opportunity to address your inquiry. If you have questions or concerns regarding the information provided in this letter, you may contact me at **************.


      Customer Answer

      Date: 01/29/2025

       
      Complaint: 22845178

      I am rejecting this response because:
      They are refusing to resolve anything and not responding on bbb should be a red flag of company refusing to resolve their screwup with ********* giving them approval to be seen and no fee was assessed per insurance *** **** given to their insurance verification *** at ********* 
      Sincerely,

      ****** *****

      Customer Answer

      Date: 01/31/2025

      The insurance company has sent secure messages through a platform that I have inform them repeatedly I can't receive messages and no one has contacted me over the phone I reached out to another rep *** company to quote policy not trying to resolve issues 
      ****** moody 

      Business Response

      Date: 02/03/2025

      2/3/25

      BBB LETTER:

      ******* ******
      Dispute Resolution Specialist
      ********************************************************************************
      Phone: **************

      Complaint ID: ******** - Follow-up Response

      Dear Dispute Resolution Team:

      This letter responds to your inquiry of 1/31/25, in which you requested a second investigation of allegations raised by the complainant.

      CareFirst BlueCross BlueShield and CareFirst BlueChoice (CareFirst) cannot respond to this inquiry using a public forum due to privacy regulations.

      CareFirst will contact the complainant within 24 business hours of this response and work directly with that party to resolve the issue at hand.

      Thank you for the opportunity to address your inquiry. If you have questions or concerns regarding the information provided in this letter, you may contact me at **************.

      Customer Answer

      Date: 02/09/2025

      The company continues to send secure messages after repeating attempts to ask them to help access and unable to access when they do message there is not a resolution it's scripted rheteric not actual response or resolution 

      Business Response

      Date: 03/04/2025

      CareFirst has already discussed this case with the complainant via telephone and email and explained our position.  A letter was mailed to the complainant on 02/19/2025, again explaining our position and provided next steps with his employer group.  Thank you. 

      Customer Answer

      Date: 03/04/2025

       
      Complaint: 22845178
      There there was no discussion taking place I don't know how they came up with February 19th that they spoke with me I did not receive a phone call from anybody ultimately what boils down to it is they are my insurance company we pay them to insure us and their job is to take care of the unnecessary necessary bills that we accrue seeing as we have been paying for almost 5 years with this company or maybe four years and they yet to want to pay for anything the customer has paid enough it is now time for the insurance company to do their part and pay
      I am rejecting this response because:

      Sincerely,

      ****** *****

    • Initial Complaint

      Date:01/09/2025

      Type:Billing Issues
      Status:
      Resolved
      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 05/14/2024, my doctor prescribed a breath test to diagnose SIBO. Called CareFirst (**) to check if I needed preauthorization and provided details and was told no preauthorization required and covered 100%. I obtained test from ************************************** (CDI) as none of the CareFirst labs offered this test.After receiving bill from CDI on 08/05/2024, I reached out to ** and was told by the agent that the claim needs to be filed again and reiterated that I am covered at a 100%. However, on August 01, 2024, ** issued a check for $23.62 claiming out-of-network.I called ** again on 09/09/2024 after receiving the 2nd bill and was told to file an appeal. I promptly did this and requested that this claim be paid in full as I had followed all of the guidelines for preauthorization procedures before obtaining this required test.On 12/02/2024 I received a decision letter regarding my appeal stating that my appeal was declined as this provider (CDI) is not in the network.None of the ** in-network providers conduct this medically required and doctor-prescribed test. Even after properly following all of the required processes and follow-up, ** has declined my claim once again. *** provide a courtesy discount and charged me $272.62 instead of the original billed amount.On 12/04/2024 I filed a complaint against ** with the Office of the *********** Ombudsman and Bill of Rights to seek a resolution to this case and request ** to reimburse me for this expense.On 12/17/2024, ** overturned their decision and agreed to consider this as in-network. However they only was willing to pay me $5.90 as the difference between in-network and out of network. ****** considered this as an in-network procedure from the beginning and paid the provider their pre-negotiated rate for covered services, I would not have to pay out of pocket. I request ** to reimburse me $243.10 for the charges I paid the lab directly due to no fault of mine.

      Business Response

      Date: 01/09/2025

      Hi *******, please see the attached, let me know if you have any questions. Thanks 

      Customer Answer

      Date: 01/13/2025

       
      Complaint: 22786153

      I am rejecting this response because: They have not contacted me as promised to resolve the situation.

      Sincerely,

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

      Business Response

      Date: 01/27/2025

      Please refer to the attached response. Thank you.

      Customer Answer

      Date: 01/27/2025

       
      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:01/07/2025

      Type:Product Issues
      Status:
      Answered
      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 have been waiting on a reimbursement check for $319.89 from Carefirst for over a year and a half. I have made many phone calls, have been told the check was mailed but it has never been received by me. Every time I call I am told I will get a call back but no one ever calls back, so I have to call and start over. Please note the address on the supporting document is old at this point, Carefirst has been advised and has confirmed my current address.

      Business Response

      Date: 01/13/2025

      Please refer to the attached response. Thank you. 

      Customer Answer

      Date: 01/14/2025

       
      Complaint: 22763193

      I am rejecting this response because:

      It does not resolve my issue, nor have I been contacted by them despite what the letter says. 

      Sincerely,

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

    CareFirst, Inc. is NOT a BBB Accredited Business.

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