Blue Cross Blue Shield Review

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Blue Cross Blue Shield Insurance Overview

The Blue Cross Blue Shield Association is made up of almost 40 different insurance organizations throughout the United States. It operates as a federation, and insurance companies are licensed to operate under the Blue Cross Blue Shield Banner.

The organization itself is a not-for-profit outfit that has come together from a collection of previous non-profit healthcare federations, including the original Blue Cross, and the original Blue Shield. The history of the organization dates back to 1929, when the original Blue Cross was established.

Since the organization is a network of insurance companies rather than one large business, consumers may find different levels of care and customer service depending on what underlying company they are working with. This review will cover Blue Cross Blue Shield as a whole, where possible, based on consumer data readily available.

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Blue Cross Blue Shield Products

Blue Cross Blue Shield offers insurance products for individuals, families and businesses. As one of the largest health care provider networks in the United States, their product offerings reflect the large scale at which they operate. Some of their most popular products include:

  • Individual Health Insurance
  • High-Deductible Health Insurance
  • Health Savings Accounts
  • Dental Insurance
  • Small Business Health Insurance
  • Corporate Health Insurance

Blue Cross Blue Shield Consumer Complaints

Since Blue Cross Blue Shield operates independently throughout the United States, there are dozens of Better Business Bureau entries for the company, most by state. Since they are headquartered in Chicago, Illinois, this review will use the Illinois BBB rating.

Blue Cross Blue Shield is not accredited with the Better Business Bureau and currently has an F rating. The first complaint was filed with the BBB in 1941. In the previous three years there have been 151 complaints lodged against Blue Cross Blue Shield, and 38 in the past 12 months.

The number one complaint according to the BBB website surrounds problems with the products and services, with billing and collection coming in second. The BBB currently shows 7 complaints in which Blue Cross Blue Shield has not resolved the issue, and an additional 8 in which there was no response from the business whatsoever.

Blue Cross Blue Shield Consumer Research Reports

J.D. Power and Associates – According to J.D. Power’s 2012 US Member Health Plan Study, Blue Cross Blue Shield scored just above average when factoring together the three largest population centers. California came in the lowest with an overall rating of 2 out of 5, while the Texas arm scored 5 out of 5 and was rated best overall in the state.

Consumer Reports –Information from Consumer Reports about Blue Cross Blue Shield proved to be sparse, at best, with California being the only state in which there was data. For the PPO plans the company was divided into two organizations, one Blue Cross and one Blue Shield. Blue Cross scored 80 out of 100, which is about average. Blue Shield, however, scored a 63 which is the lowest score recorded in any review up to this point.

For information on how we use consumer research reports, click here.

Blue Cross Blue Shield Financial Ratings

A.M. Best Rating – A

Fitch Rating – A-

S & P Rating – A+

Blue Cross Blue Shield Overall Rating

Positive

Blue Cross Blue Shield is a very large organization that operates in some capacity within every state in the United States. They offer individual, family and business plans to fit just about every need available. The underlying organization is not-for-profit, which at least in theory is a good thing.

Negative

Since the organization is broke up into smaller groups that are state specific, care can range wildly depending on what state you are in. The ratings range from below average to best depending on what state is being examined.

The Better Business Bureau rating as well as the Consumer Reports review are below average. In addition, Standard and Poor’s credit rating of Blue Cross Blue Shield puts them at a C+.

For a list of companies that we recommend, visit our Best Insurance Companies page.

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Summary
Reviewer
Eric Stauffer
Review Date
Reviewed
Blue Cross Blue Shield
Author Rating
2

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Comments

  1. Karen says

    I had Blue Cross Dental and of course I paid the quarterly payment bc there are only to option of payment “Quarterly and yearly” when I went to pay my quarterly payment BLue Cross told me I didn’t have insurance! How is that possible? the Rep told me I only paid for one month, that’s impossible bc that’s not even an option. So for 2 months I didn’t have insurance when I paid 3 months in advice in full, sounds like fraud to me! Also I had to cancel dental appointment that were already schedule. Most importantly where did my money go? and how come I cant have my dental insurance??????

  2. Beverly Thomas says

    On April 30, 2014 I called blue cross blue shield to cancel my health insurance. I called at 9:30am to make a long story short I was bounced around to 5 people the 5th person that I finally talked to was at 11:45am. I have yet to receive back into my checking account $579,29 and by the way the 5th person was very understanding of my frustration and very helpful . She told me she had taken care of the cancellation.

  3. Toby Lovato says

    I am a federal goverment employee and I have Blue Cross and Blue Shield of Arizona under the Federal Employees Benefit Program. My heart doctor ordered a CT scan for me to take. I took the exam. All indication it came out negative for any coronary problems. Now BCBS of Arizona is refusing to pay the bill in accordance to the payment schedule. Of which I’m responsible for only the copay. BCBS of Arizona has determined that the the procedure was unnecessary and have indicated that I’m responsible for the entire amount.
    Of my 30 plus years of service, I have never experienced this with any of the health insurance plans I have signed up for and pain into.
    I plan to appeal this decision. Also to make the necessary complaints etc..
    Very dissappointed in the health insurance industry.

    • Eric Stauffer says

      Hello Toby,

      I am sorry to hear about the situation you are finding yourself in.

      You are right to file an appeal. That should be the first course of action. It gives them a chance to review and see if it was a mistake. Why my first child was born, nearly 50% of the medical bills we received had some error attached to it.

      If the appeal does not work, it may make sense to get a lawyer that specializes in these types of cases involved. You can also file a complaint with the insurance commissioner in Arizona.

      Arizona Insurance Commissioner Complaints

      They can not always do something about it, but it is worth a shot.

      Finally, if you are part of a union as a federal employee, try notifying your representative. They can have a lot more sway than an individual policyholder.

      Good luck.

      Eric Stauffer

    • Lori Powell says

      I am a federal employee with BCBS (FL) I have had ongoing checkups since I was diagnosed with ovarian cancer in 2011. The doctor has ordered an MRI every 6 months (as reoccurence of the disease is most likely 2-3 years after chemo). I had MRIs performed in 2012 and 2013 and then I last one in Jan 2014 was denied as medically unnecessary. I am appealing.

  4. RoseMarie Smith says

    I had Blue Cross Blue Shield of Illinois through my employment at WalMart . During that time I was injured 11/19/2009 and had to use diablility. The case was closed the following year. I now have the problem that Medicare says there is still an open case from that time and as a result is not paying bills submitted to them. Would you please close that case and sent me written confirmation.
    Thank you,
    RoseMarie Smith

    • Eric Stauffer says

      Hello RoseMarie,

      We are not actually affiliated with Blue Cross Blue Shield, so you will want to contact them directly for any issues related to a past account. I imagine you already have their contact information, but here it is again just in case:

      http://www.bcbsil.com/contact_us/

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