Blue Shield California has outsourced some of their health care to Magellan, who outsources it to healthcare provider corporations, who hire actual healthcare providers. The good news is that they were able to help me find a local provider within 4 weeks, which is too long but still relatively fast for my local area at the time. It was clear that they deployed resources and worked hard to find a provider that fit the qualifications I was seeking. The bad news is that Magellan does not support electronic document delivery so explanations of benefits, bills, etc. all come via paper. Imagine that! It's the 21st Century and they are still cutting down trees to send paper mail to customers that don't want it. As of 10/2020, Magellan says they have no plans to fix this. Of course, you probably also want to know about the quality of the healthcare provided. Overall, the health services provided have been fine. My biggest issue is that my provider doesn't return emails or phone calls, and fails to handle requests to change appointment dates. I complained to his employer (the corporate provider) and nothing changed. My assumption is that this problem is related to how Magellan compensates and monitors the quality of providers. When you are a customer navigating through 4 levels of systems and organizations (Blue Shield, Magellan, provider's corporate employer, provider) it's hard to know who is to blame for a problem. But I can say with certainty that Magellan is to blame for filling up my mailbox with paper. read more

They first lawyer they referred me to is hours way. The second lawyer they referred me to was out of office. The 3rd lawyer lawyer they referred me to is hours way. I've wasted way too much time with them. read more

I wish I could give them ZERO stars! It's been 6 months they are wasting my daughter's time for ABA therapies. Talking to these people sounds like talking to walls! Walls listen better actually. They don't care about patients! They do care about wasting your time! they keep repeating their own words without listening! We are switching insurance because of this company! Shame on them! read more

Horrible company. Was recommended by my lovely insurance for mental health services. When I got on the phone, I was with a lady who at first appeared nice. But as she went through my assessment she would make comments under her breath on the phone. She gathered my information and put somethings in incorrectly. She then transferred me to someone in Florida (I'm in Texas) and assured me this person would read the assessment we just did. Turns out, the next lady in Florida I was transferred to, didn't have a clue of my information I just went over with the previous representative. So I would not recommend this service at all. read more

The absolute worst. They must have financial incentives to prevent people from using their health benefits or submitting for healthcare reimbursement. The barriers they create, like 1-2 hour wait times to speak to someone in claims, are unethical and should be illegal. I don't blame the customer service people, but as a company they are shamelessly terrible at providing service to their customers. read more

They're such a bad company that I can't find providers who take it. My insurance is changing to Magellan, & I will be losing my provider. I have no options even close to the standard of care she gave me. read more

I have been a behavioral health provider for Magellan for years and have tried and tried to navigate their system to service existing longterm clients who are Blue Shield members. The barriers put up to provider support, claims status, proper phone numbers or emails are too many to count. No ability to get through. Most recently, the support # I received in a letter goes to a sales pitch for a medical device. The reimbursement is well below the reasonable standard, it took me a year of persistence to get to a renegotiation reimbursement, and even that is below all others. I see all the other provider and client reviews same as mine and completely agree. And no attempts to make any changes. It's been years of this. It's unacceptable for a huge provider like Blue Shield. You need to be better. You are contributing to poor healthcare and mental healthcare in a big way read more

Impossible to find a provider. No one accepts this insurance. I was assigned a specialist to assist with my family's needs and they never provided any of the information they promised and eventually just stopped communicating. I'm paying for insurance I can't even use and paying out of pocket for services that should be covered. read more

The company doesn't understand Pharmaceutical Law. They believe the 28 day rule applies to prescriptions that are less than a 30 day supply. A simple look at Federal and most state laws state that is the supply is less than 30 days, the 2 day rule applies, meaning 2 days prior to the supply running out, you can get a renewed prescription or a refill on controlled substances. They will just reject coverage for "too early refill" amd make you pay full out of pocket. They don't have any understanding of the law and violate the law. They should have their license revoked. read more

I truly don't have the energy to write about my traumatic experience with Magellan (through Blue Shield), but I will write a brief summary because I don't want any mental health patient to ever have to go through what Magellan has put me through. The amount of resistance and hoops I was subjected to in my venture to receive life saving care (as directed by dozens of physicians who have worked with me for years and treated me during emergency hospitalizations) is truly crazy, unethical, and infuriating. The staff who answers the phone does not know what they are talking about, and anyone who does will not call you back (we were told 15 times that "Stephanie", a supervisor, would call us back after the representatives couldn't help us. She never did). After a suicide attempt, my physicians directed me to immediately enroll in a DBT IOP. Magellan claimed to cover the IOP services that I was requesting, so I was first sent to a drug addiction treatment center (I do not have a SUD, let alone ever tried any form of drugs), a weekly group that did sound bowls (sorry, but this alone is not sufficient to treat depressed and suicidal young adults), and a process-based group where my therapist did not have a license and couldn't remember my name. I eventually had to get an attorney through the California Department of Managed Health Care to force Magellan to cover my treatment, since they refused to provide any services that were close to being appropriate and strung me along for over 6 months as I struggled with active SI, self-harm behaviors, and emergency hospitalizations. Now, they are refusing to call us back or give us any direction as to how we can get reimbursed for the out-of-network services the CADMHC is instructing them to cover, and are paying thousands out of pocket every month. I am going to have to go back and get the attorney involved, yet again. It has been almost a year since I was initially hospitalized and directed to an IOP and have been expending great energy trying to get the treatment I desperately need. Avoid these services at all costs if you can. read more

I pay high premiums for Blue Shield of CA. Had no idea that they outsource to Magellan for mental health. My interactions with Magellan health have been terrible and unethical. They call me to offer "services" and ask for personal heath information about my family members. What happened to confidentiality? This is enough to get me to NOT renew my Blue Shield of CA insurance. I see from the reviews that this is a consistent experience. I hope Blue Shield gets the message that this is NOT okay. read more

The website is hard to navigate. It seems to be made by just shoving things under random titles. Oh IF you can even get in to the page without it crashing. Call costumer service if you want to talked to like a toddler with an abusive parent on the phone. I was told to shut up tell NICK was finished telling me what he thought I was asking. Lucky NICK gets out of people complaining about him by just being a jerk tell you hang up. read more

I wish I could mark -5 stars. I am a provider and the quality of interaction I get with Provider relations staff was terrible. I needed to tell her that I understand you may be stressed but please talk to me kinder tone of voice. It was my mistake to mention to her, oh she began yelling at me and did not let me to explain my point. At this point I had a choice to hang up the phone or yell back to her. I am finding a lot of one stars here and it really make sense. read more

I've had a horrible experience with Magellan. All I wanted was to have an appointment with a therapist. However, after the appointment was over the therapist told me they didn't accept insurance. I told Magellan this and they said they'd look into it. Keep in mind, this therapist was listed on Magellan's website as being in-network. I've spent the last five months reaching out to Magellan every few weeks just to get an answer on whether I can get reimbursed for that one appointment or not. Every time I call I get a totally different answer and some variation of "somebody will reach out to you." And then nobody ever reaches out. Every interaction with this company has left me with worse mental health. read more

I am a provider and am no longer able to find EOBs for payments I receive via EFT deposit so that I know for whom they are paying and which sessions. Until recently it was doable on the Magellan site. That is no longer possible and has been assigned to Availity. When I log into Availity and select the Magellan tab, I receive an error message every day this week. When I send a message on the Magellan website, they now go unanswered or terse replies. I do not recommend this insurance company to any consumers or providers. read more

The reason why I left the Magellan is because I heard a disturbing conversation about guns. There were 2 people talking about guns, bragging having several guns & being good shooters during Zoom Training class. The conversation was very disturbing. My husband was shot 3 time and suffers from PTSD This was very disturbing. Especially when News reports says people have multiple firearms shooting people . I kept asking myself is this for several days " is this company that I want to work for ? "I resigned. read more

STAY AWAY!!!!! Unless you like spending hours on the phone trying to get a perception with no answers & no help and just keep calling back with the same results and your blood pressure going up daily. its not worth it..... read more

Have been trying to get help for someone for over 6 months. No providers available and the no providers seem to want to be part of this system. It's incredibly frustrating that they again wasted hours of my time to insist someone was out of network, even though they were eventually discovered in network. Again services delayed because of incompetence. BCBS pushed me to this mess and I'm so frustrated since I chose BCBS for their services not this!! One connection made by Magellan was a joke. Nothing promised was provided. read more

The worst! I pay very high premiums for our Blue Shield of CA PPO insurance to find out BS subcontracts mental health care through Magellan - and it i just the worst. I looked up 25 in network therapists in our area and they all got terrible reviews: doctors and therapists that provide terrible, seedy care - sometimes apparently dangerous care-, collect whatever money Magellen with throw at them, and move on no matter what happens to their patients. It seems like the bottom of the barrel in regards to mental health insurance and providers. Yikes. Shopping for new insurance with better mental health coverage. read more

Feb 2024 I had to get prior approval for a medication I've been taking for a year with this insurance, and while my doctor sent in a prior authorization request to them for both 30 day and 90 day supplies of it, apparently those submissions do not count the medication itself. So after 6 days of withdrawals from my medications (wherein which I got letters of prior authorization being granted) I still could not obtain my meds. Their automated phone systems are shit and I could not find out that I needed prior authorization for the actual medication itself through their Customer Care number, I had to call a different number on the insurance card because of course the people I needed to be connected to to figure out why I can't get my medications would be under the "member" phone number and not the more obvious "customer care" phone number. Absolutely ridiculous that they don't have better more obvious customer help and even stupider that and approval for the amount of medication I can receive is separate from the medication itself. read more

Magellan used to to run the In Transition Program for the military, my appointment last year took several months to schedule with therapist Jeff Cowan, he never called or even followed up on my emails. When I complained, manager Sharon Berry told me there's nothing she could do, contact my congressman, and then thanked me for my service. read more

I agree with everyone Magellan is horrible. Very few doctors accept Magellan and the few thst accept them will jot not return phine calls. We pay premium prices for horroble service read more

Blue Shield of California uses Magellan Assist for processing behavioral health service claims. In turn, Magellan Assist makes it as difficult as possible for consumers to actually access benefits. The Magellan Assist website contains no reasonable claim form. There is only a cut-paste link to a CMS 1500 form that has the word "SAMPLE" across the center of the page. The requirements for submitting a provider's bill are equally ridiculous. The site indicates the out of network provider must list the patient's insurance membership and group numbers on the provider's bills. Magellan Assist knows that out of network providers do not do this. There is no process for submitting claims through the website. One must actually print and mail a hard copy. The website does not even list the address to which the hard copy claims should be mailed! It is clear they are making it as difficult as possible, so that the average consumer will not be able to access benefits for out of network services. In short, Magellan Assist is a garbage company that exemplifies everything wrong with the medical insurance industry in the US. read more

So so disappointing that this is what I am paying for with my Blue Shield membership. I'm not surprised this review page hasn't been approved by the company. Anyway it is a shame that people's mental health once again are places in the back burner. I am not sure how hard working people who pay for insurance and can't afford out of pocket deal with the choices made available. I hope one day people's mental health is recognized as important. read more

If it were possible to give this company negative stars I would. I cannot find anyone who accepts Magellan insurance, even the ones listed on their own website inform me that they do not accept Magellan. I have gone several years without needed care because of this company and cannot afford an alternative. I am fairly certain that this company's practices are in violation of insurance parity laws. read more

I have a standing prescription for a 90 day supply of medication. If I do not refill the prescription within that 90 days, they will not refill it. I, my doctors office and my pharmacy have to go through a long drawn out process of phone calls, mostly being on hold, being transferred to someone else, waiting to hear back from magellan, etc. It is a nightmare. I strongly suggest that you find insurance coverage with another company. read more

I have so many clients who are insured with Magellan. I have been listed with Blue Shield as a PPO for years. However, now, it's only out of state or Federal employer Blue Shield compensates for. PPO is preferred provider, however, you don't get a preferred provider for mental health, you have to go through Magellan, which is an HMO and a poor excuse for a mental health service. I have been in the business for 20 years, and I'm just not going to bother with this insurance plan. I did try to sign up, but from what I've heard their pay is horrible. Also, half the people I talked to didn't even understand and send me in the right direction, finally after hours on the phone I got the information I needed. When is this country going to be out of the grip of the Health Insurance Mafia??? A universal system like they have in Australia would cut costs by 20%. Shameful! read more

This is the worst rx company I've ever had. Got medication last month now I need pre-authorization. Which would be fine had they let me or my Dr know before the day of the refill. Pharmacy won't fill unless it's approved or denied but it's neither so guess I'll just miss work. Horrible. read more

Horrible customer service!! There was no in network Psychiatrist who would take my daughter as a patient. Her medical Dr. spoke to a colleague who agreed to see her however he is out of network. For six months they have passed me around from care manager to care manager. They even had their own people calling all the same Dr.'s I called and they couldn't find anyone. Six months later she has still not been seen by a psychiatrist. If I treated my customers they way my daughter and I have been treated I would have been fired!! For Everyone at Magellan who knew about my daughter and passed the buck Karma is a bitch!! You or your family member will need help one day and get stuck with someone as useless as you were to us!! read more

They SUCK!!!!!! I was told by a cardiologist that they sent me two that I had two heart attacks after he asked to get the angiocardiogram and other test done they sent me letters saying that it had been denied because they deemed it not medically necessary are you effing kidding me? Every other thing that every doctor has asked to do to me has been deemed not medically necessary I called and got a caseworker there she sent me a bunch of people that supposedly accepted Magellan I've called 6 this morning of the 20 or so she sent me none of them accept Magellan they suck!!!! I give them - 1000 stars. Maybe after i have a massive heart attack they will deem it medically necessary dumbasses. The only reason I'm putting one star on here is because that's the only way it would let me post it about these jerks. read more

Gatekeepers who deny treatment even though there is no chance of abusing this treatment, and without explanation. Did I go to too much therapy? Not enough? Too much medication? Not enough? Are there reasons that a person with a health problem would be unable to access treatment in the past? What do people do when they need help and are denied it? read more

Magellan gets a zero rating from me. They are the service that approves/disapproves services for my Medicare Advantage plan through Connecticare. This is the second time this year they have refused services or to pay for procedures because they claim the physician did not give enough reason for the procedure. When I spoke with care givers they say they used the correct language for the procedure. Spoke to a male representative at Magellan and he was yelling at me. I have appealed the first refusal and I am still waiting for an initial letter to show that I have appealed. Since I'm on Medicare, I have no choice but to have their services. Horrible. read more

Three years ago they tried to deny me a hip replacement. I was in extreme pain and every step was painful. Fortunately my orthopedist was able to give them information that ended us in approval, but I only got the approval less that a week before the scheduled surgery. I had cancelled my pre-admission testing because I was afraid if the denial was upheld I'd be stuck with the bills for the pre0admit testing. Now my family doctor wants me to have an MRI and they have denied it. Who is running our health care, out doctors or these hacks??!! read more

Horrible! They have had me going in circles for a month. All the providers they provide (I have called well over 30) are either not contracted, do not see pediatric (yes Magellan said these were pediatric providers) or did not call back. One would see my son but in august... AUGUST! PEOPLE know your rights! Especially with mental health you have legal rights under your contact with the ins to bee seen in an appropriate amount of time. Meaning within 2 weeks or sooner. As well as if they can not find a contracted provider to do this they need to create a "per diem" contract for a provider who can (per diem means pay per service with out a contract, aka out of network provider) It is RIDICULOUS that Magellan is even contracted with BCBS and other healthcare providers for mental health contracts. To have people already in pre and current crisis to go through this is disgusting. Any ins who contracts with Magellan clearly does so, so that they have less claims to pay and hopes that people will not know their rights and the legalities and will either suffer or pay out of their pocket. read more

Magellan is not popular with psychotherapists, and I am planning to exit from their list, which is a shame because there are so many desperate people on Magellan looking for therapists and not finding them. For the provider, the pay is relatively poor, but on top of that, you have to really stay on top of billing to be sure you're paid. They give you 90 days to submit your bill, and it's easy to, for instance, submit the bill to Blue Shield because as the patient was insured by Blue Shield, you were dumb enough to think Blue Shield was the billing contractor. Nope, it's Magellan, and if you don't get it all figured out fast enough, you're out of luck, and out of the money. I've been locked out of the web site over and over and over again, for no reason, which prevented me from billing in a timely manner as I don't have all day to sit around trying to get my bills in. Tough luck, says Magellan. Let me know when you match other insurers with a 180-day window, Magellan, and perhaps we'll do business again. read more

Magellan's web interface is really awful. It's profoundly unclear where one is meant to file new claims, and trying to submit a question to their team to ask sends one through a labyrinth of web pages, all of which are full of vague corporate-speak that are rather useless... read more

They will not pay your due reimbursements, period. They will run around in circles using any excuse imaginable. I have called them for payment over 100 times in the past year. I know all their excuses, so I send the claims certified and keep a copy, so they can't say, "the claim didn't have the NIP," or, "we never received the claim." Now they say some checks were sent to my provider and others to me. My provider has never received a check. This is either the most incompetent office, or more likely, A FRAUD. read more

If I could give them zero stars, I would. Their "in network" carve out for mental health has a $15,000 dollar deductible. What a joke. A deductible that size essentially means that you have no insurance. But want to know the really sad thing? They apparently have an "out of network" deductible too. Which means if you try to do a self pay thing, you are out of luck and don't get that discount because you "have coverage" If you are trying to get any mental health help, you are better off just not presenting the insurance to the mental health provider and getting the self pay discount. If you have BCBS HMO and need mental health care, don't even both showing them your insurance card because the self pay discount becomes a no go. read more

Customer service is great. Clinical supervision is appalling - unhelpful, rude, and obstructionist. Today my daughter's clinical reviewer hung up the phone on me. read more

Bad company to work for! I currently work for this company and i have made a mistake. The management is horrible and they dont care about the employees. I will be quitting this place is sad!!!!!!!! read more