Anthem vs. Blue Cross Blue Shield Insurance
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While Anthem is within the Blue Cross Blue Shield (BCBS) group, there are cases when Anthem and BCBS health plans are sold in the same state. In this Anthem vs. Blue Cross Blue Shield mashup, we’ve found that BCBS performs better overall than Anthem, offering coverage in all 50 states compared to Anthem’s 14 and outperforming Anthem in user reviews.
Read our Blue Cross Blue Shield vs. Anthem comparison to see which company is best for your health insurance needs.
Key Takeaways
|
History of Anthem
In 2004, WellPoint Health Networks Inc. and Anthem, Inc. merged and became the nation’s leading health benefits company.[1] In December 2014 WellPoint Inc. changed its corporate name to Anthem, Inc and in 2022, Anthem rebranded to Elevance Health.[2][3] In 2023, Elevance Health was ranked 22nd on the Fortune 500.[4]
Click to read our full Anthem review.
History of Blue Cross Blue Shield
Blue Cross Blue Shield traces its roots back to 1929 when Blue Cross partnered with Baylor University Hospital to bring affordable healthcare to financially struggling patients, especially educators. In fact, the initial payment plan cost just 50 cents each month for up to 21 days of hospitalization over a one-year term. Today, BCBS is a network of regional and independently-operated health insurance companies with a presence in all 50 states.[5]
Click to read our full Blue Cross Blue Shield review.
Anthem vs. Blue Cross Blue Shield: Quick Glance
Comparison |
Anthem |
Blue Cross Blue Shield |
---|---|---|
Plan Types |
HMO, PPO, CDHP, EPO, FSA, HMO-POS, Indemnity, HSA, Medicaid, Medicare, POS |
HMO, PPO, CDHP, EPO, FSA, HMO-POS, Indemnity, HSA, Medicaid, Medicare, POS |
Availability |
14 states (varies by plan type) |
50 states (varies by plan type) |
Coverage Limit |
Varies |
Varies |
Varies |
Varies |
|
Maximum Annual Benefit |
Varies |
Varies |
Waiting Period |
Varies |
Varies |
Providers In-Network |
1.7 million |
1.7 million |
Covers Telehealth |
Yes |
Yes |
Policy Management |
Mobile app, online account, phone |
Mobile app, online account, phone |
Anthem Pros and Cons
Pros |
Cons |
---|---|
Access to BCBS’ network of 1.7 million providers |
Available in only 14 states |
Blue Cross Blue Shield Pros and Cons
Pros |
Cons |
---|---|
Available in all 50 states |
Medicare Advantage (MA) plans not available in all states |
Has a provider network of 1.7 million |
|
Accepted by 80% of doctors and 90% of hospitals in the U.S.[6] |
|
Anthem vs. Blue Cross Blue Shield: Plan Structures
Anthem and Blue Cross Blue Shield offer diverse healthcare plans including HMO, PPO and POS, as well as specialized options like CDHP, EPO and HDHP. They also provide supplementary services such as FSA, HMO-POS, HSA, indemnity plans, Medicaid and Medicare. These providers cater to both individual and family needs and offer employer-sponsored plans with dental and vision coverage.
Plan |
Anthem |
Blue Cross Blue Shield |
---|---|---|
Dental |
✓ |
✓ |
Family |
✓ |
✓ |
Individual |
✓ |
✓ |
Medicaid |
✓ |
✓ |
Medicare |
✓ |
✓ |
Vision |
✓ |
✓ |
Group |
✓ |
✓ |
Anthem vs. Blue Cross Blue Shield: Plan Availability
Blue Cross Blue Shield takes home the gold in this round with availability in every state. Keep in mind, however, that BCBS does not sell Medicare Advantage plans in Alaska, Mississippi or Wyoming.[7]
Anthem lags behind BCBS when it comes to availability, offering individual and family coverage in only the 14 states below:[8]
- California
- Colorado
- Connecticut
- Georgia
- Indiana
- Kentucky
- Maine
- Missouri
- Nevada
- New Hampshire
- New York
- Ohio
- Virginia
- Wisconsin
Keep in mind that Anthem health plans may operate under different names in certain states, such as Rocky Mountain Hospital in Nevada or Community Insurance Company in Ohio.[9]
Anthem vs. Blue Cross Blue Shield: In-Network Providers
Anthem and Blue Cross Blue Shield are on even footing when it comes to network size but this is largely because Anthem is licensed with BCBS. BCBS boasts a considerable network of 1.7 million healthcare service providers across all 50 states.[10] While Anthem serves only 14 states, its relationship to BCBS gives Anthem’s policyholders access to BCBS’ larger network.[11]
Anthem vs. Blue Cross Blue Shield: Cost
Rates are highly customized and based on the individual’s health profile and budget so it’s difficult to make a fair pricing comparison between Anthem and BCBS. Premium costs for all health insurance companies differ based on factors such as age, lifestyle habits like smoking, location, deductible level, plan type and insurance provider. In addition, your plan’s tierwill influence your out-of-pocket expenses and monthly premium.
Anthem vs. Blue Cross Blue Shield: Policy Management
Anthem and Blue Cross Blue Shield offer online portals and mobile apps for policy management, including doctor searches, coverage reviews and claims tracking. As for which company has the better app, it will depend on the region.
To share some examples, in Illinois, the BCBS app is rated less favorably than the Anthem app but have the same star rating as the Anthem app on the Apple App store in California and Florida. The Anthem app is called Sydney Health.
Company |
Google Play Store |
Apple App Store |
---|---|---|
Anthem |
4.7/5 stars[12] |
4.8/5 stars[13] |
Blue Cross and Blue Shield of Illinois |
3.3/5[14] |
3.2/5[15] |
Blue Shield of California |
4/5[16] |
4.8/5[17] |
Florida Blue |
4.6/5[18] |
4.8/5[19] |
Anthem vs. Blue Cross Blue Shield: Coverage Limits
Anthem and Blue Cross Blue Shield, like all health insurance companies, can't set financial limits on essential medical services, which include outpatient and inpatient care, urgent needs, lab tests, mental health, child and maternal care, medications, chronic condition management and rehab devices.
Anthem vs. Blue Cross Blue Shield: Medical Loss Ratio
The Medical Loss Ratio (MLR) is a metric used to determine how much of the premium income collected by a health insurance company is actually spent on medical care and improving the quality of services. By law, insurers are required to spend at least 80% of the premiums collected from individual health insurance plans and 85% from group plans on healthcare services.[20]
Elevance Health reported an 87% MLR for 2023 so policyholders will not be receiving any rebates for that reporting year.[21] As for BCBS, whether rebates will be issued will depend on which entity serves your region. Several BCBS companies are still gathering data for the 2023 reporting year but there were some instances when 2022 MLR rebates were issued. For example, BCBS of Montana did not issue any 2022 MLR rebates but BCBS of Massachusetts did.[22][23]
Anthem vs. Blue Cross Blue Shield: Enrollment Process
The annual open enrollment period for buying individual health plans from your state’s marketplace starts November 1st, allowing you to choose from Anthem and Blue Cross Blue Shield plans on the health insurance marketplace depending on where you live.[24] It may be possible to enroll outside of the individual sign-up period if a significant life event occurs, such as gaining U.S. citizenship, starting a new job or getting married. Meanwhile, the first opportunity to switch from Original Medicare to a Medicare Advantage plan each year is on October 15.[25]
Anthem vs. Blue Cross Blue Shield: Policyholder Experience
Of the three review platforms reviewed, BCBS ranked higher than Anthem on two of them and equally on one of them:
Company |
Anthem Rating |
Blue Cross Blue Shield Rating |
---|---|---|
BestCompany |
1/5[26] |
3.0/5[27] |
Affordable Health Insurance |
4.6/5[28] |
4.6/5[29] |
BBB |
1.08/5[30] |
1.12/5[31] |
A J.D. Power and Associates 2023 study of customer satisfaction with commercial member health plans compared several healthcare providers, including Anthem and BCBS, in several regions. In the eight regions where both a BCBS company and Anthem were among the top companies, a BCBS company outperformed Anthem in four of those regions.[32]
However, there were some regions where Anthem was ranked lower than one BCBS company but higher than another, which was the case in the east south central and heartland regions. Both Anthem and a BCBS company were tied as the top-ranked health insurance companies in the northeastern region.[32]
How To File Claims With Anthem and Blue Cross Blue Shield
For both companies, in-network providers will file a claim with your health insurance company on your behalf when you receive services. However, if you opt for out-of-network care, you'll typically be responsible for submitting the claim yourself.
To seek reimbursement, Anthem members should either obtain a claim form by request or download it from the available forms section on their website, then follow the provided filing guidelines.
BCBS members can submit claims electronically or by mail. Customers can use the Real-Time Claims web tool for electronic claims submissions or by signing up for the Electronic Data Interchange (EDI).
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