Health board hears complaints after Blue Shield Medicare PPO transition; insurers and SFHSS say issues are being addressed

San Francisco’s Health Service Board spent a sizeable portion of its January meeting reviewing complaints and implementation metrics after SFHSS moved roughly 19,100 Medicare‑age members into a Blue Shield Medicare Advantage PPO (MAPD PPO) plan.

Members told the board they faced delayed ID cards and welcome kits, provider confusion over prior authorization, and problems getting prescriptions filled. At the hearing, SFHSS operations manager Olga Stavinska Velasquez said the system sent enrollment files early so cards could be mailed starting Dec. 16 and that “a small number, around 7% of the records sent to Blue Shield” required manual processing and additional follow up to complete mailings and correct errors.

The concern from retirees and other callers was immediate and sustained. One in‑person commenter, Sarah Coe, described losing continuity of care at an acupuncture clinic she and her husband had used for 11 years because the clinic does not contract with Blue Shield’s specialty vendor; another caller described missing a spine procedure because the provider office said formal approval would not come for “7 to 14 days.” Several callers said they repeatedly encountered long phone waits when trying to reach HSS or Blue Shield.

Bl…