Horrible service, money goes in and never comes out. After a year receiving large postcards telling me to get a mammogram I did. Denied - "your plan does not cover this service." Appealed. Denied. Their BBB grade is a resounding and well-deserved F. The Sydney app they provide appears to have been designed and written by middle-school students. Overall, the worst health insurance company I've ever dealt with. read more

Where can i start? I started with this insurance in 2021, under the essential plan 2 I had nothing but this insurance. Like the no copays, and like that one doesn't have to do much of anything. However, i seriously dislike that one has to claim a pcp. What if a patient doesn't trust their doctor? Also how do you know if a doctor is truly working with each specialist or other doctor managing healthcare?Also very poor communication, I called empire to see if they take Nurx prescriptions, and got a nasty representative, "Go to a gyno to get birth control". I do what i do because i had a bad experience at the gyno, and refuse to go. No offense, but one doesn't know if they had a bad experience or not. Another example of poor communication was that on their sheets that come with enrollment, it said you can change your pcp online, however, the first time i did it, i had to call. Why can't you have a dedicated email to changing pcp so that shy people, or people who don't talk much, or people who care about the representatives they get on th e phone, can change their provider without interference (although think this was with liberty, which is the dentist they use, too). pandemic hit, and luckily did not have to renew. Let me just pause for a moment and say some positive things: once it was updated, the website was very easy to use, and easy to understand and find your provider, as well as prescriptions. Over time though, i only used this for 1 doctor once i got insurance through my job. Then, in 2023 current time, without my consent, (and maybe part of this is NY State of Health), they renewed my insurance, and got Empire blue cross plus with medicaid. They didn't even change my PCP or call to see if i still go there. I manually changed my pcp myself to my current provider. Then, i get a message from Empire about a cervical cancer screening. I messaged Help@anthem.com complaining about that. I mentioned that i have insurance through my job in the email. Yesterday, i get a letter from NY State of Health stating that my coverage will end with empire on Septemeber 30th. Now, thanks to a representative that i called yesterday i understand why. However, no word from the email i sent, in which i stated that i did not want to take action. (meaning keep my insurance) Even in the email, they should have stated that "Sorry, but being that you said you have other insurance from your job, we have laws, and due to following the law, we will have to drop you from your current coverage." You need to follow up with your emails, i do not like that there was no word from the company itself. Also i mentioned in the email that my current coverage medicaid- the site isn't very user friendly, and did not want to take action. in other words, if you want respect from an insurance company, this isn't it. Also no intent on consent, and what the consumer wants to do. Highly don't recommend, unless one is content with their doctor. Afternote: Although since calling NY State of health, Medicaid will do the same job as the empire insurance, so i am content with that, however, I should have heard from the company itself before getting a letter in the mail. read more

For their MLTC plan: the home health aide agency told me I should notify BCBS immediately to report that their patient fell. The care manager at BCBS said they have over 90 patients and can't be bothered to get a call every time a patient falls. My understanding from the conversation is: Don't call. We don't care. read more

I work with this Bs insurance as a provider they don't care about you just don't choose this insurance. There is better out there they don't give a care about you trust me. I work with elderly and they even told my clients they don't have time for there little problems just boycott this insurance. read more

It's like a l scary comedy about a scam. I can't get an appointment with a primary care doc. I can't see any doctors without a referral from my non existent primary care. Many of the doctors listed are not actually on the plan. (They must know this). Once I get to the right level of representative they are sorry they can't help and agree that the system is of little use. I hope (but am not certain) this insurance will help if I get hit by a car. It is of very little use in keeping you healthy. I accept that level of care mat not be the best. But I was wrong in my hope I could at least get access to some care. read more

Carrie helped me with my MRI approval request, there was some information missing from the healthy facility and there incorporation but she was so eager to solve this and she did, but how she did it, was pure grace , kind and tried different things n finally resolving it . Lots of love and blessings go out to her read more

Bluecross Blueshield has put a lien on our settlement because we pursued a attorney for recovery. If you're involved in a motor vehicle accident and you use your health insurance they are federally entitled to most of your money. And it's absolutely legal for then to do this...am beyond words...it doesn't matter that you pay your premiums, co-pays, deductibles they still take your money...we paid A LOT of money out of pocket for his surgery, therapy, meds, medical equipment etc.. they should be going after the person that hit us and ran. We would be using our insurance for treatment even if we didn't go the legal route. Insurance Company's rape us every month and now they continue to do so when we are hurt the most... read more

Consumer beware. Having @AnthemBCBS is a waste of your precious money. I thought I was paying for the Cadillac of health insurance. Boy, was I wrong. They refuse to pay for my MRI because they deem it "medically unnecessary." I had two doctors write letters on my behalf explaining why it was indeed "medically necessary," sent them my MRI results, and current diagnosis. @BCBSAssociation rejected my appeals. An external appeal is now being lodged. Make it right, @AnthemBCBS. read more

Ahh, health care in America is literally a sicken issue, unresolved yet plagued by politics. Albeit, Empire Blue Cross has been one of the very few with very reasonable co-payments, good quality network of compassionate, sincere doctors and widely accepted by providers. Sadly, I'm not longer covered under Blue Cross for nearly four years but the lasting impression was a good taste of hope. Hope in the sense that Obama and his entourage will amend the existing health care issue for all American taxpayers at lesser costs. This issue is one that is taken to my heart where good health should NOT compromise sincere quality of doctors nor a hefty price. Pharmacy benefits administered by Caremark. N.B. Empire BlueCross BlueShield do not provide potential members coverage for individual plan either the Health NY and any of its plans in New York State. As a New York State resident seeking individual plan coverage (no dependents), Empire BlueCross BlueShield abandon me in sickness and in health. read more

This shouldn't even be considered health care. It has positioned me to become wrapped up in their cost reduction policies and not taking care of my injury. read more

Empire Blue Cross Blue Shield used to be a good company, until it was absorbed by Anthem, arguably the worst health insurance company in the United States. I fell and broke my wrist, requiring first emergent care, and then surgery when it could be scheduled. This is a very painful break. Anthem/ Empire, Blue Cross refused to pay for pain meds after the surgery. I had been given a script when I went to urgent care because the break was so bad. But then after the surgery, they refused to pay for the meds because I had, "exceeded my 14 day limit of that category of drug." Despite the fact that I had had a very painful surgery with plates and seven screws inserted into my wrist, and my surgeon wrote the scripts, which were within the stated guidelines for rx this drug, I could not get the pain meds covered by the insurance company. I had to pay $100 a script out of pocket for each 7 day refill. Apparently , the surgeon hadn't "sought their pre-approval" before prescribing these meds for a surgical procedure. So now surgeons can do the surgery, but patients are at the mercy of Antham for their pain relief afterward. They were completely unapologetic about this. They didn't care in the least that I had had surgery requiring more pain meds after the initial emergent treatment. Too bad for me. I filed a grievance. They conducted an internal review of themselves, and found that they were in compliance with their own policies. If you were contemplating the surgery, set aside a pile of cash to pay for your scripts afterward, or get another health care carrier before you do so because Empire, Blue Cross/Anthem is not on your side. read more

The absolute worst MLTC. Run by incompetent people. They have a line for complaints, and all they do is return you back to the person who couldn't handle the issue in the first place. DO NOT USE BCBS FOR A MLTC FOR YOUR LOVED ONE!!!!! read more

I work at a provider's office and just wanted to ask them how we can submit claims to their office. Spoke to a rep from the Philippines. Despite all the information ins no., provider no. etc, Rey, the rep still cant give us an answer on how we can sent in a claim. We've asked for a fax number, email or address but said he cant provide any without confirming our identity. He kept repeating these words the whole entire time like a robot. Which made me think, he is doing this on purpose because he really didn't want to help. It is frustrating enough that this simple question is a general question and can be easily provided by a reputable insurance company. I tried explaining that to him and still got the same repititive answer. If you are hiring a third party company to deal with inquiries from clients, please do take the time to train them well. The one I spoke to (Rey) lacks the basic skills and knowledge of representing your company. I think of Filipinos of being highly educated and smart. This person however, contradicts that perception. Or perhaps he is jusy too lazy to do anything. read more

Dealing with severe hypoglycemia with unawareness not a diabetic they don't want to cover 300 dollar for a monitor that tells me what my glucose levels are specially at night and wakes me up if it goes to low. But they don't mind covering 2000 a month for liquid medicine 1500 a month for glucagon injections. Or paying 15000 for a 3 day hospital stay to prove what we are already know. They also don't mind to pay 5-10k for every er visit. But they still do mind to pay 300 in prevention for all of the other costs! This company is f. Upped this is wrong so wrong and 3 appeals later even the letters of my doctor stating it is medical nessesary they refuse it not even worth 1 star Aetna the insurance I had before they covered it and allowed me to actually work again without passing out of low blood sugar read more

I have this company for my dental coverage. When sending claims they provide you with the very antiquated way of sending by USPS ONLY. They have no fax nor email. You can send overnight by FEDEX OR UPS, but they don't have a physical address for you to send it to, FEDEX does not accept PO Boxes. So now what I thought would expedite my claim by sending it overnight,is now taking twice as long because FEDEX needs to return my package to me so I can turn it around and send by USPS. This is infuriating. How can you not have a physical address or provide your customers with email or faxing services. read more

I am absolutely disappointed with having this as my medical insurance. Ever since I had serious medical issues, this insurance company has disrespected my pronouns, not once corrected into the system, doesn't pay attention to their plans nor do they provide actual support when disputing claims. I have even been yelled at by representatives. DO NOT GET THIS INSURANCE if you want respect, integrity, support or even organization of your plan and claims. This has been months of disappointing service, and it is an ongoing hassle to get anything problem solved. read more

I would NEVER recommend this company to anyone that needs insurance! This is absolutely the WORST company Ive EVER had to deal with. I am so disappointed that I ever switched from health first to this piece of shit ass company that you can't even get an appointment with a primary care doctor. DO NOT DO IT!!! If you are looking for insurance for a loved one... HEALTH FIRST is the way to go (866)463-6743. I'm switching my dad back TODAY!!! THANK YOU JESUS!!! Jenny was absolutely amazing (646)794-6596 she can help you!!! read more

Had them while a single young male via employer, a terrible awful fashion e-commerce startup in SoHo, and truly awful coverage to match the awful conditions and other "benefits" at that employer. The terrible coverage is both due to the awful culture of no-care for the employees that guided their negotiating with Empire BCBS for a plan and lowest rate cutthroat low-approval system Empire BCBS runs to lure employers in with low employer portion premiums (usually 50-70% of the full premiums with the employee paying the rest) while providing bad service: no real useful website, large network masking the low coverage, constipated claims system, similar payment system, and missing features topped with a lack of care and contact. Avoid Empire BCBS, either choosing alternative plans or employers accordingly. read more

If I could give 0 stars, I would. They did not notify me that my coverage was ending and "mistakenly" approved claims after it had supposedly ended. Now they retroactively denied them and I owe over $2k. Almost impossible to get anywhere with customer service, and the appeals process is a shitshow. read more

Fast forward a few months later. The Empire website has randomly changed the PCP back to the random MD. So now I have to start over and get them to change the PCP again. Company computer systems should not work this poorly. read more

Refused services provided at an ER as these were out of Network!! I had no choice.Then later after getting a bad cancer diagnosis at a big NY Hospital, I went to the A Team-Sloan Kettering where I was correctly diagnosed and treated. Empire BCBS turned all the expenses down as being out of network. Oh right, I should have stayed with the bad diagnosis and run up a Gazillion dollars in network, and maybe be very sick. This company owned by United HealthCare, typifies all that's wrong w Health Care in America. Oh yeah, their new app Sidney sucks, as do 95% of the telephone reps. MOVE ON DON'T BECOME A CUSTOMER. read more

The worst insurance ever. I've had Blue Cross in various forms for over 15 years. Over the last 3 years, it has been a total nightmare. 3 years ago I signed up for auto billing on their website. Everything seemed to be working. Then all of the sudden I got a threatening letter in the mail saying they had terminated my coverage due to non-payment. When I called to enquire, I had to wait on hold for about 45 minutes. They told me I could not re-enroll because we were not in the open enrollment period. I asked why the auto billing was not working and they had zero explanation. So I had to pay about $2,500 in tax penalties for not having insurance for 6 months our of the year, for their billing fault. Same thing happened last year. I changed plans (this one was 200% the cost of the prior year). Signed up for auto billing. Luckily this time they sent me a threatening letter 2 months in saying the account was overdue. I made a payment over the phone, yet the auto payments all went through as normal, so I was double billed for 2 months. I would have never even known this unless I randomly logged into my account. Same thing has just happened. Signed up for a new plan, the cheapest one they offer for me is $770.00 per month. Just got another notice of non-payment even though I enrolled in auto billing in January. I also noticed they were continuing to auto bill me for the previous plan, which I had cancelled. The billing issues are just the tip of the iceberg. The "insurance" doesn't cover anything. I had over $12,000 in surgical bills I had to fight for 9 months for them to cover. It was a total nightmare. I wish I could just cancel my plan, or had the right to change plans anytime I want for any reason. read more

Worst customer service representatives ever. You have a choice, rude or uninformed. Worst website ever if you try to avoid talking to the rude or uninformed reps. No breakdown online of how much they applied to your deductible just a list of the "benefit" they negotiated with the "in network" provider. So they paid the provider nothing and I paid the bill. The rep told me to look at my 120 page contract to see what my deductible would apply to. Out of control time wasting insanely inefficient US healthcare. Thank goodness it wasn't major. read more

This is the worst dental plan I have ever had. There agents are rude, take forever to get back to you. They gave my dental office such a hard time, they are almost ready to drop me as a patient. They refuse to pay my claims although the should be covered. It's is the saddest position I have ever been in, in my life. Try your best to avoid this complany. I'm gonna contact the BBB read more

Could we possibly give them zero stars? This company has "customer service" that has no accountability or quality control of any kind. After over 20 calls, emails and even "expedited" central office services, they cannot even record the primary care physician on my record or provide me with an ID card that has his name on it. They randomly assigned me a doctor I've never heard of in my life and I have had the same doctor for 14+ years! Every time I call they promise to correct it and it has been 7 months and counting now! Would you believe them? read more

Don't use Empire Blue Cross...they didn't come to my aid at a time when I desperately needed it. After corrective jaw (orthognathic) surgery to address facial deformity, I was left with some severe sequelae: difficulty eating/chewing, swallowing, breathing, sleeping, and severe asymmetry of the back of the jaw (on one side, the ramus of the jaw was terribly flared out). My occlusal plane angle was severely out of the range of normal, causing my biting difficulty. My airway was still severely narrow and obstructed, leading to sleep apnea and breathing problems. Both of my jaws were still retruded (too far back) and vertically underdeveloped. I also had a prognathic chin. I chose a world-renowned surgeon for revisionary corrective jaw surgery, and he wrote a clear letter to Empire Blue Cross explaining why this procedure was medically necessary. However, Empire Blue Cross refused to cover the hospital fees, and I had to pay Baylor Medical Center $30,000. After having had this surgery, my condition is now significantly improved. Not to mention...after appealing the initial denial, the subsequent denial letter left blank the entire area where the explanation for the denial was supposed to be shown. After I contacted Empire Blue Cross (over several attempts) to try to get this resolved so I could access the explanation for the denial, it took an unreasonably long time for a revised letter to be sent to me. I was in bad shape and needed the surgery. My family had to assist me and I took out loans. read more

This is a sham. The 90 day prescription issue is out of control and the don't have the systems ti deal with it efficiency. My Premium is over 500 per week. They can't get the timing down On prescriptions. I was told to get 90 refills. I did. I submitted it and was told that I can only get 49 days. When challenged they said I can't get 90 day because I just fill A 30 amount. This is not a game. I will continue to call them out as necessary. read more

Empire BCBS received a D- from the Better Business Bureau and that exactly matches my experience of them too. I can't even find a Primary Care Physician (PCP) because everyone I've contacted on their PCP list is not accepting new patients. Even the PCP they themselves assigned to me is not accepting new patients. read more

A word to the wise: Keep your paper copies: every EOB, approval of service, every payment. Download electronic records from the web-site onto your hard-drive often. BX Claims and payments that are paid for and recorded seem to be subject to change as much as 18 months after the claim is accepted. The patient will be stuck between the provider and the insurer, so be prepared to have the necessary paperwork on hand in the event of a dispute. The good news is that last year I needed major surgery and had a hospital stay that blew though the $7000 deductible. The hospital services and subsequent follow-up visits were paid 100% with no issues. Also, on several occasions where there was a dispute with providers, the BLX reps did (after a lot of time and many calls as indicated above) eventually resolve the issues in my favor. read more

The ABSOLUTE WORST. I got BCBS through the Exchange, which apparently only makes you a second rate customer. I got Blue Cross because my lady doctor takes it, after I had to switch from Aetna (who are awesome). Turns out, they take every Blue Cross plan EXCEPT the one through the Exchange, and they can't do anything about it. They tried and were super nice, which is why I am keeping that doctor, and NOT Blue Cross. Also, a "Tier 1" generic medication still cost me $55. On Aetna it was $15. So that's ridiculous. High deductible, high out of pocket, and expensive month-to-month to boot. And their customer service is atrocious. Heed the other reviews. RUN FOR THE HILLS. read more

DO NOT USE Empire BlueCross BlueShield: Just had a non-constructive experience with a customer representative. Apparently when they are 'done with you' they "transfer you to a manager". Only the call is not escorted or professionally transitioned, instead you are left on hold with no idea of how long you must wait, after 20 minutes I gave up. All this because I requested was a letter reflecting what happened to cause me to lose my insurance. Apparently unless a template exist you ain't getting nothing from their "robot" customer support. The Situation: You judge. April 28th I made a premium payment (the 2nd since enrolling). The payment was due May 1st. On May 21st I called Empire BlueCross BlueShield because a letter they sent to me reported I did not make payment and policy was to be terminate. Fortunately, helping my cause, their records noted this call on the 21st and subject discussed. It did not include the details but what the representative said to me was (a) my account was in good standing, (b) that I was enrolled in auto pay, and (c) that the termination letter was sent out in error. So, when I got the second notice the following month I placed another call. I waited 25 minutes before having the call dropped by their system. Guess what! I found out today I was not enrolled in auto pay and the second letter was not in error. Now, I will own the loss of insurance as being my fault for failure to pay. I should have followed up and not assumed it was yet another mistake. And in the future, I should set hours aside during business hours to follow up, for dealing with any insurance company. I will most certainly NOT return to Empire BCBS. All I wanted from Empire BCBS was for them to acknowledge in writing that very first letter sent was an error on their part. That's all. But nope, not going to get it. Instead I get transfer to the abyss. I just wanted to document what I believe to be the root cause of my failure pay. Again, my it was responsibility, it just that I wanted something to offer as mitigating circumstances. For the Tax Man and the Market Place where I have to go back and find another insurance company outside the enrollment period. Not feeling very confident. I am very disappointed with Empire BCBS. Sadly their customer support is so poorly managed. There is not an outlet for customer seeking to provide feedback. Thank you Yelp to allow a constructive forum! Stay Healthy Everyone! read more

Empire BlueCross BlueShield of New York State is a TOTAL MESS! My wife and I signed up for the Bronze Guided Access (cabs) plan as part of the New York Health Care Exchange in Nov. 2013. Up to a few weeks ago we had never used or visited any in-network Dr. in the past 7 months. Finally my wife made an appointment to see the PCP that Empire arbitrarily assigned to us as new members in Jan. Because she didn't call Empire before the apt. to notify Empire that she was going to see our PCP for the first time the visit was not covered. According to to bill we received from Empire, you have to call them and notify them that the PCP they assign you is the PCP you will be using or your are effectively not covered by any Dr for any apt. SERIOUSLY! After calling both 888-553-5429 and 855-748-1806 multiple times I was NEVER ABLE TO TALK TO A HUMAN about the charge or how to notify them about upcoming visits to our PCP. I was either routed to the Pay-by-Phone feature or simply disconnected. Each call was over 10 minutes and I never reached a person. If you can't talk to a Health Plan Adviser and you can't notify them you want to see your PCP then you are paying for what? At over $500 a month we are spending more than $6000 a year to ensure we don't get to see a Dr. and can not talk to anybody at the company to fix the situation! Empire BlueCross BlueShield of New York State is a TOTAL MESS! read more

EMPIRE BLUE - I FEEL LIKE I'VE BEEN CHEATED I have been a loyal customer of Empire Blue Cross and Blue Shield for years. I had a decent plan that I paid on time every month and only used for exams. I followed all their steps to sign up for Obamacare very early, back in December, on the New York State Health Insurance Marketplace. I gave them my credit card info and requested to be put on auto pay. I travel a lot for work and all my important mail goes to my mother's house, so I have all my bills on auto pay. Today, April 7th, I returned home from a trip to find a letter at my apt, which they have never sent a letter to before, dated March 20th, saying if I didn't pay them by March 31st I would lose my insurance. This is 2014, everything is done via email, text, or phone calls. You think something this important doesn't warrant an email or phone call? So I called them and (after 2 hours on the phone, normal) they said they couldn't give me a plan but they would file an appeal, but the guy did not sound very optimistic. So here I am, with no insurance, a loyal customer, doing everything I can to be in compliance, and they won't even let me pay and backdate my payments to give me a plan. I asked them when these plans would become available again and he said only if I had a life-changing event. WTF! I heard the same thing from a friend. I feel like they really dropped the ball, or worse let some big things slide by so as to dodge as many obamacare plans as possible. Shame on them for this. The worst part is they CAN help me and give me a plan, but won't. Ok I accept a small portion of the blame for not opening my mail on time, but seriously, what young person living in NYC opens mail! Auto pay is the only way to go. This sucks. read more

Run for the hills. I can't believe this company will exist for much longer. You can wait through half an hour of automated menus and then get a person who can't even help you. It happens all the time. I was switched to another insurance company thanks to the ACA and THANK GOD!. When I call them I get a real person within 5 minutes. Night and day never looked so contrasting. I know the employees are trying their best but this company makes the entire health care system look terrible. My suggestion to EMPIRE: even if there is a 20-45 minute wait have people call and talk to a real person that can help them rather than sending them through a pre-required 20 minute automated system and then not even necessarily getting someone who can help. Train your employees to do everything! read more

Go to their website and look for the number for customer service and call it. The result of your test will tell you everything you need to know about how horrible this company is. read more

This company should be shut down immediately. 2 years later and I still haven't received correct documentation and they still haven't correctly processed my claims from ALL of 2017, for all four of us. This company is a scam, don't waste your money. read more

The automated system is absolutely horrendous. The system doesn't pick up the member ID correctly after providing it 15+ times, and then REFUSES to connect you with a rep. CONNECT ME and then I can provide the member ID to an actual human being that registers it properly. No other plan gives us this problem. Customer service is equally as awful, taking upwards of 30 minutes to connect with the rep (when most other plans take less than 5 minutes). As a provider, I try to avoid working with this plan at all costs. read more

I have had this coverage for several years. Under which I have been seen and treated for preexisting conditions. My biggest issues have been with billing from out of service providers which have submitted claims that I had to dispute. The other issue is separate coverage for prescriptions which leads to complications for maintenance prescription coverage. In both cases advocates from empire have been extremely helpful. I was temperaraly switched to emblem by the market place advocate assigned to me. The entire experience with emblem was a disaster. read more

Empire Blue is almost the only available insurance in New York and it sucks! We recently changed to Empire Blue. We are paying out of pocket for insurance because we own our own business and do not qualify for employer insurance plans due to low employee members. Unless you pay a very high premium per month for insurance the covered is horrible. Many doctors have dropped the Pathway X Enhanced insurance, the insurance supplied by BlueCross BlueShield if you opt for government discounts on your premium. Due to this we have very little options for doctors and are still paying out of pocket. Once we were aware of how bad Pathway X really was it was too late to change and now we are stuck paying high premiums and high out of network costs. Way to Go Obama Care. read more

I landed up with Empire BCBS recently when I joined an excellent union in NYC. Since I bypassed sales and went right into the service, I'll tell it like it... it's been good so far. Good selection of Doctors both in NJ and in NJ that qualify as "in-network". I'll update this again after I've lived with it for a while. read more