Health insurance hangups for new Blue Cross and Blue Shield Cust - KLTV.com-Tyler, Longview, Jacksonville, Texas | ETX News

Health insurance hangups for new Blue Cross and Blue Shield Customers

Posted: Updated:
QUITMAN, TX (KLTV) -

The last year has been rough for the health insurance industry. The Affordable Care Act was implemented, delayed and, now, according to healthcare.gov, is finally in effect.

However, one East Texas family who signed up for new individual insurance plans through Blue Cross Blue Shield says the healthcare company is not holding up their end of the deal, and they are not the only family having a problem.

Liesse Langlois says she has done everything she was supposed to do. She and her husband signed up for an insurance plan through healthcare.gov in October. They received their Blue Cross Blue Shield welcome letter and registered their account online. That's where, Liesse says, everything good about her new insurance plan stops.

"I never got a bill. I never got my ID cards. I never got my policy. So, I just went ahead and sent a payment in," explains Liesse.

Her plan shows it was effective starting January 1, but Liesse says when she went to have some prescriptions filled, she learned that wasn't the case.

"Brookshires ran the numbers and they all came back invalid. She said 'You're the second person today from Blue Cross who cannot get their prescriptions filled,'" recalls Liesse.

Liesse says she has spent hours -- she estimates at least 24 hours-- since October trying to get Blue Cross Blue Shield customer service to solve her problems.

"I was thinking this was a problem with me -- maybe a few other people -- but, I went on Facebook as a last resort and read all of these complaints from I don't know how many people," says Liesse.

On the Blue Cross Blue Shield of Texas Facebook page, customers across the state say they're having the same problems. Like Liesse, these customers say they have proof of coverage but doctors and pharmacies are not recognizing their policies.

"Nobody at Blue Cross Blue Shield of Texas is responding to our complaints," she says.

We reached out to Blue Cross Blue Shield asking to speak to a spokesperson by phone. After a series of emails, we were finally able to get this out of them:

"Some [customers] are having issues because they are 'orphans.' These are new member files that have had issues with government records," explains the insurance company's media relations department.

Blue Cross Blue Shield says they define "orphans" as "customers that have enrolled on the marketplace but did not have records on a document the government sends insurance companies."

"It's important to note that the number of orphan files we are seeing are very low,"  Blue Cross Blue Shield says in an email statement.

However, back on their Facebook page, customers are posting complaints by the hour, and Liesse has filed a complaint with the Texas Department of Insurance. What Liesse really wants is the coverage she's paying for.

"This was a good opportunity for us to get insurance and it was affordable, but it's not going to be any good -- no matter how affordable -- if you can't use it," says Liesse.

Blue Cross Blue Shield also says they're working with the Centers for Medicare & Medicaid services to try and fix the problem. They say they are also extending their customer service line hours. To see those extended customers service hours click here.

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