I’ve been with BCBS since late 2023 through this forum. Last year, there were no issues at all, and they covered part of my appointments.
I had two doctor appointments in January and have two scheduled this month. Last Thursday, I got a call from my doctor saying the claim was denied because BCBS apparently isn’t my primary insurance, which makes no sense since it’s my only insurance (my job doesn’t offer any). I checked the app to confirm my premium was paid, and it showed no bills. Great.
I called today, and they told me their system mistakenly had BCBS listed as my secondary insurance. I have no idea how that happened. They recommended that I have my doctor resubmit the claim. But then it got rejected again, supposedly because I hadn’t paid my premium… which the app says is not true.
Now I’m really frustrated and on hold. The person I spoke with said my plan doesn’t cover this even though it was covered last year. Is anyone else facing this same mess? What are my next steps?
Edit: I’m 33 years old, living in Ohio, and my income is not something I’ll share here.
It seems like you may need to fill out a coordination of benefits form. This document confirms to the insurance company that you do not have any other insurance. If there were other plans, it would help both companies figure out which is primary and which is secondary.
Could it be that your doctor is now out of the network? Many plans change their coverage at renewal time, which usually happens in January. Have they given you a reason why it’s not covered? Is it just a normal doctor visit or does it involve something specific?
@Wynn
I got BCBS in October last year. Everything was filled out correctly, but somehow they didn’t bill me, and I didn’t notice until December. (My fault). They canceled my insurance without telling me about it for lack of payment, and my broker said they had a major system update. Long story short, I got back on the plan, and they covered a doctor visit from October. The error was all on their end.