Business Profile

Medical Plans

CareFirst, Inc.

This business is NOT BBB Accredited.

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Complaints

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

Customer Complaints Summary

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

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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:02/01/2024
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.
On December 30, 2023 we spoke with Julie ***** from Carefirst to find a new health insurance plan because Carefirst was increasing our rate over $700 per month. She helped find a plan and advised that we could start the new plan January 1, 2024. After checking with her manager she advised not to cancel the old plan until the new one was accepted since it was so close to the new year. The call was recorded and can be checked for verification. Carefirst has always billed us monthly (see screen shot) but billed us for January and February at the new rate $4574 (see screen shot) on original plan Jan 6. They also billed us for $1668.65 on January 6 for new plan (see screen shot) We are requesting a refund for Jan and Feb 2024 for the old plan. We have spent hours on the phone with Carefirst trying to resolve the issue.
Business Response
Date: 02/05/2024
Please see the attached letter. Thank you.
Initial Complaint
Date:01/26/2024
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.
A payment was withdrawn from my Bank Account for the month of January 2024. I mailed, through the ****, an Insurance Termination Form on January 5th, 2024, requesting, as stated on the form, that the date of my cancellation should be December 31, 2023. After at least 15 business days CareFirst has claimed they never received it. It was mailed to the **** Box listed at the top of the form in *********, **. The form was late getting there because it was late getting to me over the CHRISTMAS Holiday. After numerous phone calls to CareFirst, starting on December 22, 2023, asking for confirmation of my policy being cancelled, I got no results. The AutoPay SYSTEM of CareFirst then charged me on January 6th, 2024 for the amount listed below. I was told on the phone by numerous agents, that I would receive a refund after The Cancellation form was reviewed. I have since electronically submitted the form again, twice, with the cancellation date of December 31, 2023. I have disabled any future AutoPay feature from the website for CareFirst. Through secure email on their site, I have received notifications that there is no refund due. I want my money back, credited to my Bank Account. They keep sending me pre-programed responses to my complaint. Since it is illegal to be covered by more than one ******** provider in Maryland, I want this issue resolved. I am covered under the **** ******** ******** policy as of January 1st, 2024.
Business Response
Date: 02/22/2024
Hello *******, please accept my apologies, I have attached my response. If you have questions, please reach out to me directly. Thank you.
Customer Answer
Date: 02/22/2024

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,

******* Good
Customer Answer
Date: 02/22/2024
Thank you for submitting my request for a refund to Care First, They finally issued me the refund after a month and a half.
Initial Complaint
Date:01/26/2024
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.
Over the course of multiple months, I have had repeated issues being able to access my CareFirst account. From the start of service, I was unable to access my account for several weeks. I had to repeatedly call in to Technical Support and open multiple tickets. They would try calling me once then close the ticket, they would just decide to close the ticket for no reason, or they would try something and not communicate with me that they were no longer trying to resolve the issue. I had to waste hours of my time calling, cajoling, and arguing with people. I've been hung up on many times. I've been transferred to the wrong department multiples. CareFirst has been unprofessional, rude, and ineffective in resolving this issue. I have attempted to file a complaint with them but no one will take the complaint. I am paying for access to my account information, and I am tired of them not doing their job repeatedly.
Customer Answer
Date: 01/26/2024
Attaching completed form to provide any customer service notes related to two months of website access issues.
Business Response
Date: 01/27/2024
Hello. CareFirst BlueCross BlueShield is not able to respond to this complaint as we do not have an authorization on file to release protected health information to the BBB. CareFirst will respond directly to the complainant under separate cover. Thank you.
Business Response
Date: 01/27/2024
To clarify the authorization submitted is not valid to release information to the BBB in Maryland. Thank you.
Customer Answer
Date: 01/30/2024

Complaint: ********

I am rejecting this response because it provides no resolution. I don't understand why they would provide no option to address this either by email (I have received email from CareFirst in response to this complaint) or this platform. If CareFirst needs proper forms for release of information, please define or ask for the BBB to facilitate the resolution.

Sincerely,

******* ********
Business Response
Date: 01/31/2024
CareFirst is unable to provide any form of protected health information in a public forum due to HIPAA regulations. CareFirst spoke with the complainant via telephone on 01/30/2024. We will continue to work directly with the complainant until resolved. No additional information will be provided to the BBB regarding this complaint. Thank you.
Customer Answer
Date: 01/31/2024

Complaint: 21192298

I am rejecting this response because it has not resolved my issue. I have not been able to access my account for 10 days. This is after I wasn't able to access my account for three weeks in December.

Sincerely,

Michael Slattery
Initial Complaint
Date:01/22/2024
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.
My name is ***** ** with member ID: *********. I earned $250 blue rewards form the CareFirst wellbeing program with $150 on November 2nd, 2023, $30 on December 12, 2023, and the rest $70 on January 19th, 2024. But CareFirst did not deposit the fund into the reward card. I called the customer service many times but it is obviously no one can help me out. The card managing program asked me to call Carefirst member service with the reference number ************. I did it but still no luck to get the money back.
Business Response
Date: 02/22/2024
Dear Heather ******-
The member was responded to directly via email on 2/06/2024.
Sincerely,
Brian ** ***** PAHM
Pronouns: he/him/his
Senior Analyst | Executive Inquiry | Corporate Office of
Civil Rights
CareFirst BlueCross BlueShield
1501 S. Clinton Street
Baltimore, MD 21224
carefirst.com
Working Remotely: M-F, 8am-4pm
We work flexibly at CareFirst. I am sending this email
now because it works for me, but I don't expect that
you will read, respond to, or act on it outside of your
regular business hours.
Initial Complaint
Date:01/22/2024
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.
I applied for an Individual Health Insurance policy from CareFirst BCBS in Maryland in November 2023. I finally received a letter from CareFirst in December confirming receipt of my application and notifying that I would be issued a policy soon. On December 7, I paid CareFirst the full policy premium of $793.51 online via ACH bank transfer. I also enrolled in automatic payments using my bank account. Two weeks later, my CareFirst account online says my policy is null because they haven't received my binder payment. The online account still shows that I have a credit of $882.88 (which includes a separate payment for my dental policy) on my account and the money was withdrawn by CareFirst from my bank account correctly on 12/7.

I have spent over 12 hours on the phone with CareFirst Member Services, across multiple days in December and January, attempting to rectify the issue. I have a CareFirst member ID and temporary ID cards, but CareFirst is not able to verify my insurance coverage. To be clear, they have withdrawn the premium payments from my bank account. Each time I speak to a CareFirst representative, they have to involve their supervisor, then tell me to call back again in 4-5 business days. The last time I called on January 9th, the representative confirmed that this issue was "marked as high priority on my account", but no progress had been made by the billing department.

I took my children to the doctor on January 2nd to have their virus symptoms evaluated and CareFirst would not verify my coverage, despite my having a Member and Group ID, and, AGAIN, proof that I had paid CareFirst my health insurance premium. I need to take my two children, both under the age of 7, to the doctor and the dentist. This is absolutely unacceptable and I am at a complete loss as to how to resolve the issue because it appears there is no other way to contact someone at CareFirst that can help.
Customer Answer
Date: 01/22/2024
Thank you *******,
I have completed the Authorization form for CareFirst and attached it to this message. I look forward to your response. Thanks again.
*** *******
Business Response
Date: 01/30/2024
*******, please see my response attached. A valid authorization must be on file with the Privacy office.
Business Response
Date: 01/31/2024
Hello *******, I submitted the authorization form to the Privacy Office for review on January 30, 2023. Please allow additional time for the process and in the meantime, I will continue to work towards a resolution for the member. Please allow until February 6, 2024, for a resolution. If the Privacy office does not approve the authorization, we will respond directly to the member. Thank you.
Business Response
Date: 02/02/2024
Please refer to the attached response. Thank you.
Customer Answer
Date: 02/07/2024

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:01/22/2024
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.
Signed up for medical insurance during open enrollment 12/20/2023. Payment was processed through my bank account. Did receive my ID card in mail. Used at local pharmacy and was active. However, to date, when checking my CareFirst on-line account the medical card and payment is not listed on the website. Since 1/2/2024 have talked to numerous customer representatives. Have been constantly re-directed, promised call-backs, and assurances that they will send my concerns to the correct party for resolution. Have been given three ticket numbers ************, ************, and most recently on 1/17/2024 by customer rep Sherry INC5382946. Need to have this situation resolved ASAP so that I can access my account information on-line. Lastly, have not yet received my member information packet in the mail.
Customer Answer
Date: 01/22/2024
HIPPA release
Customer Answer
Date: 01/29/2024
1/29/2024:
Wanted to update status of complaint ID ********.
On 1/22/2024 received an e-mail from CD social Media inquiries from CareFirst:
Dear ***** ** *******
Thank you for your inquiry concerning help desk ticket number **********. We apologize for any inconvenience this matter may have caused. Our technical team is diligently working on your concern. Please allow 3-5 business days for a resolution.
There was no person or phone number listed to respond to in the message.
On 1/31/2024, noticed that the payment information was posted to my on-line account, but not the actual copy of the membership card.
This information disappeared later that day with a message on the server that they were having technical difficulties updating account information. That message disappeared later that evening.
Checked account this morning and issue still not fixed.
Thank you for your assistance with my concern,
***** ** ******

Business Response
Date: 01/31/2024
Tell us why here...

Please refer to the attached response.
Thank you.
Customer Answer
Date: 02/04/2024

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,

***** ******

As of 2/4/2024, my CareFirst on-line portal does show that the requested corrections have been enacted. I do want the original post to remain as I did need to spend a month trying to correct this issue with numerous CareFirst customer representatives. The issue was resolved only after I escalated my concerns to filing a claim with BBB.
Initial Complaint
Date:01/16/2024
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 am a mental health provider in Pennsylvania. I see a client who has Care First. I have been waiting for payment for 11 months. Both I and the member have made numerous calls to various entities (including **** ***** **** ******) to resolve the issue. Care First representative contend they call and leave messages (which they haven't). I have been redirected to different phone numbers and different addresses to send claims.

Care First/BC/BS owes me in excess of 2500.00.
Business Response
Date: 01/31/2024
Good Morning-
We will need the patient's name, DOB and CareFirst BCBS ID number in order to proceed.
Thank you.
Brian
** ***** ****
Pronouns:
he/him/his
Senior
Analyst | Executive Inquiry | Corporate Office of Civil Rights
CareFirst
BlueCross BlueShield
1501 S. Clinton Street
Baltimore, MD 21224
Customer Answer
Date: 01/31/2024
Hello
Care First is requesting more information. Since this is a HIPAA sensitive issue, I would need them to contact me directly. I see the response. I need them to contact me directly, which is part of my complaint. They do not return calls.
If there is a way to provide my contact information that would be most appropriate.
Thank you.

Business Response
Date: 02/08/2024
Dear Heather ******:

CareFirst ********* ********** and CareFirst
(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.
I added an attachment, then deleted the attachment as it has the incorrect member's name. I sent the correct attachment for Dolores Mihalich. If you received an incorrect attachment, can you please call me at ***** ********?

Sincerely,

Donna ***************

Donna
***************
Senior Analyst,
Executive Inquiry
CareFirst
BlueCross BlueShield
carefirst.com
Initial Complaint
Date:01/11/2024
Type:Billing 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.
On 11/21/23 ******** ******** sent to care first a letter stating we receive a $17 tax credit. Then on 11/24/23 they sent Care first an updated, corrected letter stating we receive a $628 tax credit. On the last week of 2023 I contacted the exchange to let them know care first was only showing a $17 credit. They said wait until the 1st of new year for info to update. I was also advised to make my premium payment of $621.93 which I did. I waited until 1/2/24 and it showed the policy was canceled. I called the exchange and they said the correct tax credit of $628 was sent and there was nothing more they could do and to contact care first. I called care first and the rep advised she would escalate my case but there was no time frame for this to be corrected. She said to keep checking the site and call back to check status. I called on 1/3/24 to check back and spoke to Kimberly. She would hardly allow me to speak and had me on hold repeatedly to try to get the pharmacy dept to make the policy effective so we can pick up our prescriptions using our insurance. She said it takes at least 72 hours for the case to be reviewed and at least 24 regarding the pharmacy. She assured she would call us back in 24 hours. No call back ever. I called again on 1/8/24 and spoke to Rikki * who said the case was escalated and she would check with the enrollment dept. I was on hold for a bit and she came back and said there was some issue with the application payment information and she would have to call me back. I did not receive a call back. I paid my premium and the government paid my tax credit but Care First refuses to give me coverage for the plan I was approved for through the ******** ********. I am unable to get my prescriptions or even visit a doctor because of this. My husband is a diabetic in need of urgent medical care and medication as well.
Business Response
Date: 01/17/2024
Hello *******, please see response for *********** ******* ***** attached. If you have any questions, please feel free to reach out to me at *************@carefirst.com.
Customer Answer
Date: 01/18/2024

Complaint: ********

I am rejecting this response because:

BBB is giving me 5 days to say if I’m satisfied with Care First’s response but the email states they will respond after 10 days. I am rejecting the response because 1) I was never given the opportunity to complete the authorization form required 2) the response time is outside of the BBB timeline given to me to determine if I’m satisfied or not.

Sincerely,

******* *****
Customer Answer
Date: 01/22/2024
I’ve attached the completed authorization form. Thank you.
Business Response
Date: 01/30/2024
On January 16, 2024, CareFirst received an inquiry from the
Maryland Insurance Administration regarding this case. As such, we will
respond to the regulatory agency and not to the BBB or the complainant.
The complainant will be notified of the outcome by the MIA upon completion of
their investigation. Thank you!
Customer Answer
Date: 01/30/2024

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.

I had to escalate this matter and contact the Maryland Insurance Administration. This matter is now being handled by the Maryland Insurance Administration and no longer through BBB. This is the resolution to my BBB complaint. I advise others with similar problems to go directly to the MIA and file a complaint.

Sincerely,

******* *****
Initial Complaint
Date:01/05/2024
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 11/14/23 I changed my healthcare plans through ** ****** ******** during open enrollment. It is supposed to take 7-10 business days for this change to become effective. However for both the December health coverage and January multiple phone calls have been made to get the plan to be manually updated or changed to the correct plan. As of today, 6 weeks after changing it online I still have the incorrect plan because CareFirst refuses to change it claiming the health exchange owes them completed forms when the exchange says CareFirst has those forms. There’s also little consistency between answers to questions during calls. I would like them to change my plan to the one I picked out once and for all.
Business Response
Date: 01/18/2024

Good morning Ms. Pigott,
I hope this communication finds you well.
This is in response to your inquiry under case BBB-2108113, for ******** ********
The authorization form included in the case has been submitted to the dedicated business area, and additional time will be needed for approval of the form. In the meantime, I will work to formulate a response to your inquiry. Please allow until January 26, 2024, for a response.
Thank you.

Angie *******
Initial Complaint
Date:01/04/2024
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.
We need BBB’s help to have CareFirst (1) refund us for premium payments that we made for Nov and Dec 2023 and (2) terminate our CareFirst coverage for 2024. (1) My wife and I terminated our joint CareFirst account on 10/30/23 by contacting both the Marketplace (HealthCare.gov) and CareFirst. Since I had moved to Medicare, Marketplace created a separate account just for my wife, and we were advised by CareFirst to pay the November premium for the joint coverage as it would take a few days to process the changes. However, the changes were not made, and we received bills for both the joint account and the new individual account for my wife. We contacted CareFirst on 11/20/23 and were advised to pay the December premium for the joint coverage while they resolve the errors. A couple of weeks later, we found out that CareFirst had terminated my wife's individual account due to non-payment. Then on 12/08/23, CareFirst posted a message, indicating that our joint account is now termed effective 10/30/23. In sum, while we made a payment of $1182.94/month for November and December, we did not receive coverage from CareFirst, but we have yet to receive a refund. (2) Starting in 2024, Virginia residents are required to use Virginia's Insurance Marketplace instead of the Marketplace (HealthCare.gov). We found out that we had been automatically re-enrolled with CareFirst for 2024, so we canceled this and my wife enrolled with a different insurer on 12/07/23 during the open enrollment period. However, CareFirst continues to bill us for the January 2024 premium and shows that my wife and I have a new joint coverage for 1/1/24-12/31/24. The Virginia Insurance Marketplace representative confirmed that we are not enrolled with CareFirst for 2024, and that CareFirst has been notified. However, CareFirst continues to assert that they did not receive a notification from the marketplace and therefore cannot terminate our 2024 coverage. We have attached a detailed summary of these issues.
Customer Answer
Date: 01/04/2024
Hello,
As requested, please find attached our completed authorization form for information release. Please let us know if any further information is needed. Thank you,
***** ****
Business Response
Date: 01/13/2024
Good afternoon Heather ******,
Please be advised that the member's 2024 coverage was voided on December 15, 2023. Also, a refund for the requested payments was processed electronically on January 3, 2024, to the account that was originally charged. The member may contact their financial institution to confirm that the payment was received.
Regards.
Danielle *******
Business Response
Date: 01/16/2024
More Information...Good morning Heather ******,

Please be advised that the original complaint was received on January 5, 2024, with a due date for January 15, 2024.

The authorization form that was included with the complaint was forwarded to our Privacy Office for review. Once approval was received advising the form was valid and that it was ok to reply to the BBB directly, the following response was uploaded into the portal on January 13, 2024, which was within the timeframe that was allotted.

"Please be advised that the member's 2024 coverage was voided on December 15, 2023. Also, a refund for the requested payments was processed electronically on January 3, 2024, to the account that was originally charged. The member may contact their financial institution to confirm that the payment was received."

Let me know if you have questions or concerns.

Regards.

Danielle *******
Customer Answer
Date: 01/20/2024

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,

***** ****

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CareFirst, Inc. is NOT a BBB Accredited Business.