Blue Cross Blue Shield vs. Cigna Insurance

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 most healthcare facilities in the U.S.

Key Takeaways BCBS’s network of 2 million providers is larger than Cigna’s network of 1.5 million providers. Cigna individual and family plans are available in only 11 states, whereas BCBS serves families in all 50 states. In a J.D. Power customer satisfaction study for commercial health plans, BCBS scored higher than Cigna across most regions. 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 to make healthcare more affordable and accessible. 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.^[1]

Cigna History

Cigna traces its roots back to 1792 when a group of citizens formed the Insurance Company of North America (INA). In 1982, INA combined with the Connecticut General Life Insurance Company to form Cigna as we know it today.^[2]

Blue Cross Blue Shield vs. Cigna: Quick Glance

Comparison	BCBS	Cigna
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
Availability	50 states for individual/family plans	Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Mississippi, North Carolina, Tennessee, Texas, Virginia
Coverage Limit	Varies	Varies
Deductible	Varies	Varies
Maximum Annual Benefit	Varies	Varies
Waiting Period	Varies	Varies
Providers In-Network	2 million	1.5 million
Covers Telehealth	Yes	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

Pros	Cons
Individual and family plans available in all 50 states	Medicare Advantage (MA) plans are not available in all states
Provider network of 2 million
Accepted by 80% of doctors and 90% of hospitals in the U.S.[3]

Cigna Pros and Cons

Pros	Cons
Provider network of 1.5 million	Limited availability
Offers individual health insurance plans and group health insurance	Consistently ranked lower than BCBS for customer satisfaction in several regions in a recent J.D. Power study[5]
Dental plans are available in all states except Massachusetts[4]

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 offer specialized plans, including CDHP, EPO, and HDHP. Both companies offer additional services, including FSA, HMO-POS, HSA, Indemnity, Medicaid, and Medicare. They cater to individuals and families, offering group plans through employers, as well as vision and dental insurance.

Plan	Blue Cross Blue Shield	Cigna
Individual & Family	✓	✓
Medicare	✓	✓
Medicaid	✓	✓
Dental	✓	✓
Vision	✓	✓
Small Business	✓	✓
Self-employed	✓	✓
Short-term	✓	✓
Student	✓	✓
Indemnity	✓	✓

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.^[4] Meanwhile, Cigna sells medical plans in the following 11 states:^[6]

1. Arizona
2. Colorado
3. Florida
4. Georgia
5. Illinois
6. Indiana
7. Mississippi
8. North Carolina
9. Tennessee
10. Texas
11. Virginia

It is worth noting that Cigna dental plans, on the other hand, are widely accessible, with coverage available in all states except Massachusetts.^[6]

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 2 million providers. However, Cigna remains impressive, boasting a provider network of 1.5 million providers worldwide.^[4][7]

Blue Cross Blue Shield vs. Cigna: Cost

Rates for health insurance 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 the lowest premiums and platinum has the opposite.

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 offer digital platforms and mobile applications that enable users to manage their policies, search for healthcare providers, and track claims. The user experience for these apps can vary depending on the location.

For example, Cigna has the same Apple App Store star rating as Blue Shield of California and Florida Blue, but its star rating is higher than BCBS of Illinois. Meanwhile, Cigna has a lower Google Play Store star rating than both Blue Shield of California and Florida Blue, but still places higher than BCBS of Illinois.

Company	Google Play Store	Apple App Store
Cigna	4.2/5[8]	4.8/5[9]
Blue Cross and Blue Shield of Illinois	1.6/5[10]	1.4/5[11]
Blue Shield of California	3.6/5[12]	4.8/5[13]
Florida Blue	4.7/5[14]	4.8/5[15]

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. If they fall short, they are required to issue rebates to their policyholders.^[16]

Blue Cross Blue Shield consists of independent regional entities, so MLR rebates may vary by state and year. For instance, BCBS of Texas did not issue rebates for the 2023 MLR reporting year, whereas BCBS of Massachusetts will be issuing rebates to 17,800 individuals and 19,800 small group employers.^[17][18] However, Cigna’s MLR ratio in 2023 was 81.3%, so no MLR rebates were issued for that year.^[19]

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 or winter:^[20]

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, such as changing jobs, moving to a new zip code, having a child and more.

For those looking to enroll in a Medicare Advantage plan, there are separate Medicare enrollment periods.^[21]

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, the two are close, with BCBS slightly edging ahead of Cigna in some rankings.

Company	Blue Cross Blue Shield Rating	Cigna
BestCompany	2.0/5[22]	2.5/5 stars[23]
Affordable Health Insurance	4.6/5[24]	4.2/5[25]
BBB	1.14/5[26]	1.04/5[27]

In a 2025 J.D. Power study that measured commercial health plan member satisfaction, BCBS outperformed Cigna in several regions. In 18 of the 22 regions where BCBS and Cigna were both among the top companies, a BCBS company ranked higher than Cigna. That said, since BCBS is a collection of multiple companies, there were some cases in which Cigna ranked below one BCBS company but higher than another.^[5]

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.