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 Find Local Branches.

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

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  Blue Cross and Blue Shield of North Carolina

  5901 Chapel Hill Rd Durham, NC 27707-3346

• 

  Blue Cross and Blue Shield of North Carolina

  PO Box 2291 Durham, NC 27702-2291

• 

  Blue Cross and Blue Shield of North Carolina

  PO Box 2100 Winston Salem, NC 27102-2100

• 

  Blue Cross and Blue Shield of North Carolina

  5635 Hanes Mill Road Winston Salem, NC 27105

• 

  Blue Cross & Blue Shield

  PO Box 116 Jamestown, NC 27282-0116

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

• Initial Complaint

  Date:04/09/2024

  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.

  I am a retired Federal employee and have health insurance through the Blue Cross/BS insurance company of North Carolina Federal employee program. At the end of Dec 2023 I filed a claim for a hearing aid replacement which is covered by my policy. BC/BS processed that claim in early Jan 2024, approved it and listed on line my Explanation of Benefits that at charge of $1499.99 was paid on Jan 19, 2024. But I never received an EOB in the mail or a check for that amount' After a near month delay I phoned BC/BS and told them no check . They said they would investigate that but no check ever came. After numerous calls every week or two I kept getting told that they would cancel the lost check and send me a new one. But one never came. I talked with BC/BS personnel for more than 15 times and each time told its being processed , or the check is in the mail. After contacting the ************** of OPM that agency contacted BC/BS about this and a new insurance employee contacted me- from an ****** of ******** Satisfaction- and said the issue was being resolved and I would soon have a check. That was near the end of March. After more than 2 weeks of that I was told yesterday that they are still working the problem but replacing a lost check is very difficult and time consuming. Now it is nearly 90 days since they had approved my claim and nearly 60 days since I first reported it but this "difficult " problem of a lost check seems to be impossible by BC/BS to resolve. They seem to be the most incompetent, uncoordinated company with a minimal amount of concern for their customers when problems occur. For weeks and weeks and by numerous employees I have been told that the problem is being resolved and my check is on the way- but to date- April 9, 2024 I have yet to receive it or told when to expect it. Pure management incompetence at the highest level.

  Business Response

  Date: 04/09/2024

  Thank you for the referral. Since 3/26/24, we have been in communication with this member regarding this issue. We will reach out to our
  member and continue to address any questions or concerns.

  Customer Answer

  Date: 04/10/2024

   
  Complaint: 21552033
  
  I am rejecting this response because: The issue has NOT been resolved. The claim has not been paid yet.  This is the same response I have been getting for weeks that "the problem is being handled and the check is in the mail. "
  When I receive a check for the approved claim then I would consider this issue resolved but that is NOT YET the case.
  Sincerely,
  
  ***********************

  Business Response

  Date: 04/10/2024

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

• Initial Complaint

  Date:04/05/2024

  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.

  BCBS showed in network for a provider that I went to, and a few months later I received a bill that stated the provider was out of network. I had to file an appeal to make sure that I am not paying $800 for bloodwork. I have sent the appeal in twice and BCBS says that they do not see it. I have called Blue cross so many times and on the phone for hours. And the issue is never resolved!

  Business Response

  Date: 04/08/2024

  BlueCross ** will contact the complainant directly regarding their concerns.

• Initial Complaint

  Date:03/22/2024

  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 policy with them ended on 12/31/2023. I did NOT renew any policy. My Agent has already told them, that I did not renew. I did not pay my first premium for 2024 because I did NOT renew my policy. They continue to send me a bill every month with a new total. There have been ZERO claims filed with them under my name in 2024 because: 1. I cancelled my policy verbally to my agent. 2. My agent cancelled my policy electronically to BCBSNC. 3. I have NOT paid any premiums for 2024. I have tried multiple times to contact them over the phone, but all I get is the amount OWED for a policy I no longer have!

  Business Response

  Date: 03/22/2024

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

• Initial Complaint

  Date:03/21/2024

  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.

  I found out, through Cover ** *********** on March 18, 2024, that I was receiving healthcare coverage through Anthem Administrators ** since July 2022. I was not aware, nor did I consent to this coverage through Anthem Administrators **. In addition, I have NEVER lived nor been employed in the *********** at any point in my life. It does not make sense that I have been a full-time student at *** since 2020 that has been receiving coverage through ** ******** AND be receiving benefits through another policy based in **. I have contacted Anthem in VA and ** and have not received any resolution (resolution being termination of this policy and filing a personal incident report) to this problem. Currently, this policy shows as active under my social security number and prevents me from receiving my ******** benefits in VA.

  Business Response

  Date: 03/21/2024

  BlueCross ** will contact the complainant directly regarding their concerns.

• Initial Complaint

  Date:03/13/2024

  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 policy when renewing on the marketplace back in December of 2023 never went into effect. I sent BCBS a message on 12/6 asking what else I needed to do to ensure I made the open enrollment window. I was told it would take 2-4 weeks to update and then I could pay my premium to start the policy. *** comes around and my new policy still isnt showing. I follow up again on 1/14 and am told I need to pay the premium for my old policy that auto renewed , which was not suppose to happen, prior to my new policy rate taking effect. I make the payment in full and when the next bill cycle comes Im being charged the price as the prior month (double what my policy should cost per my new policy). I call BCBS and am told to contact marketplace. I do this and marketplace confirms my new policy was showing on there end. I tell BCBS this and they tell me to continue to wait for it to hit their system. I follow up again on 2/12 and BCBS acknowledges my new rate in writing and tells me they are opening a ticket to have it corrected. Im told this should take 1 week. I follow up the next week and am put on hold for 45 minutes before the rep comes back and states they will need to escalate this to management and that I should be getting a refund and should see my new rate within the week. I am told they would follow up around 5pm the next day to confirm, this never happened. I wait a week and call back again as no change in my policy has occurred. The rep stays on the line with me for over an hour and the final resolve is its been escalated to management and my new rate and refund will take 24 hours to process. This doesnt happen and I follow up again. I am told by the rep to STOP FOLLOWING UP as it restarts the process on their end to fix it! I wait another week and STILL my policy rate has not been updated, no refund issued, and the app is showing me delinquent on my monthly payment for March. I sent another message yesterday and have yet to receive a response

  Business Response

  Date: 03/13/2024

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

• Initial Complaint

  Date:02/16/2024

  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.

  I have *****'s my doctor put in for my infusion order on feb 5th. I have been getting sicker with stomach pains more often, BCBS took my rumicaid away for another infusion med because it was to expensive. what i have been on now is not working. I was supposed to of had my infusion two weeks ago. my husband contacted the insurance company just to be told it would be between 48 hours up to 15 days. he asked when it will be given to me, was told by the employee of BCBS that if a doctor put in a emergency order it would be 48 hours up to 15 days. for the past week i have not been able to hold much down, smells of food just make me sicker, all this because of wanting to save money. still waiting on BCBS of ** to contact me on when i can get my infusion.

  Business Response

  Date: 02/19/2024

  BlueCross ** will contact the complainant directly regarding their concerns.

• Initial Complaint

  Date:02/12/2024

  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.

  2/2/24. I went to fill my medicine and found out my health insurance was canceled. I called bcbsnc ************ was on phone for 2 hours. Got disconnected. All these calls I can prove on my phone bill. Called back that night, the ** rep put my issue as ***** for some reason. Didnt make since. The switched me to another ** rep for him to tell me the previous person shouldnt have done that. The issue is bcbs cashed my money. They said I never paid it which makes no since cause I added dental insurance and that was paid the exact same time and posted to my bank. . So bcbs cancel my policy for no reason. I called back 2/5 2/7 2/9. Each time 2+ hours. I sent them an email of my bank where both health and dental posted. Mean time I have canceled 2 doctors appointments and am now 7 days out of my medication. Just was on hold for 37 minutes when ** rep hung up. Called back got a nice lady that put me through to a supervisor **** ***. She said she waiting on whoever to ok that they did take my money. Which I wont hear anything til Monday 2/13 and that is if someone has looked at the bank statement. I have another doc appointment Tuesday 2/14. If they are not gonna reinstate my policy I want my 100.14$ back and cancel my dental. I will never ever have bcbs again

  Business Response

  Date: 02/12/2024

  BlueCross ** will contact the complainant directly regarding their concerns.

• Initial Complaint

  Date:02/05/2024

  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.

  In October 2023 I submitted a claim for multiple chiropractic visits and was told I needed a different diagnostic code. I resubmitted the claim in December 2023 and called to follow up today, February 5th and the representative first told me that she could see my claim had been processed, but could not see for what amount or when/if my refund had/would be sent. She recommended I call back in a few days. I asked to speak to a supervisor and she placed me on hold for 20 minutes and then asked me to hold longer. When I asked why she said she was checking my refund amount. I inquired why she could all of a sudden check that, but couldn't before and she had no answer. I continued holding and she came back again to tell me that I needed to resubmit my claim for each individual visit. I asked her why she said it had been processed and she just repeated that I needed to resubmit the claim. I asked again to speak with a supervisor and was put on hold again. After holding for an hour I asked her to have someone return my call and her response was to take my number and tell me MAYBE someone would call me back lol. She told me her name was: *********

  Business Response

  Date: 02/06/2024

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

• Initial Complaint

  Date:01/17/2024

  Type:Sales and Advertising 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 had a baby on 02Nov23. I made a change of life event request to add the newborn to the policy. Once my employer confirmed this was processed on their end to BCBS I contacted them due to an upcoming doctors appt. They confirmed he had not been added and recommended I talk to employer. After the two parties spoke and resolved the issue, a new card was to be created confirming 2023 newborn coverage. After multiple attempts via chat and phone I have had no 2023 coverage for my child. I do however have **** coverage. I now have out of pocket expenses and denied insurance claims. As a resolution I am being told "just resubmit the claims and you might get a refund". There has been no escalation allowed and I haven't been able to speak to a supervisor. I am now requesting the BBBs support in obtaining a resolution.

  Business Response

  Date: 01/17/2024

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

• Initial Complaint

  Date:01/12/2024

  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.

  Message: I have gone NUEROUS rounds with BCBS North Carolina Experience Health. I have been waiting for an almost $700 reimbursement since September 12, 2023 (with an expected up to 45-day process) and it is now Jan. 10, 2023.The last excessive wait time was for $900.00.I have talked to Senator ******** office I have filed a grievance with Medicare.I was in need of that reimbursement before Christmas and it is accruing interest on a credit card.I WANT REIMBURSE FOR CREDIT CARD INTEREST THEY CONSISTENTLY HAVE NOT RECORDED MY NEW ADDRESS There are no less than 30 phone calls, all documented by BCBS This, for seniors, is negligent customer service. There are oh so many adjectives that can be added to this, but the service I have had has caused excessive anxiety. Think about it: someone has your money and doesn't pay you. They have more excuses than you can count and the company, with I think genuinely good people...can't seem to get you your check ether. ...This was sent to the Senator:Sent grievance Jan. 5th to Senator ****** Service was 9/12/23 - it is now Jan. 10th. Amount ****** of dental service. Mailed: ******* the dental receipt 9/12/2023. 11:00 a.m.BCBS insurance reimbursement # SF20230809271021572 Supervisor's # - ************************* ************** Experience *********************** ************ ---Good luck ANYBODY...and if anyone can get me my money. Great....Iet is now Jan. 12 and no check. They said there was a reissue...AND I FIND OUT IT WAS SENT TO THE OLD ADDRESS. THIS IS UNCONSCIONABLE CUSTOMER SERVICE.But this company needs to be called on the carpet for the most ineffectual customer. This time frame is negligent to receive a reimbursement. NO SENIOR NEEDS THIS RUN AROUND.I have all receipts....BCBS cannot provide a mailing receipt to me....however they did tell me they sent the new refund check to the old address. There is no excuse whatsoever for any of this.

  Business Response

  Date: 01/12/2024

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