The 2022 Blue Cross Blue Shield Health Insurance Review
Read our review on Blue Cross Blue Shield Health Insurance and find out how it compares with other U.S. health insurance providers to help you reach a decision on what health plan to buy.
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Why You Need Health Care Insurance
As you grow older, your health starts deteriorating and you are more prone to ailments and illnesses which require more frequent visits to the doctor, dentist, optician, or other medical service provider.
Health care is expensive and for many it is unaffordable if they do not have health care cover.
One of the biggest threats to your finances is a serious health condition or an injury requiring hospitalization and extended care. These can devastate your finances and even lead to financial ruin.
The Need for Private Health Insurance
The health care system in the U.S. is broadly divided into federal health cover provided by the government and private health insurance provided by private companies.
Medicare consists of four parts: Part A (Hospital Insurance), Part B (Medical Insurance), Part C (Medicare Advantage Plans) and Part D (Prescription Drug Insurance).
You get Original Medicare (Part A and Part B) from the government and Part C and Part D plans from a private insurance company.
Original Medicare (Part A and B)
Original Medicare, also known as Obamacare or Bidencare, is a federal government-funded health insurance program aimed at people 65 years or older.
Younger people who are disabled or have diseases such end-stage renal disease or amyotrophic lateral sclerosis (ALS, or “Lou Gehrig’s disease”), can also get Medicare cover.
Remember -
You need to enroll in Medicare Parts A and B during the open enrollment period from January 1st through March 31st each year. Your coverage will start on July 1st.
The focus of Original Medicare is to provide urgent and necessary care, and it is limited in its scope.
For example, Medicare Part A and Part B do not cover routine vision and dental care costs, hearing aids, or extended long-term care.
They do include visits to a doctor or other providers when medically necessary. Parts A and B also give you cover for hospitalization, some skilled nursing care, and some cover for at-home and hospice care.
The need for private health care insurance is that you may require more extensive cover than Original Medicare provides, or you do not qualify for Original Medicare.
To find out more about Medicare and how it works, read more here: https://policyscout.com/medicare/learn
Remember -
To take out a Medicare Advantage Plan, you have to be enrolled in Original Medicare first.
If you have health insurance through your job, it is because your employer has taken out a private health care insurance plan for its employees.
This is called group or employer insurance. The extent of the cover will depend on the particular plan your employer has chosen for its employees.
Private Insurance: Medicare Advantage Plans
Private health insurance is open to people of all age groups regardless of their health condition. The only requirement is that you must be able to pay the monthly cost of the plan, which is referred to as a premium.
There is a difference between Original Medicare cover which is provided by the government and Medicare Advantage Plans, even though both contain the word Medicare.
Firstly, Medicare Advantage Plans are available from private health insurance companies that have an arrangement with the government’s Medicare program to sell these plans.
Secondly, Medicare Advantage Plans differ in the extent of their coverage. These plans bundle the cover that the government’s Original Medicare plan provides, with additional cover. For instance, prescription medication is covered on most Medicare Advantage Plans.
The costs of Medicare Advantage Plans vary widely based on the insurance company’s offering, the extent of the cover, and the state in which you live. A plan with a higher cost, or premium, will generally offer more cover than one with a lower premium.
Apart from Medicare Advantage Plans, there are other types of insurance policies available from private health insurers. These include stand-alone prescription drug plans (also called Medicare Part D plans) and supplemental vision and dental plans.
Provider Networks - What you need to know
Most health plans have a list of doctors, hospitals, and other service providers that members are encouraged to use for their health care.
The idea behind a provider network is that it helps keep the costs of services low for members and for the insurance company.
This is possible because the insurer negotiates prices with the various service providers in return for sending patients to these providers.
The option to use a provider out of the network, and whether pre-approvals are required for services, will depend on the type of provider network associated with your health care plan. Some plans allow you to use a service provider outside of your plan’s network—but if you do, you may have to pay extra.
There are 4 types of provider networks you need to know about: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO) and Point of Service Plan (POS). Read What you should know about provider networks to find out more.
Blue Cross Blue Shield: The Company
Blue Cross started off in 1929 and in 1982, merged its staff and operations with Blue Shield to form Blue Cross Blue Shield.
Today, Blue Cross Blue Shield is one of the largest insurance companies in the U.S. and is an association of 34 independently-run Blue Cross Blue Shield companies that operate in the various states.
It also provides health care cover to around half of all U.S. federal employees through its Federal Employee Program.
Blue Cross Blue Shield offers Medicare Advantage Plans in 47 states as well as Puerto Rico, and Medicare Prescription Drug Plans in 42 states.
Pros and Cons of Blue Cross Blue Shield
Pros and Cons of Blue Cross Blue Shield
Pros
✅ Offers a wide range of insurance plans.
✅ Has a very large nationwide and global network of medical service providers.
✅ Is widely accepted at hospitals, doctors’ offices, and at other service providers.
✅ Some plans have access to health and wellness discounts—for instance, on exercise classes and fitness watches.
✅ Offers several Medicare Advantage Plans including some $0 premium plans.
✅ Has an online Medicare comparison tool to help you choose a plan that suits you.
✅ Provides virtual health consultations by phone, mobile app, or online video call.
Cons
❌ Website information on Blue Cross Blue Shield's general Medicare coverage is limited.
❌ The 34 companies that provide Blue Cross Blue Shield operate independently, so their plans differ in cost and coverage by state. As a result, there is limited generic information on the Blue Cross Blue Shield website.
❌ Some health plans have high deductibles. This means you have to spend a significant amount out of your own pocket before the insurer starts paying.
❌ The availability of special needs plans (SNPs) is limited and only available in around half of the U.S. states.
Health Care Cover from Blue Cross Blue Shield
The insurer offers numerous health insurance plans of different types, but the number and specific plan options may differ depending on where you live.
This is because Blue Cross Blue Shield has 34 independent Blue Cross Blue Shield companies that deliver health insurance in all 50 U.S. states, as well as the District of Columbia and Puerto Rico.
Some of the plans you can buy include:
Medicare Advantage Plans.
To shop for Medicare Advantage Plans, visit the Blue Cross Blue Shield website for the 2022 list of plans.
Prescription Drug Plans (Medicare Part D).
If you need cover for prescription drugs, you can choose a stand-alone Prescription Drug Plan if your health plan does not include cover, or if the drug cover is insufficient for your needs. Most Part D plans have lists of covered prescription drugs and you generally have to use an approved pharmacy in the service provider network.
Medicare Supplement Insurance Plans.
The company offers around 8 different supplement plans that are available for purchase by any Medicare member. These plans are also called Medigap plans.
Employer/Group Insurance Plans.
Blue Cross Blue Shield offers a broad range of plans to suit the budgets of employees. It includes dental and vision plans, as well as a prescription drug program.
High-deductible Health Plans.
These plans have a high deductible, which is the out-of-pocket cost you carry each year before the insurer will pay toward the medical services you use. The benefit of a high deductible is that the monthly premiums of these plans are cheaper than standard plans. High deductible plans are better suited to people who rarely need medical care and want to pay lower premiums.
Other Health Care Plans.
Other plans from Blue Cross Blue Shield include Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRAs), Flexible Spending Accounts (FSAs), and short-term health insurance plans.
Additional Benefits from Blue Cross Blue Shield
Aside from medical and prescription drug cover, many Blue Cross Blue Shield plans give you access to health-related perks which include:
The Blue365 Rewards Program which offers discounts on health and fitness clubs, weight loss programs, and other health-related products and services.
A telehealth line which is available 24/7.
A mobile app to manage your plan and other benefits.
Support for mental health and substance abuse disorders.
Premiums And Other Out-of-pocket Expenses
Health care plan premiums vary widely and what you will pay will depend on the plan you choose.
The type of provider network—for example, Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), or Point of Service Plan (POS), as well as the plan category (bronze, silver, gold, or platinum), play a role in the setting of the premium.
The metal category (bronze, silver, gold, or platinum) refers to the cost-sharing split between you and the insurer. On bronze plans you pay 60% and the insurer pays 40% of the cost. On a platinum plan you pay only 10% of the cost and the insurer pays 90%.
Learn more about plan categories on the government health care website.
But, the premium is only one of the out-of-pocket costs you carry as a member of a health care plan.
These are the other costs you need to take into account:
Deductible is a set amount—either in dollars or a percentage—that you pay before the insurer starts paying toward your medical expenses. It generally resets each year.
Coinsurance refers to your share of the cost of a medical service. If you choose a plan with a 20% coinsurance payment, you will pay 20% and the insurer will pay 80%. Bear in mind that this split will apply only after the deductible has been reached.
Co-payment, or co-pay is specified in your health plan and is the first portion of every medical bill you have to pay. You usually pay this portion at the point of service—for example, at the doctor’s office, and it is generally a set dollar amount.
Out-of-pocket limit is the maximum you can expect to pay out of your pocket toward insured services in a year. Once you reach the specified maximum limit on deductibles, co-pays, and coinsurance, your insurer will pay 100% of the cost of all medical services you use until the end of the year.
Remember -
The deductibles, co-pays, and out-of-pocket limits of health plans reset each year and are applied from scratch. Make sure you set aside some savings every year to pay for these out-of-pocket expenses.
Is Blue Cross Blue Shield A Good Insurer?
Assessments and ratings by organizations or companies can tell you more about whether a company has a good reputation and customer service levels, and also whether the company is financially strong.
ConsumerAffairs.com
ConsumerAffairs is a private company that provides useful information to consumers. It assesses companies based on reviews from real customers.
Only some of the Blue Cross Blue Shield independent companies are rated on the ConsumerAffairs website.
The number of stars awarded varies between the companies.
For instance, Blue Cross of California only has 2.6 out of 5 stars, Empire Blue Cross Blue Shield of New York has 3.8 out of 5 stars, and Blue Cross Blue Shield of Florida has 3.9 stars.
Centers for Medicare & Medicaid Services (CMS)
CMS is a government agency in the Department of Health and Human Services (HHS) that runs the federal Medicare program.
The organization released its 2023 Star Ratings for Medicare Advantage and Medicare Part D Prescription Drug Plans in October 2022. The star ratings take into account various factors, including how members rated the plans, how insurers ensure the health of their members, how members are assisted to manage their chronic illnesses, and customer service levels.
A 1-star rating means the plan performed poorly and 5 stars reflect an excellent performance.
Blue Cross Blue Shield has various plans with 4.5- and 5-star ratings.
The following is a list of Medicare Advantage Plans that achieved the top rating of 5 stars.
National Committee for Quality Assurance (NCQA)
The National Committee for Quality Assurance, or NCQA, each year assesses health insurance plans based on their quality of care, client satisfaction, and the health plans' efforts to improve. Plans are given between 1 and 5 stars. The lowest rating is 1 star and the highest is 5 stars.
The various Blue Cross Blue Shield Medicare plans achieved between 2.5 and 4 stars. The majority of Medicare plans from Blue Cross Blue Shield received from 3 to 3.5 stars.
Visit the NCQA’s website to see its report cards on the various Blue Cross Blue Shield plans and how they are rated.
Financial Rating from AM Best
Credit rating agency AM Best gave some of the Blue Cross Blue Shield companies an “A” or “Excellent” rating for their financial strength. Blue Cross Blue Shield companies have their own ratings.
According to a news release from AM Best in June 2022, Blue Cross Blue Shield of Mississippi improved its rating from “A” to “A+”.
J.D. Power
The J.D. Power 2022 U.S. Commercial Member Health Plan Study measures satisfaction among members of 147 health plans across 22 regions throughout the U.S.
It assesses health plans on the following six factors: billing and payment; cost; coverage and benefits; customer service; information and communication, and provider choice.
The study also measures several other key aspects of the experience and engagement of a plan’s members. Blue Cross Blue Shield health plans featured strongly in the top ranked plans.
J.D. Power awards points to each plan out of 1,000. The higher the number of points, the better the plan performed on the metrics measured.
source: jdpower
How Blue Cross Blue Shield Compares With Other Health Insurers
| Blue Cross Blue Shield (BCBS) | UnitedHealthcare | Cigna | Aetna | Humana | |
|---|---|---|---|---|---|
| Availability / service area | There are 34 independent Blue Cross Blue Shield companies that provide health insurance coverage in all 50 states, the District of Columbia, and Puerto Rico. It also offers plans to individuals and employers who live, work, and travel internationally through its Blue Cross Blue Shield Global. Services are provided in Canada, Ecuador, Panama, the U.S. Virgin Islands, and Uruguay. BCBS does not offer Affordable Health Care Act Plans in Mississippi, Nebraska, and South Dakota. | UnitedHealthcare is available in 18 U.S. states, including: Alabama. Arizona. Colorado. Florida. Georgia. Illinois. Los Angeles. Maryland. Massachusetts. Michigan. Nevada. New York. North Carolina. Oklahoma. Tennessee. Texas. Virginia. Washington. | Cigna has medical plans available in 12 states in the U.S., including: Arizona. California. Colorado. Connecticut. Florida. Georgia. Maryland. Missouri. North Carolina. South Carolina. Tennessee. Texas. In addition, it offers dental insurance in 49 states, as well as the District of Columbia. Cigna health insurance plans are available outside the U.S. | Aetna is available across all 50 U.S. states including Washington D.C. Aetna is also available to U.S. citizens who live outside the country. The full range of health plans is available from Aetna, including employer health insurance, individual plans, Medicare plans, as well as dental and vision insurance policies. | Humana offers health insurance plans in 13 states, including: Alabama. Arizona. Florida. Georgia. Kentucky. Louisiana Michigan. Mississippi. North Carolina. Tennessee. Texas. Utah. Virginia. Humana offers Medicare and Medicaid, as well as dental and vision insurance in all 50 states, including Washington D.C. and Puerto Rico. It does not offer individual health insurance policies. |
| Provider network | Blue Cross Blue shield gives its members access to more than 1.7 million providers in the U.S. and around the world. | The UnitedHealthcare network includes 1.3 million physicians and 6,500 hospitals. You can use their website to search for a health care provider near you. | Cigna has a large network of health care providers in the U.S. and globally. This includes 1.5M+ health care providers, clinics, and facilities, and 67K+ contracted pharmacies. You can use the search function on the Cigna website to find a health care provider near you. | Aetna insurance plans cover out-of-network service providers and have a large provider network. Aetna offers a search function on its website where you can find doctors and pharmacies near you. | Humana has a network of more than 22,000 physicians and clinicians. |
| Customer Service Options | Telephone Call 888-630-2583 to get connected with your local Blue Cross Blue Shield company. The names of the independent Blue Cross Blue Shield companies differ from state to state. For a full list of affiliated companies go to: https://www.bcbs.com/bcbs-companies-and-licensees The contact details of your local Blue Cross Blue Shield companies can usually be found under the About Us section of the websites. | Telephone UnitedHealthcare provides an extensive list of contact numbers on the Contact Us page of their website. Social Media You can also reach them 24/7 via their Facebook and Twitter accounts. For customer care on Twitter, you can Tweet @AskUHC along with your query. | Telephone Contact the Cigna Customer care line on 1-800-997-1654. This line is available 24 hours a day, 365 days a year. Online chat Cigna has an online live chat facility that is available from Monday to Friday: 9am-8pm, ET. You will need to create an online profile on Cigna.com to be able to chat to Cigna online. Social Media You can reach out to Cigna using its customer service Twitter channel with the handle @Cignaquestions. | Telephone For any queries, you can contact the Aetna Corporate Contact Center at 1-800-US-AETNA (1-800-872-3862) between the hours of 8am and 6pm ET. An agent will direct you to the correct department. Social Media Aetna also supports customer service over its Twitter channel. You can use the handles @Aetna and @AetnaHelp This channel has specialized customer service representatives standing by to assist you 24/7. | Telephone Contact Humana on Call 1-800-457-4708 (TTY: 711), Monday to Friday, 8am-6pm. Social Media Customer service is available 7 days a week from 6am to 8pm on Twitter. |
| NAIC complaint index (2021) The “median complaint ratio” from the NAIC is 1.00. A ratio above 1.00 means fewer complaints than the median. Higher ratios mean more complaints than the median. | 0.58 | 0.32 | 0.98 | 0.26 | 2.98 |
Summary: Why Choose Blue Cross Blue Shield
As one of the largest health care insurers in the U.S., Blue Cross Blue Shield serves the health care insurance needs of one in three Americans.
Due to its vast network of doctors, hospitals, urgent care centers, dentists, and other service providers, you are likely to find the service provider of your choice to visit.
The insurer’s health plans are many and varied, and its rates are similar to, but in some cases, more expensive than plans from other companies.
Their health plans on offer include:
Health maintenance organizations (HMOs).
Exclusive provider organizations (EPOs)
Preferred provider organizations (PPOs).
These types of plans refer to the kind of provider network that is available on a policy. Knowledge of these plans can help you identify the best level of coverage for your premium on a health insurance marketplace, such as the federal government’s healthcare.gov website.
The Blue Cross Blue Shield association of companies generally have a good reputation. It’s very stable financially and due to the company’s size, it has an extensive choice of plans from which to choose.
Customer reviews on BestCompany indicate that many customers are happy with claims, coverage, and customer service from the insurer, and its overall rating on the BestCompany website is 3.7 out of 5 stars.
The National Association of Insurance Commissioners (NAIC) Complaint Index for Blue Cross Blue Shield is 0.58, which is better than average and indicates fewer complaints relative to other insurers. Visit for a list of Blue Cross Blue Shield plans and their ratings.
Blue Cross Blue Shield scored an A+ rating from AM Best, indicating its financial strength. It also shows that the insurer is in a good position to pay claims from your Blue Cross Blue Shield service provider, as well as the expenses related to running its business.
Overall, it is recommended that you consider a Blue Cross Blue Shield health plan when shopping around for health cover. Because it is a large established insurance company, it has a very wide provider network and many of its plans are well rated.
Frequently Asked Questions about Blue Cross Blue Shield
Is Medicare Advantage the same as Blue Advantage?
Blue Advantage (PPO) is a Medicare Advantage (Medicare Part C) plan.
This plan may be suitable for you if you want a package plan that includes medical coverage, as well as prescription drug coverage with extra benefits for dental, vision and hearing, and preventative care services.
With this plan you need to make use of the network of doctors, hospitals, pharmacies, and other service providers in its network.
What is the minimum health insurance cover one should have?
At the minimum, make sure you have cover for large unexpected events such as hospitalization in case of an accident.
The amount of day-to-day cover for visits to the doctor, dentist, and other service providers will depend on your health, how often you need medical care, and your budget.
Is Blue Cross Blue Shield a good insurance company?
Blue Cross Blue Shield is a highly rated, quality health insurance provider that offers a large network of health care providers and a huge range of health care plans with different levels of cover.
Which Blue Cross Blue Shield plan is the best?
The top-rated plan may have an excellent reputation in the marketplace, but it may not be the best plan for you.
Factors you need to consider when choosing a health plan include: your state of health; how often you need medical care; whether you want to use medical service providers within a small network or prefer to choose your own doctors and specialists; and finally, your budget.
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