UPDATED: Blue Cross Blue Shield's Obamacare Fail Continues

Categories: Whatever

Screengrab via Facebook
Customer frustrations with Texas Blue Cross Blue Shield aired on its Facebook page.

UPDATED: Louis Adams, the media director for the Dallas branch of Blue Cross Blue Shield, got back to us with a statement via email on Monday morning:

"Blue Cross and Blue Shield of Texas understands our members' frustration as they call our customer service line, which has experienced high volume and long wait times. We are working hard to support our new and existing members by adding call center representatives and extending our call center hours to 7 a.m. - 8 p.m. Monday - Friday and 7 a.m. - 5 p.m. Saturday. Our website is prepared to handle very high amounts of traffic for new enrollments and customer service requests. Members can visit the BCBSTX website (www.bcbstx.com) to find answers to frequently asked questions. We know that our members' time is valuable and we are working very hard to deliver the level of customer service they have come to expect from us."

To translate, they are extending the call center hours -- though we can't help but wonder why it took so long -- and if you have a question basic enough to be answered by the frequently asked questions part of the site, you can go there and avoid the whole call center debacle entirely. Otherwise, if you're still wanting for real communication with someone from Texas Blue Cross Blue Shield, it seems that patience is a virtue you had best develop quick.

ORIGINAL POST: If you have Texas Blue Cross Blue Shield, the odds are good you have sat on the phone enjoying their hold music recently.

Cat Jeanes, of Austin, has definitely gotten an earful of that happy snappy guitar that plays on the automated system, and she isn't alone, judging by the other complaints surfacing on social media.

Jeanes is having her first baby any day now. She's 37 weeks along, she and her husband know it's going to be a boy. They have a name all picked out - Indiana Jeanes. "He's going to have his own theme music," she said.

And since she and her husband are self-employed - he's in real estate and she quit her public relations gig when they started a family - they buy their own health insurance. They were already with Texas Blue Cross Blue Shield, but the plan they were on didn't provide any maternity care, so when the Affordable Care Act (aka Obamacare) got started they went online and changed their plan.

Like Fred Rhodes, a Houston lawyer who first brought the issues with Blue Cross Blue Shield to our attention on Wednesday, Jeanes and her husband paid the premium, got their new insurance cards and started doing all the things you do when you're about to have a baby - namely going to the doctor and picking up prescriptions.

The people at the doctor's office couldn't pull up Jeanes's information, which seemed odd, but a call confirmed that she was covered by Blue Cross Blue Shield, Jeanes said. But then she tried to fill her prescriptions. The pharmacist said she wasn't in the Blue Cross Blue Shield system and when the pharmacist called a Blue Cross Blue Shield representative, Jeanes was told that she was listed as having been uninsured since 2008, which was odd since she had her newly issued insurance card in hand and the payment already went through to guarantee her coverage, she said.

Jeanes has gestational diabetes so she went ahead and picked up her prescriptions, paying for it all out of pocket. The Walgreens pharmacist said they could refund her the money if she got things straightened out with the insurance company in five days. The CVS pharmacist said she'd get a refund if she could sort things out within seven days. That was back at the first of the year and since then Jeanes has been taking turns with her husband calling Blue Cross Blue Shield.

That has meant hours waiting on hold, with the automated system generally hanging up on her after about an hour, so she'd have to start all over again. Jeanes has yet to speak to a real person, she said.

She has also tried email and has posted on the Blue Cross Blue Shield Facebook wall. That was the only time she got a response. Someone from the company replied to the thread and asked her to private message the account with her information so the problem could be sorted out. That was last week and she hasn't heard anything since, she said.

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Blue Cross Blue Shield does not cover costs that ARE covered. We made the terrible mistake of switching from United Health Care to BLUE CROSS BLUE SHIELD in January. I have Common Variable Immune Deficiency a Primary Immune Deficiency and do not produce protective antibodies against LIFE THREATENING INFECTIONS.  My Immunologist who is the best in Dallas had to talk to an OBGYN at Blue Cross Blue Shield to APPEAL their decision to DECLINE my Gamma globulin infusion treatments that have been working.  He appealed again and requested a Immunologist with a specialty in Primary Immune Deficiencies and that "Contractor" denied it as well that I should go on a "Drug Holiday" There is no more basis for this Drug Holiday than one of a diabetic taking an insulin holiday!  In the mean time, I can't breath, my asthma is awful, and I have had three breakthrough infections and cellulitis in my face.  How is it that we have lost ALL OF OUR RIGHTS SO QUICKLY in this country and we are allowing insurance companies to practice medicine??  I's amazing what greed will do.  We will wipe each other off the face of the planet for $500,000 in lobbying money.  How incredibly sad. United Health Care, I am sorry I left.  You were an honorable insurance company and always treated me right.


these insurance companies use EXTREMELY archaic systems to enroll members and update information THATS THE MAJOR PROBLEM.  I have worked for them. I agree it should all be single payer and remove the profit out of the insurance side. BCBSTX has told me thirty different stories. Each time telling me that the issues would be resolved and to call back in a few days.  I have called everyday since the the 16th of December.  They have WRITTEN 3 POLICIES ON ME AND NOW TELL ME THAT IS WHAT IS CAUSING THE PROBLEM (tried to blame it on me but I told them I only called one time that day and the agents told me they were having computer problems....and guess what....they issued 3 policies) only to be told by the agent assigned to me that he couldn't delete the policies as it was AGAINST THE LAW...LOL!   I am not paying the premium but going with a different carrier.  Hopefully there will be hell to pay for the incompetence and poor planning.


Sure would be easier and more efficient with a single payer system....there is really no role for insurance companies to come between medical providers and patients needing care.

JefWithOneF topcommenter

I'm sure their system and organisation is completely swamped. I called them in late November and got through almost immediately to have an issue resolved. Tried that again in December and it was chaos. Hopefully it'll settle down some soon. 


Thanks for bringing attention to the problems with BCBSTX. In my numerous calls to BCBS TX Customer Service over the last two weeks (yes lots of on hold time), I have ascertained that they have some serious software issues. One that has me caught in it is that their system merges accounts from folks who signed up via the exchange. Meaning that when they bring up your account, there is more than just you listed on the account, usually with both of you listed as primary. This is supposedly a HIPAA violation, I've been told. The result is that your id is not valid in the system (it may not even be your real id). I signed up via the exchange and received a welcome letter from BCBS on Dec 2nd, called shortly thereafter to ensure I was in the system, which I was and was told I would receive cards and invoice within a couple of weeks. That never happened, still hasn't. Have been calling and emailing since Dec 28th. Still have not been given a timetable as to when this issue will be resolved.


Reading around the net shows that you can find these kinds of stories, but the MSM and sympathetic sites strain to insist that all will be well and that people will now have healthcare.  They may have insurance, but that's not healthcare.  Buyer beware indeed...


@grayson Seriously, the only thing worse than an insurance company coming between us and our medical provider is the federal government doing so. That is Definitely not the answer,.


@txsavvy go check out their face book page...there are hundreds like you and me.  I was interviewed by KLTV Channel 7 in Tyler on a segment on these problems last nite.  There are some things you can do...file a complaint with the Texas insurance Commission, call your congress critter, the Atty general's office and the Federal Dept. of Health and Human services.  I have a feeling we number in the thousands...BCBSTX is in an EPIC fail about these new signups.

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