UnitedHealthcare vs. Blue Cross Blue Shield Insurance
Which health insurance company is the best option for you and your family? Compare UnitedHealthcare and Blue Cross Blue Shield side by side.
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UnitedHealthcare (UHC) and Blue Cross Blue Shield (BCBS) are similar in plan availability, health plan selections and ways to manage your policy. UHC has a slightly smaller network than BCBS but both networks are still considerable, featuring millions of providers nationwide. UHC had the highest market share of the U.S. health insurance market in 2021 and sold the most MA plans in 2022, suggesting that UHC was the more popular choice with consumers.
Keep reading to learn the strengths and weaknesses of each company to determine which is the better option for you.
UnitedHealthcare vs. Blue Cross Blue Shield: Quick Glance
UnitedHealthcare |
Blue Cross Blue Shield |
|
---|---|---|
Plan Structures |
HMO, PPO, CDHP, EPO, FSA, HMO-POS, Indemnity, HSA, Medicaid, Medicare |
HMO, PPO, CDHP, EPO, FSA, HMO-POS, Indemnity, HSA, Medicaid, Medicare, POS |
Availability |
50 states for individual/family plans; 46 states for MA plans |
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 |
1.3+ million |
1.7 million |
Covers Telehealth |
Yes |
Yes |
Policy Management |
Mobile app, online account, phone |
Mobile app, online account, phone |
UnitedHealthcare Pros and Cons
Pros |
Cons |
---|---|
Largest market share in 2021 |
Medicare Advantage plans not available in all 50 states |
Network of 1.3 million healthcare providers |
|
More favorable consumer reviews |
>> Click to read our full UnitedHealthcare review.
Blue Cross Blue Shield Pros and Cons
Pros |
Cons |
---|---|
Available in 50 states and partnered with more than 90% of doctors and hospitals nationwide |
Medicare Advantage plans not available in all 50 states |
Larger network than UnitedHealthcare |
|
Study shows BCBS ranked higher in overall customer satisfaction than UnitedHealthcare |
>> Read our full Blue Cross Blue Shield review.
UnitedHealthcare Vs Blue Cross Blue Shield: Plan Structures
UHC and BCBS are similar in available plan options, offering individual and family plans, Medicare Advantage (MA) plans and group health insurance plans for employees. Consumers can also add dental and vision benefits to their plans.
Plan |
UnitedHealthcare |
Blue Cross Blue Shield |
---|---|---|
Individual & Family |
✓ |
✓ |
Medicare Advantage |
✓ |
✓ |
Dental |
✓ |
✓ |
Vision |
✓ |
✓ |
Employer Group |
✓ |
✓ |
UnitedHealthcare Vs Blue Cross Blue Shield: Plan Availability
When it comes to individual and family health insurance plans, UHC and BCBS are tied, with availability in all 50 states. However, availability will vary by the type of health insurance plan.
MA plans through BCBS are available in 47 states, while plans through UHC are available in only 46 states. With this one-state difference, BCBS wins in this category.
However, UHC emerges victorious when it comes to MA plan popularity. UHC is the most popular Medicare Advantage provider, accounting for 28% (7.9 million) of all policies sold in 2022. BCBS sold only 14% (4.1 million) of policies.
UnitedHealthcare Vs Blue Cross Blue Shield: In-Network Providers
Both UHC and BCBS boast an extensive health insurance provider network, but BCBS has a slightly larger network. In partnership with 1.7 million doctors and hospitals nationwide, BCBS claims to have the largest health insurance network. UHC’s network includes 1.3 million medical care professionals and 6,500 hospitals, which is still impressive.
UnitedHealthcare Vs Blue Cross Blue Shield: Cost
With so many variables going into the cost of health insurance, pricing can vary greatly based on age, health history and other factors. Below are common factors that insurance companies consider when calculating your premium:
- Age
- Health habits (e.g., smoking, drinking)
- State
- Deductible
- Plan category (see below)
- Location
The plan category (or tier) that you choose will affect your monthly premium and out-of-pocket costs. Both BCBS and UHC sell health insurance plans in categories bronze, silver and gold. The plan category determines your costs but not the quality of care.
- Bronze: Plan with a low monthly premium, but higher out-of-pocket costs (e.g., deductible, copay, coinsurance).
- Silver: Plan with average monthly payments. Out-of-pocket costs are lower than a bronze plan but higher than a gold plan.
- Gold: Plan with higher monthly payments, but lower out-of-pocket costs.
Since UHC and BCBS both sell individual and family health insurance plans in all 50 states, you’ll want to compare quotes from both companies. Each company has their own methodology for calculating rates and you may find that company offers a cheaper price for the same coverage.
When shopping for Medicare Advantage plans, keep in mind that the premiums for Medicare Parts A and Part B are bundled into your MA plan premium. Part A is typically zero dollars if you’ve paid Medicare taxes for at least 10 years. Part B costs $170.10 per month in 2022 and will decrease to $164.90 in 2023.
UnitedHealthcare Vs Blue Cross Blue Shield: Coverage Limits
Each health plan is customized to the member’s budget and healthcare needs, so coverage limits will vary. Talk to your health insurance company and review your health history to determine which plan works best for you.
If you’re purchasing an MA plan through UHC or BCBS, be sure to confirm your out-of-pocket limit. MA plans must enforce a maximum on how much you pay in copays, coinsurance and deductibles each year. If you visit the doctor frequently, consider a plan with a lower annual limit since those copays can quickly add up.
Get Personalized Health Insurance Quotes Here
UnitedHealthcare Vs Blue Cross Blue Shield: Policy Management
UHC and BCBS members have the option to manage their policy by calling a representative, logging in through the online member portal or downloading the mobile app. Whether you use online services or access the mobile app, you can adjust or view various aspects of your policy, such as:
- Checking claims status
- Researching estimates for treatments
- Finding an in-network provider
- Accessing your electronic insurance card
Based on consumer reviews, Android users and iPhone users had a more favorable experience using UHC’s mobile app than BCBS.
Company |
Google Play Store |
Apple App Store |
---|---|---|
UnitedHealthcare |
4.5/5.0 |
4.7/5.0 |
Blue Cross Blue Shield |
3.17/5.0 |
3.12/5.0 |
Note: With BCBS, you will need to download the mobile app specific to your state. We took the average of BCBS apps in 10 states to provide the overall average rating above.
UnitedHealthcare Vs Blue Cross Blue Shield: Medical Loss Ratio
The 2022 Affordable Care Act established the medical loss ratio (MLR) to ensure that health insurance companies are using customer premiums to improve the quality of care. If a company does not spend at least 80% of premium dollars on improvements, they are required to refund the difference in the form of a refund to their customers. Both UHC and BCBS will be issuing rebates in 2022.
Members who purchased individual plans from UHC in Arizona, Maryland, Michigan, New Jersey, Tennessee and West Virginia should be expecting rebates, if they have not already. UHC also issued rebates for group plans in the below 26 states plus the District of Columbia:
|
|
|
In 2022, BCBS will also issue MLR in several states, including Texas, Massachusetts, North Carolina and Minnesota.
UnitedHealthcare Vs Blue Cross Blue Shield: Enrollment Process
Consumers can purchase an individual or family plan through the ACA health insurance marketplace during open enrollment. The next enrollment period runs from November 1, 2022 to January 15, 2023.
If you’re signing up for a Medicare Advantage plan, you will want to keep track of two enrollment periods. From October 15 to December 7, you can complete the following:
- Switch from Original Medicare to an MA plan
- Switch from one MA plan to another MA plan
- Join a Medicare drug plan or switch to another Medicare drug plan
- Drop Medicare drug coverage completely
The next Medicare enrollment period runs from January 1 to March 31. During this period, you can either switch from one MA plan to another MA plan or drop your MA plan and return to Original Medicare. During this period, you cannot switch from Original Medicare to an MA plan, join a Medicare drug plan or switch drug plans if you have Original Medicare.
Outside of enrollment periods, you may still be able to purchase an MA plan if you experience a qualifying event, such as these:
- Change in marital status
- Having or adopting a child
- Moving to a new address
- Losing health coverage
- Change in employment status
- Death of someone who shares your health plan
- Household income falls below the federal poverty level
- Becoming a U.S. citizen
UnitedHealthcare Vs Blue Cross Blue Shield: Policyholder Experience
BCBS ranked higher than UHC for overall customer satisfaction in all 22 geographic regions analyzed in a 2022 U.S. Commercial Member Health Plan Study by J.D. Power. This study ranked the top health insurance companies based on billing and payment, cost, coverage options, benefits, customer service and provider choice.
There were some instances in which UHC ranked below one BCBS company but ranked higher than another. For example, in the East South Central region, UHC ranked below BCBS of Alabama but ranked higher than BCBS of New York.
Consumer reviews also showed that UHC had a higher average rating than BCBS on Consumer Affairs, a consumer news and advocacy organization, and the Better Business Bureau.
Company |
UnitedHealthcare |
Blue Shield Blue Cross |
---|---|---|
Consumer Affairs |
4.0/5.0 |
3.3/5 |
BBB |
1.13/5 |
1/5 |
Note: BCBS ratings listed above are the average ratings of four different BCBS companies.
How To File Claims With UnitedHealthcare and Blue Cross Blue Shield
If you’re using a provider within your plan’s network, they will file a claim on your behalf with no action needed from you. However, there are some instances in which you may need to file a claim for reimbursement — if you’re charged upfront, for example. In this case, you would need to contact your health insurance company for the next steps. You can call the number on your health insurance card for more assistance. In some cases, you will be provided a claim reimbursement form and may need to mail it to the listed address.
If you see a provider out of network, then your insurance company will not cover your costs. You will need to pay for those services out of pocket.
UnitedHealthcare History
UnitedHealth Group was founded in 1977 by Richard Burke and went public in 1984. It was Dr. Paul Ellwood, who coined the term “health maintenance organization,” and who helped Burke establish UnitedHealth. In 1979, the company created the first network senior health plan.
Blue Cross Blue Shield History
Blue Cross Blue Shield 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.
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Key Takeaways
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Looking for a Medicare Advantage, family or individual health insurance plan in your area? Just enter your zip code below or call 855.214.2291 and we’ll match you with a health insurance plan with essential health benefits that match your coverage needs and budget.
SOURCES
- Statista. “Market Share of Leading Health Insurance Companies in the U.S. in 2021.” Accessed Oct. 12, 2022.
- UnitedHealthcare. “Find Health Insurance Plans for Individuals and Families.” Accessed Oct. 12, 2022.
- Blue Cross Blue Shield. “BCBS coverage Travels With You.” Accessed Oct. 12, 2022.
- UnitedHealthcare. “About Us.” Accessed Oct. 12, 2022.
- Blue Cross Blue Shield. “The Blue Cross Blue Shield System.” Accessed Oct. 12, 2022.
- UnitedHealthcare. “About UnitedHealthcare Medicare & Retirement,” Page 2. Accessed Oct. 12, 2022.
- Blue Cross Blue Shield Association. “2022 Medicare Advantage and Prescription Drug Plans Offered by Blue Cross and Blue Shield Companies.” Accessed Oct. 12, 2022.
- Kaiser Family Foundation. “Medicare Advantage in 2022: Enrollment Update and Key Trends.” Accessed Oct. 12, 2022.
- Medicare. “Costs.” Accessed Oct. 12, 2022.
- Centers for Medicare & Medicaid Services. “Medical Loss Ratio.” Accessed Oct. 12, 2022.
- Healthcare.gov. “When Can You Get Health Insurance?” Accessed Oct. 12, 2022.
- Medicare. “Joining a Health or Drug Plan.” Accessed Oct. 12, 2022.
- JD Power. “2022 U.S. Commercial Member Health Plan Study.” Accessed Oct. 12, 2022.
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