This article examines Blue Cross Blue Shield from a quality standpoint based on objective measures. First, we evaluated Blue Cross Blue Shield's overall value as a company. Next, we examined the pros and cons of Blue Cross Blue Shield, its operating areas, plans offered, policy costs, critical reception, what to consider when enrolling in a health insurance plan, and enrollment periods.
Overview of Blue Cross Blue Shield (BCBS)
Blue Cross Blue Shield has been in operation since 1929. Since its inception, it has been one of the industry's most popular health insurance carriers. Blue Cross Blue Shield offers plans for individuals, families, employers and employees, and Medicare-eligible individuals. Coverage ranges from inpatient and outpatient settings to prescription medications, depending on the plan.
Plans vary by location, but that holds for every health insurance company. Although various plan types are offered from state to state (as well as zip code to zip code), the reviews and ratings suggest a consistent quality regarding overall customer satisfaction.
| Founded | 1929 |
| Provides coverage for | Individuals, families, and businesses |
| Accreditation | NCQA, BBB |
| Types of health coverage offered | HMOs, PPOs, EPOs, HSAs, Medicare, Medicare Supplements (Medigap) |
| Number of states where coverage is provided | 50 (including the Washington, D.C. area) |
| Additional benefits | Global coverage, health and wellness discounts, dental care, telehealth visits, pet health insurance discounts, and more |
| Provider network | Over 1.7 million doctors and hospitals |
Is Blue Cross Blue Shield good? The main perks
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Available in all 50 states and Washington, D.C, with variations based on plan types
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Offers dental, vision, hearing, and transportation coverage
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Rated 4.17 out of 5 by CMS
Blue Cross Blue Shield has a reputation for being one of the most widely available insurance companies in the industry. No matter what U.S. state you live in, you can get health insurance coverage from Blue Cross Blue Shield. This company's longevity and popularity can be explained by its extensive coverage options.
Coverage options will vary by zip code, but as you search for policies, you can find such policy types as:
- Health Maintenance Organization (HMO)
- Preferred Provider Organization (PPO)
- Health Savings Accounts (HSA)
- Exclusive Provider Organization (EPO)
You can get coverage for services such as:
- Diagnostic screenings
- Prescription medications
- Primary care
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Specialist care
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Hospital stays
- Outpatient surgeries
In J.D. Power's 2023 study of overall customer satisfaction with commercial health insurance companies, Blue Cross Blue Shield appeared among the top companies in all 22 regions surveyed, taking the top spot in five regions. The same year, J.D. Power's study of the top Medicare Advantage plans showed Blue Cross Blue Shield ranking as the leading Medicare Advantage carrier in Texas and New York.
Pros and cons of Blue Cross Blue Shield health insurance
Blue Cross Blue Shield is one of the most widely available health insurance carriers, offering coverage available in every U.S. state. Policyholders can enjoy international coverage, too. However, like other companies, policies can vary depending on what's available in your zip code and county.
Where does Blue Cross Blue Shield operate?
Blue Cross Blue Shield is considered one of the best health insurance companies when it comes to availability, as it provides health insurance policies in all 50 states in the U.S. and Washington, D.C. Here is the list of the states where Blue Cross Blue Shield provides its services:
Blue Cross Blue Shield offers individual and group health insurance, Medicare Advantage, and Medicare Supplement plans. Individual plans cover policyholders purchasing policies for themselves, and group health coverage comes from employers buying plans for their employees. Medicare Advantage and Medicare Supplement plans are for Medicare-eligible individuals. The plans you can get and the types of benefits you can obtain vary by location.
Individual plans
Blue Cross Blue Shield offers individual plans with benefits such as free preventive care visits (e.g., vaccinations and checkups), prescription drug coverage, chiropractic care, and mental health services. Plans may also include free dental and vision benefits for children under 19. Plans may come as HMOs, PPOs, EPOs, and HSAs.
Plans come in bronze, silver, gold, and platinum tiers. Bronze plans typically feature the lowest premiums but have the highest deductibles and higher coinsurance costs than the others. Silver plans have slightly higher premiums than bronze plans but have lower deductibles and coinsurance. Gold plans have high premiums but also have low deductibles and coinsurance costs. Platinum plans are the most expensive but have the lowest deductibles and coinsurance costs.
Group health insurance
Blue Cross Blue Shield offers group health insurance plans that offer different forms of coverage. Employers can offer policies that provide coverage for medical services. Additionally, employers can obtain coverage for prescription medications. These plans have an extensive list of drugs they cover, and with Blue Cross Blue Shield, some programs help policyholders save on specialty drugs.
Other group health insurance coverage types include group Medicare, dental and vision, and disability benefits. Lastly, group health insurance can consist of health savings accounts (HSA), flexible spending accounts (FSA), and health reimbursement arrangements (HRA), which enable employees to use pre-tax income for covered health services. The funds accrued in these accounts roll over into the following year.
Medicare Advantage and Medicare Supplement
Blue Cross Blue Shield offers Medicare Advantage and Medicare Supplement plans. What's available to you will depend on your county and zip code, which will also affect the benefits and the costs you can expect to cover.
Medicare Supplement plans address out-of-pocket costs after Original Medicare pays its share. Your Medicare Supplement plan can reduce or eliminate the resulting out-of-pocket costs. You cannot add a Medicare Supplement plan if you have Medicare Advantage.
Here are examples of Medicare Advantage plans available through Blue Cross Blue Shield of Tennessee in Knox County (37918 zip code) for Medicare-eligible individuals who don't receive additional help through other government programs:
| Medicare Advantage Plan | State | County | Zip code | Premiums | Deductibles | Copay (primary care) | Copay (specialist) | Out-of-pocket maximum |
| BlueAdvantage Freedom (PPO) | Tennessee | Knox | 37918 | $0 | $0 | $0 | $25 each visit | $3,200 (in-network), $5,750 (in and out-of-network) |
| BlueAdvantage Sapphire (PPO) | Tennessee | Knox | 37918 | $0 | $0 | $0 | $35 each visit | $3,900 (in-network), $6,900 (in and out-of-network) |
| BlueAdvantage Extra (PPO) | Tennessee | Knox | 37918 | $23 | $0 (health), $545 (drug) | $0 | $25 each visit | $3,900 (in-network), $9,550 (in and out-of-network) |
| BlueAdvantage Ruby (PPO) | Tennessee | Knox | 37918 | $92 | $0 | $0 | $25 each visit | $3,800 (in-network), $5,750 (in and out-of-network) |
Here are sample costs for Blue Cross Blue Shield's Medicare Supplement plans in the same state, county, and zip code as the above. Of course, rates and policy selection will vary by geographic region. These are sample costs based on a male non-smoker who has turned 65 on January 1, 2024 who desires a Medicare Supplement plan that will become effective on February 1, 2024.
| Medicare Supplement Plan | State | County | Zip code | Monthly premium | Estimated annual costs for medical services |
| BlueElite Plan A | Tennessee | Knox | 37918 | $83.32 | $1,872 |
| BlueElite Plan D | Tennessee | Knox | 37918 | $140.67 | $240 |
| BlueElite Plan G | Tennessee | Knox | 37918 | $134.40 | $240 |
| BlueElite Plan N | Tennessee | Knox | 37918 | $126.60 | $240 |
How much does Blue Cross Blue Shield cost?
Blue Cross Blue Shield's policy costs depend on location and the level of coverage. Monthly premiums, deductibles, coinsurance costs, and out-of-pocket maximums vary widely between policies. The following are costs based on an individual plan for a 35-year-old single male without dependents who earns $40,000 per year, with coverage starting in 2024.
| Plan | Sponsor | State | County (zip code) | Zip code | Monthly premium | Deductible | Coinsurance (primary care) | Coinsurance (specialist) | Coinsurance (emergency room) | Out-of-pocket maximum |
| BlueCross B10L $0 Virtual Care for Medical & Mental Health (Bronze EPO) | Blue Cross Blue Shield of Tennessee | Tennessee | Knox | 37918 | $96.12 | $7,100 | 50% (after deductible) | 50% (after deductible) | 50% (after deductible) | $8,600 |
| BlueCross B16S $50 PCP Copay + $0 Virtual Care for Medical & Mental Health (Bronze EPO) | Blue Cross Blue Shield of Tennessee | Tennessee | Knox | 37918 | $152.98 | $7,500 | $50 per visit | $100 per visit | 50% (after deductible) | $9,400 |
| Anthem Silver Pathway X Guided Access HMO 5500 ($0 Virtual PCP + $0 Select Drugs) (Silver HMO) | Anthem Blue Cross Blue Shield | Georgia | Fulton | 30301 | $274.88 | $5,500 | $20 per visit | $80 per visit | 25% (after deductible) | $9,450 |
| Anthem Silver Pathway X Guided Access HMO 3000 ($0 Virtual PCP + $0 Select Drugs) (Silver HMO) | Anthem Blue Cross Blue Shield | Georgia | Fulton | 30301 | $304.20 | $3,000 | $20 per visit | 25% (after deductible) | 25% (after deductible) | $9,450 |
| Blue Advantage Gold PPO 803 (Gold PPO) | Blue Cross and Blue Shield of Oklahoma | Oklahoma | Cleveland | 73160 | $331.65 | $1,500 | $30 per visit | $60 per visit | 25% (after deductible) | $8,700 |
| Blue Preferred Gold PPO 705 (Gold PPO) | Blue Cross and Blue Shield of Oklahoma | Oklahoma | Cleveland | 73160 | $459.34 | $1,500 | $30 per visit | $60 per visit | 25% (after deductible) | $8,700 |
As for employer plans, you can find your costs by consulting with Blue Cross Blue Shield directly. Blue Cross Blue Shield will work with you to find the most suitable plan at an affordable cost.
Blue Cross Blue Shield health insurance reviews and ratings
Blue Cross Blue Shield has had favorable reviews. In a review from Consumers Advocate, Blue Cross Blue Shield was noted as having strong financial ratings. Its status as a well-established company in the health insurance industry, comprehensive coverage, wide acceptance, and discounts that make health treatments affordable all played a role in Consumers Advocate, citing Blue Cross Blue Shield as an excellent choice. However, those in the comments section aired their misgivings about Blue Cross Blue Shield's shortcomings, particularly about having medical treatments covered.
J.D. Power's 2023 study of the health insurance companies with the highest overall customer satisfaction painted Blue Cross Blue Shield positively with a score of 700 for its MA plans in New York and 676 in Texas. It ranked among the top insurers in all 22 geographic areas surveyed in the study, taking the top spot in five geographic regions.
Its Medicare coverage is also well-regarded. Many of its Medicare Advantage plans have attained Medicare Star ratings of 4 and 4.5 stars out of 5 stars, indicating high quality.
How to choose the right BCBS health insurance plan
Choosing the right plan is easy when you account for certain factors. Prior to joining a plan, take the following into consideration.
- Find out whether your provider is in the plan's network. If your medical provider isn't in the plan's network, you may want a plan that allows out-of-network coverage.
- See what medications the plan covers. Plans that cover prescriptions vary regarding the exact medications they cover. It's good to check what medications the plan covers before enrollment.
- Look into costs. A low-premium, high-deductible plan may be better if you rarely use medical services. If you get medical treatments often, a policy offering more coverage for a higher premium may be ideal for you.
When to get a Blue Cross Blue Shield health insurance plan
You can only get a Blue Cross Blue Shield plan during the enrollment period.
Enrollment dates vary by the type of plan you're interested in. For instance, a Medicare Advantage plan may have a different enrollment period than an employer plan, and the enrollment period to join an individual plan may differ from an employer plan.
Consult Blue Cross Blue Shield to review enrollment periods depending on the specific type of plans you are interested in.
Blue Cross Blue Shield offers a wide variety of plans all throughout the U.S., and for someone seeking a health insurance policy that has garnered a positive reception from online reviewers, this company is a good starting point for getting health insurance.
FAQ
Is Blue Cross Blue Shield PPO good insurance?
Blue Cross Blue Shield's PPO is good insurance for those wanting more freedom for out-of-network services. However, not all PPO plans are the same, as costs and benefits vary by the plan that the policyholder enrolls in.
What is the best Blue Cross Blue Shield plan?
The best Blue Cross Blue Shield plan will depend on the person enrolling. Different individuals have different preferences for how they'd like costs to be structured and what they'd like to have covered. This is why looking into what the plan offers before enrolling is important.
What are the reviews of Blue Cross Blue Shield health insurance?
Blue Cross Blue Shield has positive reviews for its traditional health insurance policies and Medicare Advantage plans. Reviewers have cited its widespread acceptance as one of its major strengths. In a 2023 J.D. Power study, it ranked highly among health insurers in all 22 geographic regions.
10 resources
- J.D. Power. Commercial Health Plan Member Satisfaction Declines in Key Areas, J.D. Power Finds.
- J.D. Power. For Medicare Advantage Plans, Trust and Problem Resolution Closely Associated with Likelihood to Renew, J.D. Power Finds.
- Consumers Advocate. Blue Cross Blue Shield Health Insurance Review.
- Healthcare.gov. View health & dental plans.
- Blue Cross Blue Shield. Special Enrollment Period.
- Blue Cross Blue Shield. Open Enrollment for 2024 Has Begun!
- Blue Cross Blue Shield. Employer Plans.
- Medicare. BlueAdvantage Sapphire (PPO).
- Medicare. BlueAdvantage Extra (PPO).
- Medicare. BlueAdvantage Ruby (PPO).
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