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Business Profile

Health Insurance

Blue Cross and Blue Shield of North Carolina

This business is NOT BBB Accredited.

Find BBB Accredited Businesses in Health Insurance.

Complaints

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

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Blue Cross and Blue Shield of North Carolina has 13 locations, listed below.

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    Customer Complaints Summary

    • 88 total complaints in the last 3 years.
    • 19 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:01/09/2025

      Type:Order 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.
      *************** was my primary ********* that ended on December 31, 2024 . On, and after Thursday, January 2, 2025. I decided to have the pharmacist fill Wegovy, Promethezine, ********** and Heslthy Blue refuse to cover any medicine but not until ***** ********* was over. I had to call Healthy Blue to make sure that they knew that my primary ********* was not my primary anymore and Healthy Blue was my primary ********* and so Healthy Blue . I sent in a termination letter to Heslthy Blue from ***** as well as ***** faxing the termination letter to the fax number ********** and my doctor also sent the prior authorization for Wegovy discussing why I needed it . I have not been able to get my meds as I am sick wihtout. Paying with my food money since I do not have money. I need the $24.04 for the ********** and ************ refunded to me. I am attaching the receipt. I also want ***** taken off as my primary and healthy blue actually paying for my meds and services. I need Wegovy approved.

      Business Response

      Date: 01/09/2025

      Thank you for the referral. We will reach out to our member and address any questions or concerns.

      Customer Answer

      Date: 01/09/2025

       
      Complaint: 22786359

      I am rejecting this response because: I was contacted by BCBS and  left a message that I am not an insurance member even though  I am an NC BCBS ********************** member and gave them my Member ID. ********************** *** then hung up on me and threatened not to pay for any meds. I am not sure what is happening. No one should be mistreated this way. I cant afford  my meds and my insurance is behaving fraudulently.


      Sincerely,

      ****** B. *******

      Business Response

      Date: 01/10/2025

      Thank you for the referral. We will reach out to our member and address any questions or concerns.

      Customer Answer

      Date: 01/10/2025

       
      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,

      ****** B. *******

    • Initial Complaint

      Date:10/17/2024

      Type:Service or Repair 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 father suffered a stroke in 2023. My mother and I have filed claims with BCBS and were clearly told these would be covered. Over the last 8 months the process has been going in circles processing and re-processing, one claim approved, others not sure what is happening. When speaking with customer service we were told these already should have been approved and paid. Somebody needs to look into these and finalize these claims properly because we are wasting months and hours speaking to customer service. My father is ********* ************. Subscriber ID ************.

      Business Response

      Date: 10/17/2024

      Thank you for the referral. We will reach out to our member and address any questions or concerns.

    • Initial Complaint

      Date:10/02/2024

      Type:Service or Repair 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 mother passed away on March 29, 2024. I called BCBS to stop bank drafts April 16th and to request a refund for the premium collected in April. Two premiums were collected on 4/5/2024: $****** and $291.00. They said they would stop all bank drafts and refund money. Check received from BCBS for ****** in mom's name. 5/7/2024 BCBS withdrew $291.00 premium. Called BCBS in *** and they apologized and said they would refund money and stop automatic bank draft. I asked them to issue checks in my name. Put Letter of Testamentary in mail per their request. 6/5/2024 BCBS withdrew $299.00 premium. I called BCBS and they said they did not receive letter of Testamentary in mail. They said I could fax it over. I faxed the letter to them. They also advised that I stop payment to them through my bank. 6/21/24 I paid a fee of $31.00 to stop payment to BCBS to my bank. 7/8/2024 Called BCBS. They said they received the Letter of Testamentary. They said I should be receiving a refund for part of March, all of ****** *** and June. Case number ******** was opened. 8/1/2024 Called BCBS to check the status of refund. I was on phone for 2.5 hours after being transferred multiple times and hung up on 2 times with no resolution. 8/7/2024 I called BCBS. They state that 2 checks have been issued in the amounts of $650.60 and $249.16 that day. 9/5/2024 I called BCBS to check the status of checks. They said they should have been expedited. I was put on hold and then disconnected while on hold. I called back. BCBS said it should take 30 days from 8/8/2024. I should wait until Monday and call back if I did not receive checks. 10/1/2024 Called BCBS to check status of checks. They said they could not tell me anything because their system was updating. They would call me back tomorrow.

      Business Response

      Date: 10/02/2024


      BlueCross NC will contact the complainant directly regarding their concerns.

      Customer Answer

      Date: 10/02/2024

       
      Complaint: 22366408

      I am rejecting this response because:  My complaint is against BCBS not this company.

      Sincerely,

      ******* ****

    • Initial Complaint

      Date:09/18/2024

      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.
      Blue Cross Blue Shield has approved payment directly to me, for an ambulance ride that occurred 03/22/2024 in ****************. Since April, when they approved the claim and payment for the claim. I have been waiting for the check in the mail. i have called a total of 4 different times since April in regards to this issue. They have said that they have "voided and reissued" the check twice, but do not know why it is not getting to me. it is now September 18th... nearly 6 months later.. no payment has been received. And when asked if there can be an investigation into why i am not receiving these checks, they answer was no. We can only keep voiding and reissuing the check. At this point there seems to be issues within the company with regards to sending reimbursement to clients. I asked if there were alternative ways to submitting the money , ie. digital or to my bank. The answer is no. just a check. When asked what will happen if i still do receive a check in 30 days, the answer was we will void and reissue. How can this be escalated for investigation? or can there be alternative modes of delivery when clearly one is failing?

      Business Response

      Date: 09/18/2024

      BlueCross NC will contact the complainant directly regarding their concerns.

    • Initial Complaint

      Date:09/17/2024

      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.
      This bill was paid and we are still getting letters stating that we owe them money.I called and spoke to ******* and she left a phone message stating that it was taken care of in august.I received a letter dated September 11, stating that this is still pending and this is the 3rd notice,We wrote a letter and included a copy of the check that was cashed. Nothing seems to be addressed.We paid the amount owed in June!Please help sort this out.

      Business Response

      Date: 09/17/2024

      BlueCross NC will contact the complainant directly regarding their concerns.

      Customer Answer

      Date: 09/17/2024

       
      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:08/27/2024

      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 cancelled my health insurance in January 2024. I had already paid my bill for February so I was issued a refund of $157.21. They suppose to send me a check but it never arrived. I called back after 30 days like they told me to and they cancelled the check and reissued another one. That check also never arrived. This process was repeated several times. I moved throughout this process and updated my new address before I moved to assure there were no issues. The representative did not change my address. I have been on the phone with customer service over 20 times now each time being tied up on the phone for over two hours. Thats a lot of time wasted on the phone. I am extremely upset. I want my money back. It is now almost 8 months later and I still do not have my check. I have talked to two different **********s as well. I have 7 different reference numbers about my case. The first ********** said they tried to send me one electronically and said it went through. And they closed my case. It did not go through. I got in touch with another ********** named ****** who is now in charge of my case. We got on the phone with my bank and my credit card company to verify that the check did not go through. She assured me this time everything was processed correctly and that I would get my check just like the rest of the people said. I still do not have my money. If this was the other way around debt collectors would be after me. I am so frustrated with this company. For a multi million dollar company cant refund a $157.21 check for a middle class working person. Its ridiculous and unacceptable. Here is the latest reference number that will get you in touch with ****** who is now in charge of my case. She has been nice about the situation but ultimately has not gotten my money to me. Please help. ****** (In charge of my case)50885511 (Most recent)************** (Phone number)Reference #s past 8 months ******** ******** ******** ******** ******** *******

      Business Response

      Date: 08/30/2024

      BlueCross NC will contact the complainant directly regarding their concerns.

    • Initial Complaint

      Date:06/19/2024

      Type:Service or Repair 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.
      I was sent a letter from a collection agency due to an error on a claim for March 28. I resolved the error, however I am unable to check if it satisfys the **** system and that the collection is released. I have tried to reach the agency many times and they simply do not answer the phone. I tried to reach BCBS customer service but the agent kept answering my question incorrectly and refused to allow me to speak with a manager. Also tried to use the online system, however BSBS i tech support was unable to help me resolve website issues to get into the account. Could you assist?

      Business Response

      Date: 06/19/2024

      BlueCross NC will contact the complainant directly regarding their concerns.

      Customer Answer

      Date: 06/20/2024

       
      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,

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

    • Initial Complaint

      Date:05/28/2024

      Type:Service or Repair 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 4/29/24 I signed up for insurance with BCBS of NC to start in May using the government ************ I was approved, issued an account at ********************** NC, sent medical cards via mail, made my initial premium payment, signed up for their online platform called Blue Connect. Received a bill for ***** Logged on to Blue Connect on 5/23 to pay but there was no option on my online account. Called customer service for Blue Connect and spoke to *******. She said they would fix this plus email me a link to make the payment. Never received the email. The next morning 5/24, I tried to log onto Blue Connect but couldn't. Called Blue Connect, they were baffled but my acct was inactive. Called BCBS of NC ***************** The female sounding rep mumbled a name. First she said that my account was past due and that my first paymt was applied to April. impossible because, I was covered by different insurance company as I only moved to ** at the very end of April. I couldn't be double covered in April. Correspondence from BCBS NC shows that my coverage began in May. BCBS patched me to gov ************ Gov determined that 2 acts were opened in error, told BCBS how to fix immediately but BSBC rep was non responsive even when she was instructed exactly how to fix. *** forced to escalate the issue. *** rep asked BCBS to email.me a card NOW to the active acct, then left call. The email contained the old inactive card. When I asked BCBS why they sent me that and why she didn't comply with Gov instructions to fix my issue immediately, she said that I "needed to be nice to her." At no time was I rude to her. She could have fixed my issue but instead allowed the problem to persist and Gov forced to file an escalation. After 2hrs, 8 min, still have an inactive acct, no access to my paid insurance and a rep who did nothing for me, refused to follow the Gov *********** reps instructions to immediately correct the error or even allow me to pay my June premium.

      Business Response

      Date: 05/28/2024

      BlueCross NC will contact the complainant directly regarding their concerns.

      Customer Answer

      Date: 05/31/2024

       
      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:05/16/2024

      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.
      Enrolled in ********* Was approved. Tried for 2 months to get ******************** card sent To local DSS. Could never get anybody on the phone.

      Business Response

      Date: 05/16/2024

      BlueCross NC will contact the complainant directly regarding their concerns.

    • Initial Complaint

      Date:04/26/2024

      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.
      My mom (*************************) passed away August 10, 2023. She had a supplemental health insurance policy with BCBC of NC. Her estate is due a refund check (approximately $225) for the month of August after she passed. I have contacted customer service at ********************** 7 times (10/5/23, 12/13/23, 2/1/24, 2/22/24, 2/27/24, 3/22/24, 4/26/24) since my mom passed asking about the status of the check. Every time I am told that the request is being sent over to be processed. When I asked if there is a manger/supervisor I can talk to about it I am told no. Can the BBB please help me with this issue?

      Business Response

      Date: 04/26/2024

      Thank you for the referral. We will reach out to our member and address any questions or concerns.

    Blue Cross and Blue Shield of North Carolina is NOT a BBB Accredited Business.

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