Anthem vs. Blue Cross Blue Shield Insurance

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 (BCBS) mashup, we’ve found that Blue Cross 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 Anthem health plans are not accessible to most U.S. citizens as the company serves only 14 states, whereas BCBS has a presence in all 50 states. In a 2023 J.D. Power Study, BCBS ranked higher than Anthem for customer satisfaction in more instances and regions. Both companies offer diverse healthcare plans including HMO, PPO, CDHP, EPO, FSA, HMO-POS, Indemnity, HSA, Medicaid and Medicare. Anthem utilizes Blue Cross Blue Shield’s network of 1.7 million healthcare providers.

History of Anthem

In 2004, WellPoint Health Networks Inc. and Anthem, Inc. merged and became the nation’s leading health benefits company. In December 2014 WellPoint Inc. changed its corporate name to Anthem, Inc and on June 28, 2022, Anthem rebranded to Elevance Health. As of 2022, Anthem has 46.8 million members and is ranked 33rd on the Fortune 500.

Click to read our full Anthem review.

History of Blue Cross Blue Shield

Blue Cross was formed in 1929 as a partnership between Baylor University Hospital and its patients who were struggling financially. The administrators of the hospital wanted to make healthcare more affordable for some patients, many of whom were Dallas public school educators on restricted budgets. The initial payment plan set up by Baylor University Hospital consisted of a 50-cent prepay each month for up to 21 days of hospitalization per year. The success of the program led to enrollment by employees in other professions across Dallas.

Click to read our full Blue Cross Blue Shield review.

Anthem vs. Blue Cross Blue Shield: A 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 for individual/family plans; 47 states for MA plans
Coverage Limit	Varies	Varies
Deductible	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
Has 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.[1]

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.^[2] MA services are tied to specific geographic areas as well as physician and hospital participation.

Anthem lags behind, offering coverage in only the 14 states below:^[3]

California	Colorado
Connecticut	Georgia
Indiana	Kentucky
Maine	Missouri
New Hampshire	Nevada
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. Despite limited availability, Anthem is part of the larger BCBS Association, offering nationwide options if Anthem isn't in your state.

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. While Anthem serves only 14 states, its relationship to BCBS gives Anthem’s policyholders access to BCBS’ larger network.^[4][5]

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 tier will influence your out-of-pocket expenses and monthly premium. Anthem and Blue Cross Blue Shield use standardized tiers of bronze, silver, gold and platinum:

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 more favorably in California and Florida.

Company	Google Play Store	Apple App Store
Anthem	4.6/5 stars[6]	4.8/5 stars[7]
Blue Cross and Blue Shield of Illinois	3.5/5[8]	3.2/5[9]
Blue Shield of California	4.2/5[10]	4.8/5[11]
Florida Blue	4.7/5[12]	4.8/5[13]

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.^[14]

If an insurance company fails to meet these minimum percentages, they are obligated to give back the difference to the people who are insured through a rebate. Essentially, this regulation is designed to ensure that a significant portion of your insurance premium is being used for healthcare services rather than administrative costs or profits for the insurance company.

Anthem, on the other hand, sent out 2021 MLR rebates to 9 states, including ^[3]

California	Colorado
Connecticut	Georgia
Kentucky	Maine
Missouri	New Hampshire
New York	Ohio
Virginia

Blue Cross Blue Shield is a collection of independent regional companies so there is no central source for which states received rebates and in what year. That also means that BCBS may issue MLR rebates in some regions and not in others.

For example, in 2021, Blue Shield of California did not owe MLR rebates, while Blue Cross Blue Shield of Montana had to issue rebates for individual plans.^[15][16] Similarly, Blue Cross Blue Shield of Massachusetts issued 2021 MLR rebates to small-group account holders and direct-pay subscribers.^[17]

Anthem vs. Blue Cross Blue Shield: Enrollment Process

The annual sign-up period for individual health plans starts November 1st, allowing you to choose from Anthem and Blue Cross Blue Shield plans on the health insurance marketplace.^[18] You can enroll outside of the individual sign-up period if a significant life event occurs, such as:

• Gaining U.S. citizenship
• Changing jobs
• Altering marital status (wedding or divorce)
• Adding a child (birth or adoption)
• Income falling beneath the poverty line
• Losing current healthcare (e.g., due to a spouse's job loss or passing)
• Moving homes

The enrollment window for Medicare Advantage plans lasts between January 1st and March 31st.^[19] Additionally, you can enroll in Medigap and Part D prescription drug coverage, but you'll need to be enrolled in Original Medicare (Parts A and B) to qualify.

Anthem and BCBS plans may also be available from your employer. If plans from both companies are available, ask your human resources department for information on how and when you can enroll.

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	1.4/5[20]	3.7/5[21]
Affordable Health Insurance	4.6/5[22]	4.6/5[23]
BBB	1.05/5[24]	1.13/5[25]

A recent J.D. Power and Associates study of customer satisfaction with commercial member health plans compared several healthcare providers, including Anthem and BCBS, across 22 regions. We’ve provided a table breaking down the common regions shared between the two carriers and how they fared.^[26]

Region	Rating
California	Anthem and BCBS ranked below average. However, BCBS still ranked higher than Anthem
East South Central	BCBS of Tennessee, BCBS of Louisiana and BCBS of Alabama ranked above average and higher than Anthem Blue Cross and Blue Shield of Kentucky. However, Anthem did rank higher than BCBS of Mississippi
Heartland	BCBS of Kansas City ranked first and Anthem BCBS Missouri ranked second
Illinois-Indiana	Anthem and BCBS of Illinois ranked above average and tied
Minnesota-Wisconsin	BCBS of Minnesota ranked above average. Anthem BCBS Wisconsin fell below average
Northeast	Anthem BCBS Connecticut and BCBS of Rhode Island tied for the top score
South Atlantic	Anthem BCBS Georgia and BCBS of South Carolina ranked above average, with Anthem receiving a higher score
Southwest	Anthem BCBS Nevada ranked above average. BCBS of Arizona and BCBS of New Mexico fell below average

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).