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Blue Cross Blue Shield Medicare Review

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Eric Stauffer is a former insurance agent and banker turned consumer advocate. His priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best...

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UPDATED: Nov 30, 2018

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One of the biggest names in healthcare, Blue Cross Blue Shield (BCBS) is actually a federation of various companies, each with their own service area. While all of the companies operated under the BCBS name and banner, their plans and service differ depending on the company and the state. Among the products offered by BCBS companies are individual and group health insurance, including marketplace plans, and Medicare options. BCBS has companies in every state as well as D.C. and Puerto Rico.

About BCBS

The two companies that form Blue Cross Blue Shield have separate histories that eventually came together. Blue Cross has its roots in the American Hospital Association, founded in 1929. A decade later they began using the symbol of the blue cross, and by 1960 the Blue Cross Association had become a household name.

Blue Shield was founded to provide coverage to workers in logging and mining camps in the Pacific Northwest, but it didn’t start officially offering health care policies until 1939 in California. The blue shield symbol came into use in 1948, and the company eventually started to use that name.

The two companies merged officially in 1982, creating a major healthcare company that would go on to license its recognizable name and symbols to smaller companies across the nation. These companies include big names like Anthem, Highmark, and Wellmark. In some states, there are several different BCBS plans in operation, while others have only one.

Both of the companies became Medicare administrators early on in the program; Blue Cross was, in fact, the first company licensed to administer Medicare plans. Today their offerings vary from company to company, which is similar to the way other large companies have different plans in various states. The main Blue Cross Blue Shield website directs visitors to the correct company for their area.

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BCBS Medicare Plans

Since there are so many companies with different plan options, it is difficult to create a full overview of the available products. For the purpose of this review, we will look at the plans offered in Southern California.

Our sample area has two companies to choose from: Anthem Blue Cross and Blue Shield of California. Both of these companies offer Medicare Advantage, Medicare Supplement, and Part D coverage.

Medicare Advantage

Blue Shield of California has two Medicare Advantage plans. Both are HMO plans and both have a $0 premium (above and beyond the regular Medicare premium).

We found few differences between the plans; both do not have a deductible and do not charge for office visits. The differences are slight, with one plan having a slightly lower out of pocket but a $5 specialist copay, while the other has no specialist copay but a slightly higher out of pocket limit. Both plans have prescription drug coverage, with the first plan offering a $0 copay on Tier one and the second a $3 copay.

Anthem Blue Cross offers a long list of Medicare Advantage plans in our sample area. Many plans are very similar that we found it difficult to understand why the company offers them all. Some of the plans appear to focus care on specific conditions.

Anthem Diabetes is a $0 premium plan that is designed specifically for people with diabetes. It is a zero premium and zero deductible plan without a copay for office visits either primary or specialist. The plan does not include Part D coverage.

Anthem Heart is much like the diabetes plan, but instead of offering coverage focused on diabetes, it provides access to heart-care specific services. There is also a similar plan called Anthem Breathe, and a fourth called Anthem Touch. We had a hard time clarifying what really differentiates these plans.

Anthem Value Plus is yet another $0 premium plan that is again very similar to the previous plans. Dental, vision, and hearing are included with this plan.

MediBlue Select is an HMO plan that is similar to the diabetes plan – no premium, no deductible, and no copay for either primary or specialist visits. Part D is not included, but vision and dental can be added for a monthly charge.

StartSmart Plus is also a no premium plan, but it has a $5 copay for primary care visits. Specialist copays vary from $0-20. Again, Part D is not included with this plan.

Anthem Connect is another zero-premium plan. It has no copays for specialist visits or primary care visits, and as with the other plans, there is no Part D coverage included.

Anthem Connect Plus is the first plan on the list with a premium due each month. This plan has a 20% coinsurance for both primary care and specialist visits. Vision, dental, and hearing coverage are all included with this plan, although Part D is not.

Mediblue Coordination Plus also has a premium, and it has very similar coverage to the Connect Plus plan.

Medicare Supplement

Medicare Supplement plan offerings again differ by state, although most states use the same letter-coded standardized system. That means that Plan A is Plan A, regardless of where you live.

On the Anthem site, five letter-coded plans are available. Plan A is the base plan, covering all coinsurance amounts and the first three pints of blood each year. Plans N and G are also available, as well as what is called Innovative Plan F. It is unclear how this differs from regular Plan F, which covers nearly all out of pocket costs, but is likely a deductible plan although we did not see a deductible listed.

All of Anthem’s Supplement plans offer the option to added dental, vision, or both.

We were unable to find any plans listed for our sample area on the Blue Shield of California website although they do appear to offer them in other zip codes.

Part D (Prescription Drugs)

Both of the two California companies we compared for Medicare Advantage also offer Part D.

Blue Shield of California has two plans. Rx Plus has a deductible of $405 and copays starting at $2, while the more expensive plan, Rx Enhanced, has no deductible, but slightly higher copays, starting at $4

Anthem has three Part D plans available. The first is similar to Blue Shield’s base plan, with a $405 deductible and copays starting at $1. The other two plans have no deductible, with similar copay amounts.

Rates

Both Anthem and Blue Shield offer rates right up front on their website.

As noted, both of Blue Shield’s Advantage plans are $0 premium plans. Anthem has a long list of $0 premium plans, and their most expensive plan is the Coordination Plus at $35.50 a month. It is worth noting that none of these plans includes Part D, which is why the rates are so low. Even with that in mind though, we found these rates to be very reasonable.

Anthem’s Part D plans are priced at $83.20 a month for the deductible plan and $119.90 a month for the first no deductible plan, and $169.80 a month for the highest-level plan.

Blue Shield’s two Part D plans are priced similarly, with the deductible option at $82.50 a month and the no deductible plan at $111.30 a month.

Finally, Plan A for Medicare Supplement at Anthem has a month cost of $126.17, while the high-end Plan F costs $172.80 a month.

On the whole, all of the rates we found were in line with other companies. Some were on the low side, including the Advantage plans. We found the Part D plans to be a bit pricey, but when combined with the Advantage plans they can add up to a reasonable rate overall. Anthem’s Supplement plans are a little expensive on the low end – Plan A, but pretty reasonable on the high end – Plan F.

Claims

Like most health insurance companies, both BCBS companies handle claims internally, directly with the provider. Since all of the plans we saw listed for Medicare Advantage are HMO plans, claims should be even more expedited and simple.

On rare occasions, policyholders may need to submit for reimbursement on Medicare plans, particularly if there is an emergency abroad. We were unable to find claims forms readily available on either website, but as huge companies, this is not surprising.

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Ratings and Consumer Reviews

Before we take a look at some of the ratings and reviews out there, it is worth noting once again that BCBS companies differ from state to state, and that reviews and ratings for the sample companies we selected do not apply to other BCBS branded companies. Take a look at the reviews for the BCBS company in your area for more specific information.

It should also be noted that these companies provide much more than Medicare, and ratings often reflect the business as a whole rather than Medicare plans specifically.

Anthem has many different Better Business Bureau (BBB) pages since they serve so many areas. Since we have focused this review on Anthem Blue Cross of California, which has an A+ rating with the BBB. There are 63 complaints on file in the past three years.

Anthem has seen an improvement in their Medicare Star ratings overall in the past few years. This report applies across the country, so the star ratings for each individual plan may vary.

There are 414 reviews on Anthem on Consumer Affairs; overall the star rating is just under two stars. There are a lot of complaints regarding claims being denied. Again, as noted previously, this applies to all of Anthem’s business and not just Medicare. When looked at from that angle, the complaint volume isn’t high.

Blue Shield of California has several BBB pages as well. Most of them have no rating, and the page for the San Francisco location has an F rating, something we rarely see. The site states the reason for this as the failure of the company to respond to 46 complaints and 12 complaints that were not resolved. 179 complaints in total are listed for the past three years. This may not apply to all areas of the state, but it is certainly very concerning.

Consumer Affairs has 210 reviews with an overall one-star rating. While this is not a huge number of complaints overall, considering this is also for all of the company’s business, combined with the BBB rating it looks a lot worse.

In general, Anthem appears to have a much better reputation than does Blue Shield.

The Bottom Line

BCBS companies are widely varied, and this review cannot touch on all of them. Based on what we have seen from two California companies, the number and type of plans vary greatly, as does the company reputation. If you are seeking Medicare coverage in California, Anthem appears to be a good bet. For coverage from any other BCBS company, we suggest checking out the individual reputation of the company before making a decision.

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

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Review Information

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About Eric Stauffer

Author: Eric StaufferI am a former insurance agent and banker turned consumer advocate. My priority is to help educate individuals and families about the different types of insurance they need, and assist them in finding the best place to get it.

1 Comment

  1. Why does Blue Cross start their yearly plan in April, so we are unable to compare with other plans in the open enrollment period of Nov 15th- Dec 7. When I called them, they said they did not know their 2018 rates.

    Reply

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