baycareplus.org Reviews 10

My experience with this insurance company was devastating and, ultimately, life-altering.

In 2025 alone, my mother was hospitalized 11 times, including 8 inpatient stays. Due to these hospitalizations she became extremely weak she had health issues but was NOT critically ill, with multiple medical conditions, including a Stage 5 leg ulcer that required intensive, wound care.

Despite this, the insurance company repeatedly denied her admission to two acute rehabilitation facilities. These weren’t optional requests—they were medically recommended by numerous doctors on her care team. Each denial cited that this level of care was “not medically necessary” and claimed she did not require physician monitoring.

That decision was not just questionable—it was dangerous.

By denying access to appropriate rehabilitation and medical oversight, they stripped her of the chance to stabilize, recover, and receive the level of care her condition demanded. Those denials directly impacted her health trajectory.

Ultimately, my mother passed away.

No family should have to fight this hard for medically necessary care, and no one should lose a loved one while battling an insurance company more focused on cost than care. Stay far away from this plan they cost my family & I everything.

I have been with Baycare advantage plan for just over a year. They are all up in your business. Actually gave my information out to other doctors so they could get some referral kick back. The prescribe expensive unnecessary meds that cause serious side effects so they can increase their income. The healthy Benefits program is a scam. They lie constantly and could care less about what you actually need or want.

I had high hopes for this. They never sent the Plan book out to me which was PROMISED within 7 days. I wanted the book to review before going to their infomational mtg. So, I didn't go to mtg either. If they can't handle getting new clients, I doubt they treat their current ones with much respect.

BayCare Plus has reasonable Medicare Advantage coverage, but customer services is limited to office hours. And on their website there is absolutely no email contact to leave a message outside of regular hours. Obviously, they don't want to hear from their members unless it's convenient for them. Don't worry, after this coverage year is over, they won't hear from me anymore.

I filed a claim in January 2025 to be reimbursed for two visits to the Celebrity Cruise doctor for a knee injury then a stomach virus. Without going into all the details, after submitting my claim along with supporting documentsand numerous phone calls, a refund of $234.08 (partial reimbursement) was supposed to have been mailed March 7. Never received check, put a tracer on it, filed a grievance only to get a letter denying my claim. More phone calls, more paperwork submitted and faxes, last,week was told check to be sent out.,Today got a call from Baycare to say claim again denied. Have to laugh every time they thank me for being a loyal customer,and they appreciate my business. What a crock! I'm posting bad reviews on every social media I,can find. Buyer beware. BTW I bought Celebrity Cruise line insurance but they insist that I file a claim first to medicare and then they will process a claim for remainder. I,told Baycare today, just send me the rejection letter so I can submit my claim to Celebrity. Still waiting since January,2025 😒

A year ago I submitted a three-star review, mostly because of mediocre customer service. Now it's slipped to two stars.
Six weeks ago I ordered a hard copy of the provider directory and the evidence of coverage. Both came today. (Good thing I was in no rush.) But instead of a bound book, as in past years, all I received was hundreds of sheets of loose paper, dated 8 weeks ago. I suspect paper copies will be eliminated by next year, leaving required info only available---"for your convenience"--on-line. I'm tech savvy, but this will be a blow to lots of seniors.
I've seen the pattern gefore. Bay Care Plus must be in serious financial trouble, and grasping at any way to cut expenses, especially at members' expense.
With the government soon to crack down on waste, the Medicare program will be a target. Look for companies that have strong customer service to survive. At this rate, Bay Care Plus might not.

My review doesn't reflect the doctors as they have been fantastic but these corporate delays should be illegal. Remember they get paid even if we don't get care.
My husband and I are both over 65. We were informed we could only get a periodontal cleaning (deep clean). I got mine no problem. My husbands included filling 2 cavities requiring his bridge removed and replaced. We wer quoted after insurance $545. Not bad... so we scheduled his appointment. July 22nd while sitting in the dental chair he was informed that the price of cleaning 1/2 of his mouth would be $1600 and we needed to pay up front. Delta Dental insisted that they didn't receive the xrays or dr. notes required. The Dentist showed proof that they were sent on July 23rd. Speaking with BCPlus I was told that this was a misunderstanding and it would be straightened out in 24 hrs. Well it is now Sept 17th and they have had the exrays the whole time but we are still waiting on the cleaning.
July 29th I was told that they could no longer talk to me regarding this without a form that authorizes me to represent my husband. He is in the room with me!!!
I printed the form and faxed it the same day. This went on for 6 weeks. Aug 12th I received 4 copies of the same letter with the form. It is finally in the file with BCPlus and now Delta Dental tells me that I need a separate form for them.

I was once told that they have up to 2 weeks to address a fax once it is received.

In Sept I was told that my appeal has been in front of the pros and would be completed in 2 days but when I called on the morning of the 3rd day the only notes were it would take more time. And the customer service manager that was to call before the end of day didn't call. Monday I was told that it will take 3 weeks more.
So the 2 STARS represents the inability to get things done.
8 weeks later, I am waiting on a call from the manager again.

Remember they get paid even if we don't get care.

They are horrible.

We signed up for the BayCare Plus Medicare Advantage plan because all of our doctors are included. The most we've paid for a prescription is about $1.75. I take pantoprazole and they cover it even though none of the other plans do. I have had no trouble with approvals. The only downside is the minimal coverage when an emergency occurs and you are not in their small coverage area (essentially 4 counties). When I travel, I have to get travel insurance but, these days, I don't travel all that often. I do not pay for the dental or vision plans so I cannot report on those. We signed up for BayCarePlus in 2022 and 2023 and will most likely do so in 2024.

In fairness, my first experience with this company was excellent, and this experience does not change that. Basically I feel that the way my last call was handled could have been handled a lot better if I had not been mislead by the Agent. I just signed up, so I did not have a primary physician. I wanted to wait, so I got the list of providers to find one convenient. I went to their office and got additional information, and made an appointment. I had that appt., for about 3 weeks, but they waited until 2 days prior to tell me they could not receive pymt for my visit with the wrong Prim Phys listed and I needed to call, change it, and get the reference number before I came in. So I called. When I got through to the Agent, (who adamantly advsd me that I can/should call him) I explnd the chg needed, but I expressed that I should not have to place the Prim Phys until after I saw the Doctor, to be sure I wanted this Dr. as the Prim, so I confessed that I thought it was weird to have to do this before the initial visit. He said that it was not necessary and laughed (as did I) at this request from the Doctor. I said "I am not going to have trouble" He swore that He was forwarding the message and that I would have No Trouble being seen. When I got to the Dr. 2 days later, I explnd to the Receptionist that I did not get a Ref# because I was told that none was needed. I also told her that the agent assured me. She advsd that I shld have talked to Customer Service and got the chg ref #. They refused to honor my appointment, but I still had 15 minutes b4 the appt, so I called, and CS said that I was suppose to do something else, (I didn't catch it), but since I was there in the office, she'd go ahead and do it and gave me a ref number and I was seen by the Doctor. MY POINT IS, THE AGENT SHOULD NEVER ASSUME TO KNOW HOW OTHER DEPARTMENTS HANDLE CHANGES, AND CHANCE GIVING POOR INFORMATION, THEN DECLARING THEM AS FACT IF HE DOESN'T KNOW WHAT THE HECK HE IS TALKING ABOUT. I was an insurance agent for 33 years and always handled my clients changes from start to finish and knew the steps to process, so How did I know he was full of it. He should have said call CS, and/or transferred me instead of misleading me. Thank you, Bonita Osbon