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No matter where you are, or what your age, your gender, or the size of your wallet, Blue Cross Blue Shield can provide a health insurance plan for you.
Pros:
- Wide Provider Network: Accepted by 95% of doctors and 96% of hospitals nationwide.
- Diverse Plan Options: Offers PPO, HMO, Medicaid, Medicare, and supplemental coverage.
- International Coverage: GeoBlue plans provide global health insurance options.
- Extra Benefits: Some members access Blue365 discounts on health-related services.
- Strong Financial Backing: Many BCBS entities have A-rated financial strength.
Cons:
- Varied Customer Experience: Quality and pricing differ across 36 independent BCBS entities.
- Profit vs. Nonprofit Status: Some units operate for-profit, raising concerns about affordability.
- Claims & Billing Issues: Some regions report higher complaint ratios with NAIC.
- Limited Short-Term Plans: The availability of short-term insurance varies by location.
Shop Plans From Blue Cross and Blue Shield
Who Is Blue Cross Blue Shield?
Blue Cross Blue Shield (BCBS) was launched in Texas in 1929 as an experiment in pre-paid healthcare.1 The company has grown exponentially since then, and now sells insurance in all 50 states, Washington, D.C., and Puerto Rico. More than 107 million Americans — one in three — are insured and managed by 36 independent and locally operated Blue Cross Blue Shield companies.2 More than 96% of hospitals and 95% of doctors and specialists accept BCBS health insurance.3 While some insurers operate with a tight number of network providers, that is rarely the case with a BCBS company.
BCBS started as a nonprofit organization, but since 1994, the company has allowed its local franchises to decide whether to operate as profit-making or nonprofit companies. The conversion of some units to profit-making has been controversial, but the organization has argued that a for-profit insurer can still be committed to providing affordable, accessible, and high-quality healthcare.4
Does it matter whether your Blue Cross Blue Shield insurer is for-profit or nonprofit? A 2013 study by researchers at Northwestern University and the University of California suggested that there were no real differences in rates and that BCBS units that converted to for-profit status used some of their profits to improve the quality of their coverage.5
What Health Insurance Does BCBS Offer?
BCBS offers a broad range of insurance. Each of its 36 entities can tailor its offerings to the needs of the communities it serves.
BCBS Global offers health insurance to Americans who work, live and travel internationally.7
These BCBS entities provide insurance policies for individuals and families including:
- Preferred provider organization (PPO) plans
- Health maintenance organization (HMO) plans
- Coverage for Medicaid participants
- Medicare Advantage plans
- Medicare Supplement insurance (Medigap plans)
- Medicare Part D coverage of prescription drugs.
Blue Cross Blue Shield companies also work with businesses of all sizes to offer insurance to their employees. In some areas, BCBS sells short-term and supplemental plans like critical-care insurance. It offers dental and vision insurance almost everywhere in the U.S.
Accepted Almost Everywhere
More than 95% of doctors and 96% of hospitals in the U.S. accept Blue Cross Blue Shield health insurance.
How Do You Enroll in a Blue Cross Blue Shield Plan?
- You can locate coverage on this website by typing in your zip code, or call 888-630-2583 and you’ll be transferred to a representative in your area who can answer questions, give you free quotes and help you sign up. You can ask about monthly premiums, deductibles and out-of-pocket costs.
- Once you’re enrolled in your local BCBS unit, you’ll receive instructions for finding doctors and other healthcare providers.
How Do you File a Claim in a BCBS Plan?
In general, healthcare providers will file claims for you. Many BCBS entities provide insurance customers with online portals that allow you to check the status of a claim.
Plan Benefits
- BCBS also offers an array of benefits, such as free nurse hotlines.
- In some areas, you’ll get access to Blue365, which offers discounts on a long list of products and services. Some of these are really good deals, such as deep discounts on hearing aids and dental care, even when your policy doesn’t cover these services.
If you are insured by a BCBS company, you can be covered wherever you travel — even internationally — if you purchase a temporary or long-term Geo Blue plan.8
Extra Savings
In some areas of the country, BCBS customers have access to Blue365, which offers discounts on a wide variety of products and services.
How Is Blue Cross Blue Shield Rated?
Being able to trust that your insurer can afford to protect your health is the most basic of member concerns. That’s why you want to choose a financially strong insurer that can provide consistently good service, including paying claims quickly.
Unfortunately, there is no single rating of the financial strength of all 36 of BCBS’s separate insurance companies, but AM Best rates most BCBS entities.
You can search here for the BCBS company you are considering.
A.M. Best:
• BCBS Vermont: Downgraded to C++ (Marginal) due to declining capitalization and losses. Source
• BCBS Minnesota: Affirmed A- (Excellent) with a stable outlook. Source
• BCBS Michigan: Affirmed A (Excellent) but outlook revised to negative. Source
Standard & Poor’s (S&P): No specific ratings found for individual BCBS entities; check S&P’s official site for details.
Fitch Ratings: BCBS companies generally maintain strong financials and capital positions. Source
Blue Cross Blue Shield (BCBS) Customer Satisfaction and Consumer Reviews:
American Customer Satisfaction Index (ACSI): According to the ACSI Insurance and Health Care Study 2022-2023, BCBS achieved a customer satisfaction score of 75 out of 100, reflecting an improvement from previous years.
Better Business Bureau (BBB): BCBS operates through various regional entities, each with its own BBB profile. For instance, Blue Cross and Blue Shield of North Carolina is not BBB accredited but holds an A+ rating. Blue Cross and Blue Shield of Florida is also not BBB accredited but can view customer reviews and complaints on its BBB profile.
Trustpilot: Trustpilot does not have a consolidated profile for BCBS as a whole. Individual regional entities may have profiles, but reviews are limited and vary by location.
Consumer Affairs: Consumer Affairs features reviews for various BCBS regional companies. Customer experiences differ, with some praising coverage options and others citing issues with claims processing.
National Association of Insurance Commissioners (NAIC) Complaint Data:
The NAIC provides a Consumer Insurance Search tool where you can access complaint data for specific insurance companies, including BCBS entities. This data includes the number of complaints filed and the nature of those complaints.Search for the company on the National Association of Insurance Commissioners’ website, where complaint reports are recorded.
Next Steps
- Find the BCBS company that serves your area.
- Compile a list of the coverage you want and need. Call and talk to a representative to narrow down your choices.
- Carefully consider the information the agent provides. Health insurance is complex. If you have questions, ask and get the answers you need before you enroll.
The views and opinions expressed are those of the authors and do not necessarily reflect the official policy or position of HealthCareInsider.com or HealthCare, Inc.
