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.

close

Find a Location

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

*This company may be headquartered in or have additional locations in another country. Please click on the country abbreviation in the search box below to change to a different country location.

BBB accredited

Near

Country

USUnited States

Please enter a valid location.

Filter

• 

  Blue Cross and Blue Shield of North Carolina

  5901 Chapel Hill Rd Durham, NC 27707-3346

• 

  Blue Cross and Blue Shield of North Carolina

  5640 University Parkway Winston Salem, NC 27105

• 

  Blue Cross and Blue Shield of North Carolina

  PO Box 17509 Winston Salem, NC 27116-7509

• 

  Blue Cross and Blue Shield of North Carolina

  PO Box 2100 Winston Salem, NC 27102-2100

• 

  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:08/07/2023

  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.

  We are a small health care practice named ************************ We have been attempting to credential and register with BCBS of ** since Aug 2022. We have submitted all required documents, responded to all emails in a timely fashion, and have made follow-up calls. BCBS of ** has repeatedly asked for the same documents multiple times as well as closed part of our request that would make us start the process over again. We are a small non-profit that treats people regardless of their ability to pay and count on the funds from our few patients with insurance to cover our operating costs. We were not asking for special treatment, just a fair process. I would like to speak to someone directly involved in the credentialing process so we can cut through this miras of problems they have created.

  Business Response

  Date: 08/07/2023

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

  Customer Answer

  Date: 08/08/2023

   
  Complaint: 20434557
  
  I am neither accepting nor rejecting this response because I have been told before by this company that they were going to handle the situation and they have not. I did receive a call from them and they said they would be looking into the matter. I am waiting to find out what the outcome is before I move forward with the complaint as it has not yet been resolved. 
  
  Sincerely,
  
  ***********************

  Business Response

  Date: 08/08/2023

  On 8/7/23, a plan representative contacted the provider directly to acknowledge receipt of the case. We will follow-up directly with the provider to respond to their concerns.

• Initial Complaint

  Date:08/07/2023

  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 filed a claim for reimbursement of $300 which I am allowed for eyeglasses purchased on 1-5-23. I mailed the claim form on 2-18-23. Despite several calls I still have not received a check. I am disgusted with the old routine, the check is in the mail.

  Business Response

  Date: 08/07/2023

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

• Initial Complaint

  Date:07/11/2023

  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.

  Called Nov of 2022 to cancel policy end of Dec because of new Ins coverage eff 1/1/2023. Policy not canceled so payment taken in Jan. FYI this is a ******** suplimental policy. Called 1/6 got policy canceled and waited for reimbursement. After 8 weeks Called 3/17 was given process date told 2 checks processed. Why?? Received small amount of reimbursement but more than 3/4 still not received. Have called every other week since 4/3 looking for 2nd ck still nothing. Shows new processed date of 4/6 but that date shows pending. Called again 4/11 4/21 4/28 still pending asked to speak to supervisor 4/28 she said if check not received over weekend to call for stop payment. Called 5/8 left message requesting stop pay and a call back to make sure again she never called back. Called supervisor 6/5 7/5 checking on processing left message no call back. Called customer service again 7/5, would check to see whyand call me back. Called again 7/10 and reimbursement still shows with pending date of 4/6 and told should do stop payment which will take another 30 to 40 days just to process. They were checking with accounting about expediting a check and would call me by end of business day. Both customer service and supervisor promise call backs with my calls in yet here on 7/11 nothing. Their error to begin with because of no follow through to cancel policy and waiting for reimbursement for 6 months not acceptable

  Business Response

  Date: 07/11/2023

  BlueCross ** will contact the complainant directly regarding their concerns

• Initial Complaint

  Date:06/30/2023

  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 received a notice of account credit -- INVOICE #**MD20314688 BILLING PERIOD: 05/01/23 - 05/31/23. I have called two times now about this refund. I was originally told the check had been mailed. Now, I am being told something different. All I want is a $62.50 check mailed to me -- LIKE I WAS TOLD.

  Business Response

  Date: 06/30/2023

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

• Initial Complaint

  Date:05/23/2023

  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 have had this insurance since December 1, 2022 after I became unemployed. Since then I have been getting Mounjaro for $25 since that time. In May, when I went to get my medicine the price was a $752.00 copay. Something changed. I have Type 2 Diabetes and there is no way I can afford this medicine. I have talked to several representatives and cannot seem to get a straight answer from anyone, In order for me to get ******** for $25 BCBS has to deny coverage which they have been doing since December. Whatever changes they made is now keeping me from getting medication that keeps me living. I need to know what can be done.

  Business Response

  Date: 05/23/2023

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

• Initial Complaint

  Date:05/08/2023

  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 called the 888 number and spoke to a ****. He did not understand anything that I was asking. He kept repeating what I already knew. I asked to speak to a supervisor or someone that could answer my question. He put me on hold for almost 30 minutes then came back and said no one was available. I know that's a lie and he didn't really asked anyone. He wanted to handle the call himself yet he couldn't answer a simple question. I asked if BCBSNC cancelled all video chats. I had a cat scan done in April, 2023 I scheduled a video chat with the ****************** cancelled that appt the morning of They said BCBSNC won't let them do video chats anymore. I rescheduled my in person appt for the 24th of April. However, I had the stomach virus. I need to know if that's true? I live an hour and 20 minutes from ********* so video chat for my test results would have helped me. I don't want to drive that long for a 10 minute test result. My availability is limited as I am at the VA constantly for my husband that had covid in Jan of 2021 and had 4 strokes with it. I also know 3 other people that had tests done and their Drs. did video chats with them. They also have BCBSNC They live in my area also. Their tests were after mine also.

  Business Response

  Date: 05/09/2023

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

• Initial Complaint

  Date:05/05/2023

  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.

  My wife had an insurance plan with Blue Cross that we canceled in January. In February we noticed a payment was in process for the months premium despite ** having canceled the service the previous month. Upon calling Blue Cross, we were informed there was nothing that could be done to stop the payment and we would have to let it be charged, afterward we would be issued a refund. So we let the payment process and called back after it was done. We were then informed that our refund would take ***** days to process. So we waited the 30 days and no refund had been issued. We called back a third time at this point, was told there was some issue with the first refund process (which was never made known to us) and we had to start a second refund claim, which of course would also be another additional ***** days. We waited, and again no refund. My wife called today and again was told there was an issue and that we had to schedule another refund request with, of course, the same timeline as before. This is ridiculous, it should never have been charged to begin with, and now, months later, we still have not been issued the refund owed to us.

  Business Response

  Date: 05/05/2023

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

• Initial Complaint

  Date:04/13/2023

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  My 2022 health insurance policy cost approx $100/month. At reenrollment, ilI was offered a policy at $300. They claim this is tg same plan; this "comparable" and they believe reasonable that I would hav no issue paying 3x more. Upon completing reenrollment, I received a popup notification, that the enrollment period had been extended until ***uary 15 (no explanation that I would be charged for the "comparable" plan for ********* All phone lines were busy, and I would have to go through all policies to settle on one that fit my needs So, I took advantage of the extra time they were offering me, and locked my plan in after the holidays, by ***uary 15. I then discovered BCBS charged me the approx $300 in ***uary. So, I called Healthcare.gov, and they "escalated". Healthcare.gov said there had been some issues and misunderstanding, and that my money would certainly be returned, once everything was sorted. I never heard back;never was reimbursed.Yesterday, I contacted BCBS, and they told me I rightfully owed the $300, that I should have known, and there was no recourse on this unethical business practice; that locked me into a plan 3x what I was paying, for the month that had supposedly been extended to me, for my convenience (I would have submitted my application on the day the popup redirected me to wait)BCBS "escalated", but can't include an explanation of the issue, can't follow up, they do not expect resolution, as many other customers had been defrauded in this way and received none. They transfered to Healthcare.gov, saw my escalation from *** was unaddressed, told me they have no power to hold BCBS accountable, told me similar customer escalation had been denied, there's no expected timeframe, and because I'm on autopay, BCBS has right to charge 3x ; that paying $300 for a $1700 policy was a bargain. I told them that's my tax money, government money, I make $15000, mandated to pay more than justifiable, plus copays, didn't even use the plan.

  Business Response

  Date: 04/13/2023

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

  Customer Answer

  Date: 04/13/2023

   
  Complaint: 19929910
  
  I am rejecting this response because:I was on the phone for two hours today, with ******* from BCBS and with *******, and others at Marketplace.  Yesterday, I was on the phone approx 1.5 hours.  I spend weeks attempting to get through filling in my application and navigating this system, calling but being faced with prohibitive wait times, and called about two weeks after my charge was debited, to resolve it ASAP.  I escalated.  I did my diligence, and still got caught in this pitfall they created.  TlBoth entities concluded that the financial burden for their actions and policies that caused me to be misled and excessively charged was rightfully mine; that their hands were tied, and unable to affect my billing. 

  Their argument was that it was my responsibility to understand things that they had not made clear, multiple forms of correspondence that encouraged me to submit my application in ******** that I still had more time, and did not warn me that I could be locked me in to the same plan for ******** at three times the cost, if I took their offer of more time.  They told me that I was just going around and around with my argument, and insinuated that I did not read all the correspondence.  I did. . . How else would I have known about the extension, how else would I have known that the call center message told customers that they would be doing call backs and reenrollment after the 15th of December due to call volume.  I was ready to submit my application prior to Dec 15, but delayed because there was a popup that told me the reenrollment period had nue conveniently been extended til Jan 15, and I had more time.  There was no warning in the popup that I would be charged the new rate, which had been inflated, despite no changes on my end, and a near poverty level income. 

  Both Marketplace and BCBS also told me that they couldn't make an exception for me, and that it would be unfair to everyone else if they helped me.  Prior to this, I was told by both BCBS employees and by the Marketplace that other people had the same problem that I had, and that they also were denied resolution. I fulfilled my responsibility.  BCBS and Marketplace have not taken responsibility for multiple actions on their parts, with me paying the significant financial burden of those actions.   It is inexcusable that, even after being made aware of the problem, they choose not to correct the situation.  They created this method of doing business, and these policies.  There is a reason that every employee tells you nothing can be done and attempts to get you to give up trying.  There are people with authority to accomplish resolution. . . But you're not allowed to talk to those people. That is established policy; I know this because no matter who you speak with, you will never get a different response or someone attempting to problem solve or think outside of the box.

  The problem is with lack of continuity and with the Marketplace and BCBS shifting blame to each other; both claiming they have no ability resolve.  This is even more unethical, given that we are mandated to purchase overpriced insurance through this system, far beyond anything we could actually afford, and with even the premiums and copays increasing beyond  what is affordable.  We only have the option of working with a private company; it is not easy to talk to navigate automation, and increased convoluted correspondence from multiple entities.  *********** limited business hours, and AI make it often difficult and prohibitive to get through to an actual human, to cross check every detail between the two entities, particularly if you work at night.

   I tried to call several times during the application process, but wait times were so long, and I finally was able to connect to the website, so I applied on the site.  Because of marketplace messaging, I did not even realize there was a problem.  Clients, particularly those who are already struggling due to low income and/or business hours that do not correspond with marketplace and private insurance hours, are likely to fall into this problem; at the mercy of whatever the company charges, with the addition that they claim they have no agency  to affect any change on those charges.

  BCBS should ethically realize there is a problem in raising rates so significantly from year to year, and Marketplace should be regulating and overseeing the ethics, and impact on the customer.  From my experience I know that the customer is saddled with the consequences of any problem on the part of either of these entities.  Their ******************, and consistent response all the way at up to higher management, is to deny, frustrate by saying there's no point and nothing to do about it, apologize and console.   . Until the client gives up.  That's particularly easy when their policies and practices are set up to fail those who are the most strapped for time and money, and most vulnerable to the pitfalls of their complex, convoluted system, lack of clarity in messaging, lack of continuity and accountability, and time consuming enrollment at holiday time. They told me I should have started in November. . . While I was at the height of my business season, making crafts to sell at holiday markets.  Or, name be I was supposed to do it instead of sending presents and visiting family.  Instead, I had the luxury of a little more time. . . Unaware that my account would be autodrafted an excessive amount, at the time of year I could least afford it (all that Christmas show money goes back into applying for next year's shows.). There is something very wrong, when low income customers (or any customer) are saddled with $200 in excessive, unreasonably inflated and proposed charges, both entities are aware of the problem, and both take the position that blame for their system and policies and the financial burden are on the customer.  Honestly, they should owe me $20/hr for all the time I've spent doing their work for them, attempting to resolve, for their insults and shifting blame and cost to me for not being more "proactive". Now I'm also ethically obligated to let others know, so they don't fall victim.

  Sincerely,
  
  *********************

  Business Response

  Date: 04/14/2023

  BlueCross ** contacted the complainant directly regarding their concerns. Also conferenced with Healthcare MarketPlace at ************.

  Customer Answer

  Date: 04/14/2023

   
  Complaint: 19929910
  
  I am rejecting this response because: There was a problem with BCBS communication about extended period to choose a plan.  Specifically, a popup on Marketplace when I was about to submit prior to Dec 15, that informed me the period had been extended, and I had more time to pick a plan.  And specifically the fact that BCBS increased my cost for coverage in the same plan, with no changes on my end, to three times what I had paid last year.  The fact that the plan price increased that much, was unreasonable for me to expect, and that I was auto enrolled in that plan is unethical.  I was on the conference call with them yesterday for 2 hours, and both Marketplace and BCBS claimed there was nothing they could do about these two problems.  They put the fault on me for not reading everything, and not anticipating what they did not make clear in the popup, specifically, but also was not warned adequately warned of this possibiliy, if I chose to take more time as proposed.  It was unreasonable to expect to be charged three times more for the same plan as last year.   I did read everything, and I did my due diligence. 

  This is an unethical business practice, and BCBS claims they have no ability to rectify it.  Even when it has been brought to their attention, and many others had the same issue as I did.  They offered to do nothing about it, and saddle the customer with the financial burden of their practices.  No one even attempted to do anything, to take the issue to higher authority, or to change the practice so that others won't fall victim next year.  Attempting to frustrate a customer into giving up, is their resolution policy.  That is unacceptable 
  
  Sincerely,
  
  *********************

• Initial Complaint

  Date:04/03/2023

  Type:Customer Service Issues
  Status:

  AnsweredMore info

  Complaint statuses

  Resolved:

  The complainant verified the issue was resolved to their satisfaction.

  Unresolved:

  The business responded to the dispute but failed to make a good faith effort to resolve it.

  Answered:

  The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.

  Unanswered:

  The business failed to respond to the dispute.

  Unpursuable:

  BBB is unable to locate the business.

  I canceled my policy with BC/BSNC on Nov. 30, 2022, because I had moved to *****, and they took the Dec. premium out of my account on Dec 3, 2022. When I disputed this on Dec.6, 2022 they agreed to refund the money within 4 to 6 weeks. On Feb 22,2023 I called because I did not have my refund. Then I was told that it would take 6 to 8 weeks from Jan. 6, 2023, to receive the refund. I have no idea why the time from my first call in Dec. to Jan 6th. Now the refund would be sent sometime between Feb. 17, 2023, and March 3, 2023. I called back on March 8th and was told they would call me back by March 13th. On March 15 I was told they were waiting for approval from some board. On March 27th I was told the check had been mailed on March 15th and I should allow 7 to 14 days to receive it. Now it is March31st. I still have no check. I am getting a run-around. My refund is for only $328.00. That is not a lot of money to a business so large, but it is to me. I am 88 years old and on a fixed income. I want my money. Can you please help? Thank you. *************************** PS, my policy number is J1246459201

  Business Response

  Date: 04/03/2023

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

• Initial Complaint

  Date:03/17/2023

  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 was enrolled with a Blue Cross Blue Shield Plan through the marketplace and they canceled ********* due to nonpayment. The policy was canceled on 1/31/23 and I got notified about nonpayment on 3/16/23. I set up auto pay and apparently something went wrong and it never went through. I had no idea that I was delinquent on my February payment because I never got an email, phone call, or bill in the mail to let me know that. Now I am being told they can't do anything for me because payment delinquency doesn't qualify me for a special life event meaning I have to go without insurance until enrollment can start in November. I am extremely disappointed in this because I did not make the mistake and I have to take a chance on something happening to me. With as much Blue Cross Blue Shield makes I find it unacceptable that they do not have better communication and do not s**** people over.

  Business Response

  Date: 03/20/2023

  Tell us wBlueCross ** will contact the complainant directly regarding their concerns.hy here...

  Customer Answer

  Date: 03/20/2023

   
  Complaint: 19614739
  
  I am rejecting this response because: I am not sure there was a response. I at least didn't see one. I saw that they said something about contacting them directly which I have already done.
  
  Sincerely,
  
  *************************

  Business Response

  Date: 03/22/2023

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