Blue Cross Blue Shield Companies (BCBS) are part of the Blue Cross Blue Shield Association (BCBSA), an alliance of independent health insurance companies that cover members in every state. Policyholders can use a Blue Cross Blue Shield insurance card almost anywhere in the United States, subject to provider participation and plan benefits.
Each private Blue Cross Blue Shield insurance company is locally owned and operated independently. Individual BCBS companies sell and service health insurance in connection with their “home” states or regions. As such, customers rate and report interactions with their domestic BCBS plan, rather than the association as a whole. while some customers reported payment and service concerns, the businesses we reviewed received overall positive ratings from the better business bureau and other reporting entities.
blue cross blue shield health insurance: our thoughts
blue cross blue shield insurance offers a variety of coverage types including dental, vision, short term medical and individual major medical coverage. Specifically, BCBS offers Affordable Care Act (ACA) major health plans to new members in all but three states: Mississippi, Nebraska and South Dakota. existing members can continue their current coverage in these three states.
some bcbs companies do business in multiple states. For example, a BCBS entity called CareFirst covers Maryland, Virginia, and the District of Columbia. Other BCBS companies, such as Horizon Blue Cross and Blue Shield of New Jersey, operate in a single state.
availability of bcbs policies
The bcbs entities in each state are listed below. In some cases, multiple BCBS companies operate in a single state. For example, depending on where you live in California, you would be covered by the California Blue Shield or the Anthem Blue Cross.
as a reminder, bcbs does not offer plans here in mississippi, nebraska and south dakota.
plan costs and options
Below are the bronze, silver and gold levels of one Blue Cross and Blue Shield of Illinois insurance plan and one offered by Blue Cross Blue Shield of Michigan. in both cases, our cost estimates are based on a 40-year-old person. It’s important to note that some of these plans may not be available in all areas of these states, so it’s vital to visit your own health insurance exchange to see what plans are available.
blue cross and blue shield of illinois
blue cross michigan blue shield
in a valuepenguin report on plans here in michigan, we found that bcbs of michigan was among the few companies offering the cheapest silver health insurance plan in 84% of michigan counties.
blue cross michigan blue shield silver hmo quotes vs. competitor silver hmos
To maintain focus, we narrowed our review of competing insurance products to a single state. The chart below compares the individual rates for a Blue Cross Blue Shield of Michigan Silver health insurance plan with similar Silver HMOS offered by the McLaren Health Plan Community and Priority Health.
Deductible amounts for sample plans range from a minimum of $2,400 for Priority Health to a maximum of $3,700 for McLaren Health Plan Community. Out-of-pocket maximums are similar among the three options, from $8,150 for McLaren to $8,550 for Priority Care.
Deductibles, coinsurance, and copays are assessed differently between plans. For example, only BCBS of Michigan applies prescription drug costs toward the annual deductible, which means prescription drugs aren’t covered until the deductible is met.
Plans also vary in how they handle emergency room services. bcbs of michigan and priority health assess a $250 copay per emergency visit after meeting the annual deductible, plus 30% coinsurance. mclaren charges 20% coinsurance after meeting the $3,700 deductible, but no copay.
In a scenario where you received emergency services totaling $5,000 before meeting any part of your deductible, your combined out-of-pocket expense would be your full deductible, copay (if one is charged), and coinsurance for the remaining amount. the calculation of the cost of each plan is shown below.
in this situation, priority health has the lowest out-of-pocket cost. priority health also has the cheapest premium compared to the other two options. As mentioned above, BCBS fees may be higher than those charged by competitors in some areas. If price is a major factor, a bcbs health plan may not be the best option depending on where you live. bcbs provider network and company position may be features to consider, but may come at a slightly higher cost.
member resources and unique benefits
as part of the bcbs association, many bcbs plans provide access to additional health-related resources like those listed here. It’s important to remember that these are not health insurance benefits.
customer reviews and complaints
bcbs is an established health insurance company with wide availability and a large network of providers. bcbs insurance plans include multiple coverage options with rates comparable to, or sometimes higher than, the rates of other companies. BCBS has generally received positive ratings from reporting agencies such as the Better Business Bureau and the National Association of Insurance Commissioners (NAIC).
bcbs companies are separate entities, but often have similar names. As a result, customers have reported difficulty finding the right department to address their service needs.
Customers have reported concerns with BCBS of Illinois and BCBS of Michigan regarding claims payments and service, including issues with wait times, lack of tracking, and inaccurate reporting. However, when calculating ratings, the Better Business Bureau considers the number of complaints and how quickly they are handled, along with the size of the company relative to total complaints and its length of time in business. With all factors combined, the Better Business Bureau gave BCBS of Illinois and BCBS of Michigan ratings of A- and A+, respectively.
In the individual health category, naic complaint totals for illinois bcbs and michigan bcbs were below average relative to company size. bcbs of illinois received a median naic rate of 0.00, meaning that the illinois insurance department reported no complaints during the 2020 review period. for bcbs of michigan, the naic reported a median complaint rate of 0.38 for 2020.