The Blue Cross Blue Shield Association (BCBSA) consists of 39 individual companies and organizations throughout the United States. BCBSA plans can be purchased in every state, Washington DC, and Puerto Rico. Collectively, they insure over 100-million people. Blue Cross Blue Shield is accepted by more hospitals and doctors than any other insurer and its products can be found in all segments of the health insurance industry.
The Blue Cross brand originated in 1929 at Baylor University with a plan offering teachers three weeks of hospital care for $6 per year. As the company grew, it began offering coverage to other employee groups in Dallas and later expanded to national coverage. In the late thirties, its emblem was adopted by the American Hospital Association (AHA) for plans meeting certain requirements. By the sixties, the Blue Cross Association took the place of the AHA and in 1973 it severed the association completely.
The Blue Shield brand was developed at the start of last century with lumber and mining employers in the Pacific Northwest paying a monthly fee to a designated group of physicians. In 1939, the first true Blue Shield plan was unveiled in California. In the late forties, nine plans adopted the Blue Shield symbol and it was dubbed the Associated Medical Care Plan. It was later renamed the National Association of Blue Shield Plans. Blue Shield and the Blue Cross Association merged in 1982 to become the Blue Cross and Blue Shield Association.
Anthem formed as a spin-off of American General Insurance in the eighties. It went on to become a publicly-traded company in 2001 and three years later, it finished merging with the Blue Cross and Blue Shield Association. Late that same year, it merged with and changed its name to WellPoint. While Anthem is no longer officially a company, WellPoint still uses the Anthem Blue Cross and Blue Shield name in eleven states.
Insurance companies are franchised under the Blue Cross and/or Blue Shield name. These companies are independent and offer their own plans in different regions of the country under one or both brands. BCBSA offers some form of coverage in every state, Washington DC and Puerto Rico. In certain states they also act as Medicare administrators providing group coverage to state and federal employees.
WellPoint is a publicly-traded company with coverage spanning 14 states. Several other BCBSA multi-state organizations include the Mid-Atlantic region’s CareFirst and the Pacific Northwest’s The Regence Group. The largest privately owned BCBSA member is Health Care Service Corporation, which operates two plans in the Midwest (Illinois and Oklahoma) and two in the Southwest (Texas and New Mexico).
I was wondering the difference between united health care and blue cross blue shield.
So Much Confusion
I attempted to have a prescription filled using my Blue Cross Blue Shield card only to be told by the pharmacist that my card was flagged. After further investigation, the pharmacist stated that Blue Cross flagged my account because I had another active insurance plan. My previous plan ended (I called my previous insurance provider to verify this fact) and Blue Cross stated that the insurance plan was still active according to their system. After several back and forth with the pharmacy, my former insurance, and Blue Cross and Blue Shield, I was finally informed from Blue Cross that the flag was to be removed from my account, but it wasn't. When I called Blue Cross and Blue Shield, they stated that now I would have to get a written letter from my former insurance provider and have it sent to them verifying that I no longer have the old insurance. I then requested to speak to a manager to explain to me why one person tells me the flag will be removed and it wasn't. A manager stated there was some misunderstanding and I need to have a letter verification because a Blue Cross and Blue Shield rep spoke to someone from my former insurance provider and my former insurance provider stated to them that "yes" my account was still active - even though Blue Cross did not document a name of who they spoke with or any other type of traceable information.
My work pays almost $1000 for my coverage monthly and the plan pays for almost nothing. I have had lots of tests this year and their contribution has been minimal, making it impossible to meet my deductible because they turn so much down.
Terrible Infertility Test Coverage
I have had several miscarriages and was recently diagnosed as having infertility. Anthem tried to say that because I have had miscarriages, It's considered as a pre-existing condition (which it is not), and all the tests to see why I can't get pregnant are therefore considered "not medically necessary". However, our plan covers the diagnosis and treatment of infertility and also has a lifetime maximum benefit of $10,000 to use for treatments. This is why we stayed and if we knew it It took us a year and a half of bugging them to get this covered I wouldn't of taken it. Every time we talked to someone in their customer service, they would tell us something different - mostly incorrect information. Get confirmations and the names of who you talk to just in case you have to go appeal your denied claims. If I didn't do this, one of my fertility treatments wouldn't of been paid. They will lie and claim that the call was never made if you don't have this information written down. CS is utterly rude and useless. When we had a question about our EOB for Infertility and called them, we were instructed to go on the website. Funny thing is that the website doesn't have this EOB printable at all! We had to go to my husband's HR department to see if we qualified (which we were covered).
won't Cover Procedure
I am in need of a procedure to help with my back pain. They do not want to cover this procedure but said that if I got the typical cortisone injection and it helped my pain be 50% that they would cover the procedure. The claim has been denied 3 times. I cannot speak with the doctors on their end who denied the claim either. They hide behind the people who answer the phone.
I was constantly being charged money that had nothing to do with my policy. Every other month I was magically going to be canceled because I owed them $743. Yet I had all my checks saying I paid and when I asked they refused to send me a copy of my payment history. Their customer service is a joke, I don't think one person at this company knows what they are doing. I've been a customer for over a year, almost 2 actually, and I haven't actually received a bill in over a year, yet I can't get my cancellation notices. They applied my payment to the wrong account 3 times!!!
I could not search for any specialists in my area or any area using their website. The results were always "no match found". I called customer care. They had no clue.
BCBS of Indiana is terrible. As a provider, I don't want to spend hours upon hours trying to get paid.