Florida Blue
Reviews and Complaints

Absolute worst most unsavory most unethical company ever. They never call back, their staff is rude and they couldn't pay a claim correctly if their life depended on it. They denied a ton of my chemo claims in November even though my premium was paid and then said I must pay December in order to pay my November claims. What kind of hogwash is that? The claims were incurred in November so even if I terminated in December they are still responsible for paying claims with dates of service in November. incompetant people on the phones and funny how the Supervisors are always in meetings. They don't care that they are putting member's health care in jeopardy even when premiums are paid up.

Worse health care company ever and if have been in healthcare for over 40 years. This is my 3rd state complaint with them having to do the right thing each time. Can't wait to switch plans.

In October 2021, my wife turned 65 so I had to get the policy put in my name only. I have kept the exact policy and assured that there would be no additional problems or expenses due to having a new policy exactly the same as the one I had all year. Today, I am still having problems getting my prescriptions without having to pay a copay which I should not be having to do as my deductible was fully paid at the end of July. I am not having any problems getting lab work or going to the doctor, they show my deductible has been paid in full. For some reason the prescription part of my insurance refuses to deal with it. My wife and I have spoken to at least 10 people since Nov 1, 2021 and each time were are told they are escalating the request to straightened this out and to date on Nov 15th we have gotten nowhere. Today when we called we were told the same thing again, that it was being escalated to top priority and it will take another 3 to 5 days which is what we keep hearing. The claim # is 9-[protected] which was actually started on Nov 5th. Each time we talked to someone new they say that it was sent to the wrong department or this time that on Nov 5th is was not escalated to priority which we were told it was being done on the 5th. We have been transferred to the complaint line which is a joke as none of the options actually work, it just disconnects you. My out of pocket was actually over the $5, 500 that was required by $34 dollars and some change. We understand and have been told if I would have gotten a different plan than I would have had to start over, but because I have the exact same plan and it had to be in my own name due to my wife having to go on Medicare all my deductibles and copay carry over to the new plan number. I should not have to keep paying copayments for my prescriptions, this has gone on long enough. If it isn't resolved I will contact the insurance commissioner to see what can be done to get this resolved and my money back that I am being forced to pay if I want my medications. No one should have to make this many calls and deal with what we have had to and to be treated the way we have been treated by several of the people in the Prime Therapeutics Pharmacy Department that you have choose to use. You may reach me at

[protected]
Robert A Malloy or my wife Dorene Malloy

This is the worst coverage in the world the entire time i was on this plan i could not get any service for anything no real person that has any sense answers the phone BUT they sure will hit your Bank account on time and more than once i WILL NEVER GET TRICKED INTO THIS COVERAGE AGAIN i have filed with everyone else who are a part of the lawsuit in hopes of a good outcome

I called on 9/22 @ 1036 and 1043 am Eastern to Florida Blue. I spoke with a male customer service rep. As I advised him of the reason for my call, he yells whats your member #. I said I am not trying to be rude but did you just cut me off. He said in order to help I need your member #. I exclaimed, well I would think you would allow me to finish speaking first, and he hung up right in my face. I called back got another male representative with a very strong accent. I advised him my primary listed was Blank and needed it changed for the 3rd time. He stated there was nothing he could do but give me a reference number to use at each appointment because the system automatically chose my provider and would not allow them to change it. I advised that's unacceptable. After going back and forth with the rep, the call went mute for 1-2 minutes, so I hung up. He called back and stated he could change the PCP, and it would update in 24 hours. This by far was one of the worst customer service experiences. It took 3 calls and 32 minutes on the phone to just get my PCP changed. I hate it here!

Why tf were you blowing up my phone... months after i enroll . Try to use this waste of money insurance and all providers near me are at least 60+ miles lol. My main complaint is I've been calling for 2 hours trying to get my policy number and no one wants to give it to me.

ID #H38552303
SUSAN J FISHER
6606 7TH AVE CIR W
BRADENTON, FL 34209
Ph. [protected]
Email [protected]@icloud.com

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BACKGROUND:
When selecting an Insurance Plan for 2021, I carefully chose one that included VIBERZI in the Pharmacy Drug section, with an affordable Co-Pay of $65. The monthly cost for my Insurance Plan is $1, 086. That's over $13K per year.

Based upon the fact that approval has been granted each time I needed a new script in the past, I had no hesitation or thoughts about VIBERZI not being approved.

So now, I have a very expensive Insurance Plan that doesn't want to cover my IBS-D medication.

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MY MEDICAL ISSUE AT HAND:
I am having severe diarrhea, with terrible cramping and extreme bloating; which is affecting my overall quality of life.

I have IBS-D, which primarily causes diarrhea (as opposed to constipation). My Doctor has prescribed VIBERZI to help control my case of chronic IBS-DIARRHEA, yet Florida Blue has denied the most recent approval request. All necessary and pertinent information was completed and submitted to Florida Blue numerous times (in February and March 2021), by my current PCP, Dr. Arleta Anna KITLAS.

I do get a Colonoscopy every 5 years, which does check the Colon and Bowel for anything new or more significant. However, there are no X-rays, mri's, sonograms, ultrasounds, scopes, bloodwork, or any other test that can diagnose/monitor Irritable Bowel Syndrome.

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AVAILABLE DRUGS FOR IBS:
While there are many prescription drugs currently available for IBS-CONSTIPATION, prescription meds for IBS-DIARRHEA are very limited. These are:
- Lotronex (alosetron HCL) - Serious GI adverse reactions may occur.
- Xifaxan (rifaximin) - Short term antibiotic.
- Antispasmodics - Prescribed for abdominal pain and cramping. I CURRENTLY TAKE LEVSIN (hyoscyamine), AS NEEDED.
- Antidepressants- Tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) may work to reduce symptoms of IBS-D through their action on neurotransmitters in the intestines. I CURRENTLY TAKE WELLBUTRIN (bupropion) TWICE DAILY AND PAXIL (paroxetine) ONCE DAILY.
- Bile Acid Binders - Testing for BAM is extremely limited in the United States. According to the ACG, there is not enough information yet to recommend these medications to everyone with IBS-D.
- VIBERZI (eluxadoline) - Reduces episodes of diarrhea and abdominal pain in IBS-D. It works on opioid receptors within your digestive system to regulate the speed of intestinal contractions, fluid secretion, and pain sensations. I WAS INITIALLY PRESCRIBED THIS MEDICATION FROM MY PCP IN PITTSBURGH, PA., A FEW YEARS AGO, AND HAVE BEEN TAKING IT UP UNTIL RECENTLY, DUE TO LACK OF APPROVAL.

IN ADDITION, I TAKE CYCLOBENZAPRINE, AS NEEDED FOR EXTREME ABDOMINAL PAIN.

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BENEFITS OF VIBERZI:
- VIBERZI allows me more comfort and confidence when going out, with fewer accidents, less abdominal pain and fewer trips to the bathroom. I'm more hydrated without constant diarrhea. In short, it helps to keep me more regulated. My quality of life does not suffer as much when taking this medication.
- On the days when there is additional stress in my life, then along with the VIBERZI, I take the Hyoscyamine and/or the Cyclobenzaprine, for more immediate relief.

The bottom line….VIBERZI truly helps my Irritable Bowel.

I am William Ellis, 5688 Oakhurst Dr., Seminole, Fl 33772

I dropped this Plan H53841240 in Oct., 2020 with your Jacksonville Medicare coordinator by phone and letter.

I was paying more for the plan than the cost of my single prescription for Terazosin a prostate med.

Now I keep getting billed monthly out of your Dallas office, now at $221.10

I plan on filing a harassment claim if this false billing doesn't cease and desist.

Informed me if had access to 13k monthly I qualified. Explained had Liguid cash, savings no direct deposit. Told me to lie. Told him not a liar and refused. Told me to run through underwriting and they would tell me same thing. They did, want to hear recorded conversation. 57 years old, never lied in my life. Four paid mortgages, 20 paid cars, no lates lapses ever and government telling me to lie! Hard times, trying to cut expensives. Blue cross cancelled me for on time payments last letter recicieved with refund check didn't cash. How currupt is country. Did right all life for what?

I contacted Florida Blue to see if a Dr was in my Network.
The first call I was put on hold and hung up on.
Than I tried again put extended hold, hung up.

I contacted social media. I got incorrect information.

I was told she was in network but not accepting new patients.
I called the Drs office they said they are taking new patients.

I called Florid Blue on 2/18 and I was told she was in network.

I can not correct information from Florida Blue without calling several times.

incorrect information about a Dr cost me $, as well searching for a new Dr.

i called to see if a dr is on my plan. The rep could not undestand me. i had to beg for a superiaior. i repeated and spelled numrous times.

After a long hold i was told i would get a call back!
phone system is a maze, long hod time. Reps don;t understand English even after spelling it.
everytime i call it takees multiple people to resolve an issue.

Florida blue needs to improve customer service,

I cant get an updated list of internal medicine providers.

I finally got through the phone system today.. The rep could not nunderstand me! After repeating 5 times, I asked for a supervisior, in was sent back to thr maim menu. I put in my date o birth 5 times before giving up! It kept saying I can't get that!

Florida blue customer is deteriorating. Every call is a chllange to get correct information.

I recently received a letter dtd 12/6/20, stating that Florida Blue was going to drop my supplemental insurance because I did not pay them. I previously sent a letter to Ms. Malko, an officer of the company, dtd 9/18/20 to get the problem (caused by Florida Blue) resolved. No specific action was taken. We have paid $514 each month for 2020. Prior to sending my letter, I got empty promises that the situation would be taken care of - nothing was done. We never had a problem till around the middle of the year. It was at this point that our payments were not allocated properly. Our situation is very simple to to resolve, just apply our monies from the check to the appropriate accounts. Nobody wants to do what should be done to rectify the matter. Purportedly, my wife, Joanna, account is okay and it is my account that is delinquent. What happened to all of the excess monies, if I am not getting funds applied to my account? I have to wait on my doctor appointments till I get this resolved. Again, it is a very simple problem to resolve.
Sincerely,
Anthony Peri

Joanna Peri Member # XJNH31162267
Anthony Peri Member # XJNH31162294

My is diane spero. I have a florida blue plan. Vmdh28097247

I have been working on my renewal several weeks! I am transfred to person to person. Put on hold tyan hung up on! Happene again today 11/4/2020

I can't get correct information.

My plan was changed with out my consent. I was getting information on plans! I did not not change my plan.

I need to speak to a suprvisior to get my renewal clarified.!

I am on hold again!

How I file a compliant againstt usomer service,

I have been trying for weeks to talk with an agent to renew my insurance.
I hve been disconnecte by multiple agents,

I spoke to christa lainhart on 11/2/2020.
I was disconnected. I thik she fell asleep.

I called the number on het email. I got sent to thr penscola blue center,
I can;t not contct this agent.
I keep having to call get transferred go through my info again. Than hung up on. I got a vip number. 520l2192045813.

The answering is system is long. A recording music, a recording leave message for an agent another recording.

I set up an apt wth an agebt, would not call back veify apt, did npt answer apt time!

I am a florida blue customer and should be able to have a contact for renewal.

Flordia blue customer service is vey difficult to get. When you get a rep it's difficult to get a correct answer.

I have connected florida blue insurance days.
I can;t get the correct information. I am hung up on, transferred,
Given a wrong phone number. Had to find it my self.

Someone called it was not from tel a doc I asked for.

I am trying to get help f0m tele a doc. No one at lorida xan get me to the right person!

I have sent emails to social media team!

Since you are no longer providing representatives to assist with provider calls and redirecting all inquiries to Availity, please educate Availity on how to assist us with claims, payments and appeal issues. As instructed, I opened a ticket related to each individual case for the reissuance of ACH payments and Availity responded stating they were simply a clearinghouse and could not assist with my issue. They closed the cases, leaving know further guidance or how to get the issue resolved. WE NEED PROVIDER REPRESENTATIVES! Please bring them back. Unfortunately, the only recourse we have is to issue a complaint with the Department of Insurance and local Insurance Commissioner.

I called about tel health that florida blue is offering.
The rep said she would stayon the line while she connected me, and help me set up.

I was disconnected! Florida has awful ustomer service.

The phone system is amaze, the reps can;t give correct information, or disconnect you.

I am complaining about the fact that my friend had a procedure preformed that was NOT considered "still a experimental procedure". She has Humana Medicare and her out of pocket for her nerve-releasing surgery was $350 while the same surgery through BCBS is not covered so my cost would be $5000. How can this be ethical to serve someone and let them be allowed to afford a life changing surgery because they are low income but not to allow me to afford the same surgery just because I am not on an insurance for low income people. This seems to me like medical neglect to a certain group of people. Please respond to this email with an explanation how one insurance can say a treatment is considered experimental when another one says it isn't. My email is [protected]@duvalschools.org Karla Aponte [protected]