Blue Cross Blue Shield Health Insurance Review
Editor's Rating
Blue Cross Blue Shield (BCBS) is one of the biggest health insurance companies in the country. Its large provider network and unique member perks make it easy and convenient to find covered medical care. Customer service ratings can vary by region, though, because BCBS is a group of independently operated regional companies. And it has higher average rates than many other health insurance companies.
Blue Cross Blue Shield may not be the best choice if budget is your primary concern, but it could be a great option for those who value a flexible provider network.
Pros
Cons
Is Blue Cross Blue Shield good?
Yes, overall Blue Cross Blue Shield is a good insurance company. Over 90% of doctors and hospitals in the nation accept BCBS insurance, which can make it simple to get care, although the specific provider network varies based on your plan. BCBS also offers some helpful member perks, like a mobile app and a 24/7 nurse line, that can make navigating your health care benefits easier.
BCBS is one of the largest health insurance companies in the nation and offers individual and family policies, group health insurance, Medicare coverage, dental insurance and vision insurance.
Plan options
Generally, Blue Cross Blue Shield offers private health insurance, group health insurance, vision and dental coverage, and Medicare options.
Each BCBS company controls its plan offerings, which means that options will vary by state and region. For example, Credence Blue Cross and Blue Shield, which is part of Blue Cross Blue Shield of Alabama, may offer different plans than Blue Cross Blue Shield's Anthem subsidiary.
Blue Cross Blue Shield of Michigan Silver HMO vs. competitor Silver HMOs
To get a sense of how BCBS plans compare to competitor plans, we analyzed a Blue Cross Blue Shield of Michigan Silver health insurance plan and compared it to similar Silver plans offered by Priority Health and McLaren Health Plan Community.
Plan name | Cost | Individual deductible | Coinsurance | Primary care copay | Out-of-pocket maximum |
|---|---|---|---|---|---|
| Blue Cross Preferred HMO Silver Saver | $423 | $5,500 | 20% | $45 | $8,000 |
| McLaren Silver Exchange HMO | $625 | $4,300 | 20% | $30 | $8,550 |
| MyPriority Silver 3600 HMO | $407 | $3,600 | 30% | $30 | $9,100 |
The deductibles of the sample plans range from a low of $3,600 for Priority Health to a high of $5,500 for Blue Cross Blue Shield. McLaren's $4,300 deductible is structured as $3,800 for health expenses and $500 for prescription drugs, but BCBS and Priority Health have deductibles that combine health and drug expenses. Out-of-pocket maximums are similar between the three options, ranging from $8,000 for BCBS to $9,100 for Priority Health.
Deductibles, coinsurance and copays are assessed differently among the plans. For example, only BCBS of Michigan does not cover generic prescriptions until the combined deductible is met.
The plans also vary in how they handle emergency room (ER) services. BCBS of Michigan and Priority Health both charge a $250 copay per ER visit after the annual deductible is met, as well as 20% and 30% coinsurance, respectively. McLaren charges 20% coinsurance after the deductible is met but no ER copay.
If you received ER services totaling $8,000 before meeting any portion of your deductible, your total out-of-pocket cost would be your full deductible, a copay if one is charged and coinsurance for the remaining amount. The cost calculation for each plan is shown below.
- BCBS: $5,500 deductible + $250 copay + 20% of the remaining amount, or $450 = $6,200
- McLaren: $4,300 + 20% of the remaining amount, or $740 = $5,040
- Priority Health: $3,600 + $250 + 30% of the remaining amount, or $1,245 = $5,095
In this situation, BCBS has the highest out-of-pocket expense. Nationally, BCBS rates are higher than those of its main competitors, but our BCBS sample plan's average rate was quite a bit lower than McLaren's. If price is your main concern, you may want to get a quote for a BCBS plan in your area to see if the rate is within your budget. The large BCBS provider network and unique member perks might be features to consider but could come at a slightly higher cost.
Medicare
BCBS offers Medicare Advantage plans, which cost an average of $35 per month when drug coverage is included. Blue Cross Blue Shield also sells Medicare Supplement plans and separate Part D (drug coverage) plans. If you have dual eligibility for Medicare and Medicaid, BCBS has a plan to help coordinate benefits.
Highlights include large provider networks, gym and wellness benefits, coverage for hearing aids, and dental and vision benefits, depending on the plan you choose.
How much does a Blue Cross Blue Shield Silver plan cost per month?
Overall, Blue Cross Blue Shield has a higher average cost for individual health insurance than its competitors. BCBS has an average monthly rate of $607, based on a 40-year-old with a Silver plan. Compared to the other four largest health insurance providers that offer individual policies, BCBS is the most expensive.
Find Cheap Health Insurance in Your Area
Although BCBS costs more on average than many other health insurance companies, rates vary by plan type. Plans with less coverage cost less but generally have higher out-of-pocket costs.
Plan tier | Average monthly cost |
|---|---|
| Catastrophic | $332 |
| Bronze | $445 |
| Silver | $607 |
| Gold | $649 |
| Platinum | $769 |
BCBS's private health insurance plans can be purchased on the federal marketplace or a state marketplace as well as directly from the company. You can choose between Catastrophic, Bronze, Silver, Gold and Platinum plans, although availability varies based on the BCBS affiliate in your area. If you buy coverage on a marketplace, you may be able to lower your rate with income-based premium tax credits.
Availability of BCBS policies
Rather than being a single entity, the Blue Cross Blue Shield Association (BCBSA) is a collection of 34 independent regional companies. The community-based model might mean each company is more in tune with the health care needs of a given area, but it also means that available plans, coverage offerings and customer service ratings vary by region. The plans themselves vary too, with deductibles, coinsurance and copays assessed differently depending on your regional provider.
Listed below are the BCBS entities in each state. In some cases, multiple BCBS companies operate in a single state, and sometimes a single BCBS company offers coverage in several states. Coverage isn't always available statewide. Some BCBS entities may only offer policies in a few counties. BCBS provides Affordable Care Act (ACA) major medical plans for new enrollees in all states except Mississippi, Nebraska and South Dakota. Existing members may be able to continue their current coverage in these three states.
State | BCBS Company |
|---|---|
| Alabama | Blue Cross and Blue Shield of Alabama |
| Alaska | Premera Blue Cross and Blue Shield of Alaska |
| Arizona | Blue Cross Blue Shield of Arizona |
| Arkansas | Arkansas Blue Cross and Blue Shield |
| California | Blue Shield of California, Anthem Blue Cross |
| Colorado | Anthem Blue Cross and Blue Shield Colorado |
| Connecticut | Anthem Blue Cross and Blue Shield Connecticut |
| Delaware | Highmark Blue Cross Blue Shield Delaware |
| District of Columbia | CareFirst BlueCross BlueShield |
| Florida | Florida Blue, BlueCross BlueShield of Puerto Rico |
| Georgia | Blue Cross Blue Shield of Georgia |
| Hawaii | Blue Cross and Blue Shield of Hawaii |
Member resources and unique benefits
Most Blue Cross Blue Shield companies offer a variety of member perks, but those offered could vary based on the BCBS affiliate in your area. Some of the more common member benefits are:
- A 24/7 nurse line
- Blue365 for discounts on health and fitness clubs, weight loss programs and other health-related products
- Telemedicine
- A mobile app and a separate member website
- International coverage for those who work, travel or live abroad
Reviews and customer complaints
Overall, BCBS has good customer service reviews and ratings. Keep in mind that customer satisfaction is likely to vary by region since each BCBS affiliate is independently operated.
However, customers have reported concerns with both BCBS of Illinois and BCBS of Michigan regarding claim payments and servicing, including issues with hold times, lack of follow-through and inaccurate information. Customers have also reported challenges in finding the correct department to contact. This confusion might stem from how similar the names are for different BCBS companies.
To get a sense of customer satisfaction, we looked at customer and third-party reviews from the National Association of Insurance Commissioners (NAIC) for two BCBS companies: BCBS of Illinois and BCBS of Michigan. The NAIC records customer complaints and assigns each company a "complaint index" score. A 1.00 score is the baseline level and indicates an expected number of complaints. Scores under 1.00 indicate fewer complaints than average, which can be interpreted as good service.
BCBS of Illinois is part of the Health Care Service Corp., which operates Blue Cross Blue Shield companies in Illinois, Montana, New Mexico, Oklahoma and Texas. For individual health insurance, the company has a 0.20 median complaint index from the NAIC. For BCBS of Michigan, the NAIC reported a median complaint index of 0.34 for 2022. Both scores are below the 1.00 baseline, which means the NAIC received fewer complaints than average.
Frequently asked questions
Is Blue Cross Blue Shield good insurance?
Blue Cross Blue Shield is a good choice for many people. The company has a large provider network and offers member perks, including a nurse line and telemedicine options, all of which can make finding care easier. Because the company is split into independent regional providers, customer service and third-party rankings vary, so you may want to research the BCBS company in your area.
Is Anthem the same as BCBS?
Anthem is part of the BCBS family of companies. Anthem Blue Cross Blue Shield is the BCBS company in several states, although it isn't available everywhere.
Is Blue Cross Blue Shield expensive?
Compared to other major health insurance companies, Blue Cross Blue Shield is relatively expensive. The average monthly cost of a Silver plan from Blue Cross Blue Shield is $607 per month, based on a 40-year-old individual. For comparison, Aetna's average monthly premium is $450 and Cigna's is $465 for the same level plan.
Methodology
Company- and plan-level health insurance rates are based on aggregated private health insurance data from the Centers for Medicare & Medicaid Services (CMS) for plans sold on HealthCare.gov. Excluded from our analysis are states that use their own health insurance marketplace rather than HeathCare.gov. All rates are averages based on a 40-year-old policyholder.
The average cost of a Blue Cross Blue Shield Medicare Advantage plan is based on data from Medicare.gov and the Centers for Medicare & Medicaid Services (CMS) and includes drug coverage. We excluded employer-sponsored plans, Medicare savings account (MSA) plans, Medicare-Medicaid plans, PACE plans, Part-B-only plans, prepayment plans (HCPPs), sanctioned plans and special needs plans from the analysis.