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. Additionally, BCBS consistently received higher customer satisfaction ratings for commercial health plans in a recent study.

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 14 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. 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]

Click to read our full Blue Cross Blue Shield review.

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]

Click to read our full Cigna review.

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, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia
Coverage Limit	Varies	Varies
Deductible	Varies	Varies
Maximum Annual Benefit	Varies	Varies
Waiting Period	Varies	Varies
Providers In-Network	1.7 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 not available in all states
Provider network of 1.7 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	Ranked lower than BCBS for customer satisfaction in several regions in a recent J.D. Power study
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.

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 below 14 states:^[5]

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

It should be noted that Cigna dental plans on the other hand, are widely accessible, with availability in all 50 states plus Washington, D.C.^[5]

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, with its provider network of 1.5 million providers across the globe.^[4][6]

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 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 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 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 all three of the aforementioned BCBS companies.

Company	Google Play Store	Apple App Store
Cigna	2.5/5 stars[7]	4.8/5 stars[8]
Blue Cross and Blue Shield of Illinois	3.3/5[9]	3.2/5[10]
Blue Shield of California	4.0/5[11]	4.8/5[12]
Florida Blue	4.6/5[13]	4.8/5[14]

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.^[15] If they fall short, they are required to issue rebates to their policyholders.

Blue Cross Blue Shield consists of independent regional entities, so MLR rebates may vary by state and year. For instance, BCBS of Montana did not issue rebates for the 2022 MLR reporting year, whereas BCBS of Massachusetts will be issuing rebates to 18,500 individuals and 21,000 small group employers.^[16][17] Meanwhile, Blue Shield of California is still gathering data from employers for potential 2022 MLR rebates.^[18]

Cigna’s MLR ratio in 2023 was 81.3% so no MLR rebates will be 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 and these events typically include changing jobs, moving to a new zip code, having a child and more.

For those looking to have a Medicare Advantage plan, separate Medicare enrollment periods exist.^[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, BCBS wins again, with higher overall reviews from multiple sources.

Company	Blue Cross Blue Shield Rating	Cigna
BestCompany	3.0/5 stars[22]	1.9/5 stars[23]
Affordable Health Insurance	4.6/5[24]	4.2/5[25]
BBB	1.16/5[26]	1.07/5[27]

In a 2023 J.D Power study that measured commercial health plan member satisfaction, BCBS outperformed Cigna in several regions. In 18 of the 20 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. Notably, Cigna was the top ranked company in New Jersey.^[28]

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.