Blue Cross Blue Shield vs. Cigna Insurance

Which health insurance company is the best option for you and your family? Compare Blue Cross Blue Shield and Cigna side by side.

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In this Blue Cross Blue Shield vs. Cigna comparison, Blue Cross Blue Shield (BCBS) emerges as the superior health insurance company for several key reasons. BCBS offers coverage in all 50 states, boasts a larger in-network provider base and is accepted by a significant majority of healthcare facilities in the U.S. Additionally, BCBS consistently receives higher customer satisfaction ratings.

Key Takeaways

  • BCBS’ network of 1.7 million providers is slightly larger than Cigna’s network of 1.5 million providers.
  • Cigna individual and family plans are available in only 12 states, whereas BCBS serves families in all 50 states.
  • In a J.D. Power customer satisfaction study, BCBS scored higher than Cigna.
  • While both companies offer a range of plan types and digital platforms for policy management, BCBS's broader availability and higher customer satisfaction make it the more favorable choice for most individuals and families.

Blue Cross Blue Shield History

Blue Cross was formed in 1929 as a partnership between Baylor University Hospital and its patients who were struggling financially. The hospital administrators 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 program's success led to enrollment by employees in other professions across Dallas.

Click to read our full Blue Cross Blue Shield review.

Cigna History

In 1792, a group of citizens formed the Insurance Company of North America (INA), the country’s oldest stockholder-owned insurer. In 1794, INA issued its first insurance policy, for a sea captain, to mitigate the risk of death. In 1865, the Governor of Connecticut signed a special act of the General Assembly incorporating the Connecticut General Life Insurance Company, which helped make Hartford, CT, “the insurance capital of the world.” The Insurance Company of North America and the Connecticut General Life Insurance Company combined in 1982 to form the Cigna health insurance company we know today.

Click to read our full Cigna review.

Blue Cross Blue Shield vs. Cigna: A Quick Glance




Coverage Options

CDHP, EPO, FSA, HDHP, HMO, HMO-POS, HSA, Indemnity, Medicaid, Medicare, POS and PPO

CDHP, EPO, FSA, HDHP, HMO, HMO-POS, HSA, Indemnity, Medicaid, Medicare, POS and PPO


50 states for individual/family plans

Arizona, California, Colorado, Connecticut, Florida, Georgia, Maryland, Montana, North Carolina, South Carolina, Tennessee and Texas

Coverage Limit






Maximum Annual Benefit



Waiting Period



Providers In-Network

1.7 million

1.5 million

Covers Telehealth


Yes (depending on plan and location)

Policy Management

Mobile app, online account, phone

Mobile app, online account, phone

Blue Cross Blue Shield Pros and Cons



Individual and family plans available in all 50 states

Medicare Advantage (MA) plans not available in all states

Has a provider network of 1.7 million[1]


Accepted by 80% of doctors and 90% of hospitals in the U.S.[2]


Cigna Pros and Cons



Network of 1.5 million providers

Limited availability

Ranks as one of the largest and oldest insurance institutions in the country

Below average customer satisfaction rating in many regions in J.D. Power study

Offers individual health insurance plans and group health insurance


Dental plans available in all 50 states


Blue Cross Blue Shield vs. Cigna: Plan Structures

Blue Cross Blue Shield and Cigna are on even footing, offering several health insurance products, including HMO, PPO and POS options. They also have specialized plans like CDHP, EPO and HDHP. Both companies provide additional services such as FSA, HMO-POS, HSA, Indemnity, Medicaid and Medicare. They cater to individuals and families and offer group plans through employers, along with vision and dental insurance.


Blue Cross Blue Shield


Individual & Family





Small Business





Blue Cross Blue Shield vs. Cigna: Plan Availability

BCBS beats out Cigna by a wide margin, offering individual and family plans across all 50 states.[1] Cigna’s availability is limited to the below 12 locations:[3]









North Carolina

South Carolina



In contrast, Cigna dental plans are widely accessible, with availability in all 50 states plus Washington, D.C.[3]

Blue Cross Blue Shield vs. Cigna: In-Network Providers

BCBS takes the gold in this leg of the Cigna vs. Blue Cross Blue Shield competition with an impressive 1.7 million providers. However, Cigna is still impressive, offering a provider network of 1.5 million providers across the globe.[4]

Blue Cross Blue Shield vs. Cigna: Cost

Rates for health insurance, including those of Blue Cross Blue Shield and Cigna, are personalized and vary based on factors like age and lifestyle. Both companies use standard tiers (bronze to platinum) to determine costs, where bronze has the highest out-of-pocket costs but lowest premiums and platinum has the opposite.

health insurance payment coverage by tiers in bar graph

Blue Cross Blue Shield vs. Cigna: Coverage Limits

Like all health insurance companies, both Blue Cross Blue Shield and Cigna are required to offer unlimited coverage for essential health benefits. These include outpatient and inpatient treatments, emergency care, laboratory work, mental health support, maternity and pediatric care, medication, chronic disease management and rehabilitation equipment.

Blue Cross Blue Shield vs. Cigna: Policy Management

Both Blue Cross Blue Shield and Cigna provide digital platforms and mobile applications that allow users to manage their policies, search for healthcare providers and monitor claims. The user experience for these apps can vary by location. For instance, in Illinois, Cigna's app has a better rating, while in California and Florida, Blue Cross Blue Shield's app is more highly rated.


Google Play Store

Apple App Store


3/5 stars[5]

4.8/5 stars[6]

Blue Cross and Blue Shield of Illinois



Blue Shield of California



Florida Blue



Blue Cross Blue Shield vs. Cigna: Medical Loss Ratio

The Medical Loss Ratio (MLR) is a measure that indicates the percentage of premium income an insurance company spends on medical care and service quality improvement. Legally, insurers must allocate at least 80% of individual plan premiums and 85% of group plan premiums to healthcare services.[13] If they fall short, they are required to issue rebates to their policyholders. This regulation aims to ensure that a substantial part of insurance premiums is spent on healthcare rather than administrative expenses or company profits.

Blue Cross Blue Shield consists of independent regional entities, so MLR rebates may vary by state and year. For instance, in 2021, Blue Shield of California did not issue MLR rebates, whereas Blue Cross Blue Shield of Montana and Massachusetts did for individual and small-group plans, respectively.[14][15][16]

Cigna’s medical loss ratio in 2022 was 81.7% for individual plans so MLR rebates were not issued that year.[17]

Blue Cross Blue Shield vs. Cigna: Enrollment Process

To purchase a BCBS or Cigna plan from your state’s health insurance marketplace, you will need to enroll during open enrollment in the fall:[18]

Open Enrollment Period

Coverage Start Date

Nov. 1 to Dec. 15

Jan. 1

Dec. 16 to Jan. 15

Feb. 1

If you miss open enrollment, it’s still possible to purchase an ACA plan any time of the year if you experience a qualifying life event. Qualifying life events trigger what’s called a special enrollment period and often include the following:

  • Becoming a U.S. citizen
  • Changing jobs
  • Getting married or divorced
  • Having a new child, either by birth or adoption
  • Falling below the federal poverty level in income
  • Losing existing healthcare coverage (due to a spouse's job loss or death)
  • Moving

For those looking to have a Medicare Advantage plan, separate Medicare enrollment periods exist.[19]

3 months before you turn 65 to 3 months after

  • Enroll in a Medicare Advantage plan (if you have both Medicare Part A and B)

October 15 to December 7 for coverage starting on January 1

  • Switch from Original Medicare to a Medicare Advantage plan
  • Switch from one Medicare Advantage plan to another Medicare Advantage plan

January 1 to March 31 for coverage starting on the 1st of the month after the company receives your request

  • Switch from one Medicare Advantage plan to another Medicare Advantage plan
  • Drop your Medicare Advantage plan and return to Original Medicare

Blue Cross Blue Shield vs. Cigna: Policyholder Experience

In the Cigna Health Insurance vs. Blue Cross Blue Shield race, BCBS wins again, with higher overall reviews from multiple sources.


Blue Cross Blue Shield Rating



3.7/5 stars[20]

2.7/5 stars[23]

Affordable Health Insurance






A recent J.D. Power and Associates study of customer satisfaction with commercial member health plans compared several healthcare providers, including Blue Cross Blue Shield and Cigna, across several regions.[26] A BCBS company consistently ranked higher than Cigna but there were some instances when Cigna outperformed a BCBS company. One notable exception is New Jersey, where Cigna ranked first for customer satisfaction.

How to File Claims With Blue Cross Blue Shield and Cigna

When you see an in-network healthcare provider, they usually manage the insurance claims process on your behalf. However, if you use out-of-network services, you'll need to file the insurance claim yourself. Both Cigna and Blue Cross Blue Shield have designated forms for submitting these claims, which should be mailed to the specified address. You can also track the status of your claim through your insurer's online portal or mobile app.

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Blue Cross Blue Shield and Cigna FAQs

Is Cigna the same as UnitedHealthcare?

Cigna and UnitedHealthcare are two different health insurance companies, each with its own provider network and plan availability.

Is Cigna Healthcare any good?

Whether or not Cigna is good can be subjective. For instance, Cigna does rank lower overall in terms of customer reviews compared to BCBS companies but ranks higher in some regions in a J.D. Power study.

Is Blue Shield different from Blue Cross Blue Shield?

Blue Shield is a part of the Blue Cross Blue Shield Association. There are 34 independently operated companies within the association, with BCBS trademarks and names in over 170 countries.[1]


  1. Blue Cross Blue Shield. “The Blue Cross Blue Shield System.” Accessed September 5, 2023.
  2. Blue Cross Blue Shield. “Largest Network.” Accessed September 5, 2023.
  3. Cigna. “With Medical Plans in 12 States and Dental Plans in All 50 States Plus D.C., Reasons To Sell Cigna Are Really Adding Up,” Page 1. Accessed September 5, 2023.
  4. Cigna. “Cigna FlexAssure.” Accessed September 5, 2023.
  5. Google Play. “myCigna.” Accessed September 5, 2023.
  6. Apple App Store. “myCigna.” Accessed September 5, 2023.
  7. Google Play Store. “BCBSIL.” Accessed September 5, 2023.
  8. Apple App Store. “BCBSIL.” Accessed September 5, 2023.
  9. Google Play Store. “Blue Shield of California.” Accessed September 5, 2023.
  10. Apple App Store. “Blue Shield of California Accessed September 5, 2023.
  11. Google Play Store. “Florida Blue.” Accessed September 5, 2023.
  12. Apple App Store. “Florida Blue.” Accessed September 5, 2023.
  13. Centers for Medicare and Medicaid Services. “Medical Loss Ratio.” Accessed September 5, 2023.
  14. Blue Shield of California. “Medical Loss Ratio (MLR).” Page 1. Accessed September 5, 2023.
  15. BlueCross BlueShield of Montana. “Affordable Care Act (ACA) 2021 Medical Loss Ratio (MLR) Rebates.” Page 1. Accessed September 5, 2023.
  16. Blue Cross Blue Shield of Massachusetts. “Medical Loss Ratio (MLR) Rebate 2022 FAQ,” Page 1. Accessed September 5, 2023.
  17. Cigna. “Cigna Reports Strong Fourth Quarter and Full Year 2022 Results, Establishes 2023 Guidance and Increases Dividend.” Accessed September 5, 2023.
  18. “When Can You Get Health Insurance?” Accessed September 5, 2023.
  19. “Joining a Plan.” Accessed September 5, 2023.
  20. Affordable Health Insurance. “Blue Cross Blue Shield Review.” Accessed September 5, 2023.
  21. BestCompany. “Blue Cross Blue Shield.” Accessed September 5, 2023.
  22. Better Business Bureau. “Blue Cross & Blue Shield.” Accessed September 5, 2023.
  23. BestCompany. “Cigna.” Accessed September 5, 2023.
  24. Affordable Health Insurance. “Cigna Health Insurance Review.” Accessed September 5, 2023.
  25. Better Business Bureau. “Cigna.” Accessed September 5, 2023.
  26. J.D. Power. “Commercial Health Plan Member Satisfaction Declines in Key Areas, J.D. Power Finds.” Accessed September 5, 2023.

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