Baylor Scott & White Health Plan, Temple TX

If you want an insurance company who actually hears your concerns and gets things done in an appropriate time frame, don’t get the BSWH plan. You’ll be disappointed time and time again. I filed a claim almost 90 days ago. Per BSWHP communication, my claim was to be reviewed and resolved within 30-60 days. Here we are at 90 days and nothing has been resolved and they haven’t communicated anything to me. I’ve called 5+times to try to get updates and no one can provide any reliable, real updates. I’ve spent tons of time on hold with each call totaling 1+ hours. The customer clearly doesn’t come first. When I request to speak to supervisors and managers, I am always told there is no one to talk to. Save your time and money and get an insurance plan with someone else.

Horrible health insurance. I warn you to run far far away from this health insurance plan. They will ask you questions that aren't "included" in your scheduled visit and you will be charged EXTRA just for answering those questions asked by your doctor. Was told my the billing department that it was my responsibility to know which questions to answer that were included in the visit and which ones were not. SO WRONG! I've never had a poorer experience with a health insurance company - this honestly is so close to health insurance fraud, I cannot even believe it. I will be switching companies as soon as possible!

Baylor Scott & White is like the McDonalds of health insurance, actually I shouldn't insult McDonalds. Bought them through the marketplace and when I tried to cancel, it took them months after several phone calls they claimed they never received. Unprofessional and uneducated.

They put us to hell sending us doctor to doctor when my wife needs a surgery do not go to this experience might as well pay or go to another country

After approving an out-of-network surgery center in December 2022, BSWHP denied to approve the same surgery center after I changed doctors, who is in-network. Now, BSWHP wants me to change doctors again.

When filing an appeal, I not only explained the entire situation in a 59-minute phone call, but then had to fill out a paper form and mail it.

BSWHP makes it very difficult to access care and appeal denial of care.

I signed up for a BSW health plan through the Marketplace on 12/12/22. Paid my first month’s premium through the BSW Health Plan website the same day. They then said they never got my information or payment. After numerous phone calls with both them and the Marketplace customer service, I finally got a member ID number a week ago. I emailed them my bank statement showing proof of the premium payment on 12/29/22. BSW Health Plan still says they cannot find it as of yesterday. I’m having to delay necessary medical care because my hospital cannot see any insurance information! The call wait times are also terrible and growing. I am on hold now and have been for almost two hours.

Update: After approximately 2 hours on hold on 01/06/23 customer service was finally able to confirm they can see first month’s premium payment and my plan is active. God bless and a huge thank you to Mekeisha and the other ladies in customer service helping me these last few weeks (and the many other people like me based on these wait times).

The absolute worst insurance that I have ever had. I have waited 2 months for basic information like my account group number so I can see doctor. I have payed $2200 in that time. I wonder at this time if they are just fraudulent.

I do not recommend them for reliable health insurance. We’ve been members with Scott & White health plan for 18 years. Without notice, our health insurance was cancelled even though they continued to collect our premiums. We only found out after the pharmacy told us when picking up prescriptions. My family unknowingly went without health insurance for months. Incredibly scary. Please look elsewhere.

This company is has expensive radiology copays. Was on the phone for over one hour today working on clarifying charges which have not been paid for. The company owed is blaming them and BSW is blaming the company. Was disconnected and asked to call back hours later there. I did and now is no record of having the long phone call. Nothing was fixed. Problem has been since June! Lots of phone calls! Never will recommend this company!

If I could leave zero stars I would. This insurance plan is absolute garbage. We were formerly insured through BSW via my husbands company and things got so bad not just with my personal case but multiple people and families were negatively impacted to the point that the company doesn’t want anything to do with them. For my personal case, I began to seek therapy back in June to work through my infertility and recurrent pregnancy loss. Both myself and transitions health were inform by multiple people that my therapist was covered under the plan and that I only had to pay a $30 copay. Tell me how after 9 visits BSW reached out to transitions health (not me, they never informed their own client of anything) and told them I wasn’t actually covered and that I owe $1300. We filed a claim not only through transitions but also through my husbands company and BSW is still refusing to take responsibility for their screw up. Thankfully my therapist office is willing to help navigate payments because there is no way in this economy anyone can cough up $1300. That’s literally the same cost as rent in most places. BSW should be ashamed of themselves and honestly just needs to go out of business. DO NOT USE BAYLOR SCOTT AND WHITE they will rob you blind and tell you it’s your fault for their own screw up and misinformation.

I have the BSW Health plan and I definitely would not recommend it! My daughter was admitted to the hospital for bradyhcardia. We were at a store and she passed out and EMS was called. They ended up taking her to the Hospital ER because her heartbeat was only 40. After waiting in the the ER and passing out twice, the ER desk took her vitals and got her a room. After being given IV's and seeing the doctor she was admitted. She ended up staying 4 days, with a follow up cardiology appointment scheduled prior to discharge. We'll before we even made it to the cardiology appointment, we got a denial letter for her hospital admission because she didn't get a pacemaker or atropine shot. Unbelievable! Then to make matters worse I have debilitating sciatica and was referred to a pain management doctor by my PCP. He prescribed pain medication and ordered an MRI for an injection for the pain. BSW denied the MRI as well. They also denied my X-rays that my PCP ordered of my neck which showed significant issues with some disks. BSW really needs to let the doctors do their jobs and provide the services to the patients. The doctors are the ones that actually see and care for the patients. I do not think BSW Health Plan cares about their clients at all! Also not sure how they can say the are a not for profit organization, when they skimp and deny service to maintain their bottom line for Financials. Don't waste your time or money!

The epitome of corrupt! Worst customer service and claims department! They will lie to you and say they never received your claim and then drag it out so the time limit to appeal your denial will run out.

I had a traumatic accident in November 2021 and mailed in a medical claim form along with receipts of all services needed pertaining to the accident in February 2022. When I called a month later to inquire about the status of my claim, I was told they never received it in the mail. I then fedex'd the same forms in March and gave them a few days to process after being delivered and signed for. When I called I was told that it wasn't received which I disputed because I had tracking information and the person's name who signed for it. Fast forward to April and I call to find out the status of my claim and have been told it can take 45 business days to make a decision and was also told by the customer service rep that they did indeed receive my original claim that I MAILED IN FEBRUARY. It is now July and I still don't have an answer and have paid over $8,000 out of my own pocket to cover what medical insurance is responsible for. I am appalled by the negligence I've experienced. DO NOT SIGN UP with Scott & White Insurance unless you want to spend your own money paying for what they SHOULD be paying for. I would have thought they would have treated a BAYLOR employee better than this. Do yourself a favor and have a litigation attorney lined up for when your claims are denied.

New diagnosis of skin cancer. Possibly found in a later stage and accidentally found. Doctor
(who is in network) ordered a PET exam but EviCore (your 3rd party authorization department) has denied this. Stating that the doctor needs to show in conjunction with a confirmed diagnosis of cancer but also some other form of imaging that shows that from that imaging, it could not be determined how advance the cancer is.or the doctor has to also show that the cancer has spread to other parts of my body. This needs to be met before they can approve a PET scan. In the meantime, doctor has filed appeals and/or reviews which have been denied. This is ridiculous, PET scans may be pricey (but i pay my monthly premium and its not cheap) and i have to go through hoops and waste precious time waiting for some review or appeal or forced to have some lower form of imagine scan (that doesn't give the answers my doctor needs) before i can hopefully get approved to do the initial PET scan that my doctor ordered.

Everyone knows that cancer is best treated early. The doctor ordered this scan because it is what is needed. Can you get this approved or do you really want me to be in limbo waiting. If i could afford to pay out of pocket for a PET scan then i would but i have BSW insurance. So, all this is very scary for me.

Can't imagine anyone associated with this company would want to go through something like this for yourself or for any family member.

I changed to this insurance company thinking it would be easier to navigate between claims being that all my doctors are with Baylor and are also in-network but, honestly, this is more than disappointing.

As a follow up, my Doctor has recently informed me that they will have to change my plan of care and assured me that i would be receiving excellent treatment for my condition. Still, what, if, or what percentage this insurance will pay is going to be up in the air.

(Will have to update at a later date)

Well, a helpful representative did follow up with me about what caused the denial and it seems there are national protocols to have a PET scan that wasn't followed in this situation. This created unnecessary concern and worry for me and a slight delay of treatment. Hopefully they can work harder to ensure all parties and departments are on the same page so that there is not a constant back and forth between orders received and pre-authorizations Because that creates hold-ups in services for their patients.

Signed up for BS&W insurance through marketplace. 20 days and still no card/info/onboarding. Went to website to establish profile. They have no info about me - I have to tell them ID number, etc. They need me to provide a front/back of my insurance card. ARGH Will wait 24 hours to see if they can connect the dots. Hope I don't get in an accident before then. I DID get my next bill in the mail. They seem to have that side of their service fully functional. I've been familiar with their service side for awhile (elderly dad) but this is my first experience with the insurance game. Unimpressed at best.

Terrible insurance plan. They will deny all claims and won’t cover anything. You will be better off and pay less when paying with self pay/out of pocket and not have any medical bills run through insurance. Once a bill is run though their insurance, you will be stuck paying the insurance higher cost. I am stuck with a 900$ bill since it was run through insurance and they denied all the claims. The bill would have been 300$ if I had just paid out of pocket from the start.

Hate that I had to give it even 1 star. I enrolled and purchased a full price plan of $509.93 on 2/22/22 after being diagnosed with Stage 3 cancer. They have no confirmation of my payment (despite emailing my bank statements everyday since) I have called everyday since the 25th, still no coverage as of 3/8/22. I have had to pay $4,300 out of pocket for tests and my very needed surgery has been cancelled now. Where are the supervisors, where's my money? Sad that customer service expectations have become this horrible and disappointing

Worst Insurance I ever had, their website/patient portal says doctor is in network, after visiting doctor they deny claim saying out of network. This is happened with 3 family members in my plan. I was visiting for preventive checkup and received huge $$$ bills, when I call they said file appeal.its a process goes back and forth and then they close without patient knowledge at end patient is responsible as provider take signature. THIS insurance is scaring me and not even thinking of going to PREVENTIVE CARE. Why pay 1000's of dollars and get tortured.so please stay away. I am going to move out next year.

Absolutely the worst. You never know what your are being charged for. Bills that are months old will have charges added but do not state what you are being charged for! When you call, no one can answer your questions. They COLD transfer you around and never give you an answer. They are hoping you will not look at the charges and will simply pay the bill. SCAM/FRAUD!