Anthem vs. Blue Cross Blue Shield: What's the Difference? | SmartFinancial (2024)

While Anthem is within the Blue Cross Blue Shield (BCBS) group, there are cases when Anthem and BCBS health plans are sold in the same state. In this Anthem vs. Blue Cross Blue Shield mashup, we’ve found that BCBS performs better overall than Anthem, offering coverage in all 50 states compared to Anthem’s 14 and outperforming Anthem in user reviews.

Read our Blue Cross Blue Shield vs. Anthem comparison to see which company is best for your health insurance needs.

Key Takeaways

  • Anthem health plans are not accessible to most U.S. citizens as the company serves only 14 states, whereas BCBS has a presence in all 50 states.
  • That said, Anthem is also licensed with Blue Cross Blue Shield so if you will likely find a BCBS health plan if Anthem is unavailable where you live.
  • In a 2023 J.D. Power Study, BCBS ranked higher than Anthem for customer satisfaction in more instances and regions.
  • Both companies offer diverse healthcare plans including HMO, PPO, CDHP, EPO, FSA, HMO-POS, Indemnity, HSA, Medicaid and Medicare.
  • Anthem utilizes Blue Cross Blue Shield’s network of 1.7 million healthcare providers.

On This Page

  • History of Anthem
  • History of Blue Cross Blue Shield
  • Anthem vs. Blue Cross Blue Shield: Quick Glance
  • Anthem vs. Blue Cross Blue Shield: Plan Structures
  • Anthem vs. Blue Cross Blue Shield: Plan Availability
  • Anthem vs. Blue Cross Blue Shield: In-Network Providers
  • Anthem vs. Blue Cross Blue Shield: Cost
  • Anthem vs. Blue Cross Blue Shield: Policy Management
  • Anthem vs. Blue Cross Blue Shield: Coverage Limits
  • Anthem vs. Blue Cross Blue Shield: Medical Loss Ratio
  • Anthem vs. Blue Cross Blue Shield: Enrollment Process
  • Anthem vs. Blue Cross Blue Shield: Policyholder Experience
  • How To File Claims With Anthem and Blue Cross Blue Shield
  • FAQs

Anthem vs. Blue Cross Blue Shield: What's the Difference? | SmartFinancial (15)

History of Anthem

In 2004, WellPoint Health Networks Inc. and Anthem, Inc. merged and became the nation’s leading health benefits company.[1] In December 2014 WellPoint Inc. changed its corporate name to Anthem, Inc and in 2022, Anthem rebranded to Elevance Health.[2][3] In 2023, Elevance Health was ranked 22nd on the Fortune 500.[4]

Click to read our full Anthem review.

History of Blue Cross Blue Shield

Blue Cross Blue Shield traces its roots back to 1929 when Blue Cross partnered with Baylor University Hospital to bring affordable healthcare to financially struggling patients, especially educators. In fact, the initial payment plan cost just 50 cents each month for up to 21 days of hospitalization over a one-year term. Today, BCBS is a network of regional and independently-operated health insurance companies with a presence in all 50 states.[5]

Click to read our full Blue Cross Blue Shield review.

Anthem vs. Blue Cross Blue Shield: Quick Glance

Comparison

Anthem

Blue Cross Blue Shield

Plan Types

HMO, PPO, CDHP, EPO, FSA, HMO-POS, Indemnity, HSA, Medicaid, Medicare, POS

HMO, PPO, CDHP, EPO, FSA, HMO-POS, Indemnity, HSA, Medicaid, Medicare, POS

Availability

14 states (varies by plan type)

50 states (varies by plan type)

Coverage Limit

Varies

Varies

Deductible

Varies

Varies

Maximum Annual Benefit

Varies

Varies

Waiting Period

Varies

Varies

Providers In-Network

1.7 million

1.7 million

Covers Telehealth

Yes

Yes

Policy Management

Mobile app, online account, phone

Mobile app, online account, phone

Anthem Pros and Cons

Pros

Cons

Access to BCBS’ network of 1.7 million providers

Available in only 14 states

Blue Cross Blue Shield Pros and Cons

Pros

Cons

Available in all 50 states

Medicare Advantage (MA) plans not available in all states

Has a provider network of 1.7 million

Accepted by 80% of doctors and 90% of hospitals in the U.S.[6]

Anthem vs. Blue Cross Blue Shield: Plan Structures

Anthem and Blue Cross Blue Shield offer diverse healthcare plans including HMO, PPO and POS, as well as specialized options like CDHP, EPO and HDHP. They also provide supplementary services such as FSA, HMO-POS, HSA, indemnity plans, Medicaid and Medicare. These providers cater to both individual and family needs and offer employer-sponsored plans with dental and vision coverage.

Plan

Anthem

Blue Cross Blue Shield

Dental

Family

Individual

Medicaid

Medicare

Vision

Group

Anthem vs. Blue Cross Blue Shield: Plan Availability

Blue Cross Blue Shield takes home the gold in this round with availability in every state. Keep in mind, however, that BCBS does not sell Medicare Advantage plans in Alaska, Mississippi or Wyoming.[7]

Anthem lags behind BCBS when it comes to availability, offering individual and family coverage in only the 14 states below:[8]

  • California
  • Colorado
  • Connecticut
  • Georgia
  • Indiana
  • Kentucky
  • Maine
  • Missouri
  • Nevada
  • New Hampshire
  • New York
  • Ohio
  • Virginia
  • Wisconsin

Keep in mind that Anthem health plans may operate under different names in certain states, such as Rocky Mountain Hospital in Nevada or Community Insurance Company in Ohio.[9]

Anthem vs. Blue Cross Blue Shield: In-Network Providers

Anthem and Blue Cross Blue Shield are on even footing when it comes to network size but this is largely because Anthem is licensed with BCBS. BCBS boasts a considerable network of 1.7 million healthcare service providers across all 50 states.[10] While Anthem serves only 14 states, its relationship to BCBS gives Anthem’s policyholders access to BCBS’ larger network.[11]

Anthem vs. Blue Cross Blue Shield: Cost

Rates are highly customized and based on the individual’s health profile and budget so it’s difficult to make a fair pricing comparison between Anthem and BCBS. Premium costs for all health insurance companies differ based on factors such as age, lifestyle habits like smoking, location, deductible level, plan type and insurance provider. In addition, your plan’s tierwill influence your out-of-pocket expenses and monthly premium.

Anthem vs. Blue Cross Blue Shield: What's the Difference? | SmartFinancial (16)

Anthem vs. Blue Cross Blue Shield: Policy Management

Anthem and Blue Cross Blue Shield offer online portals and mobile apps for policy management, including doctor searches, coverage reviews and claims tracking. As for which company has the better app, it will depend on the region.

To share some examples, in Illinois, the BCBS app is rated less favorably than the Anthem app but have the same star rating as the Anthem app on the Apple App store in California and Florida. The Anthem app is called Sydney Health.

Company

Google Play Store

Apple App Store

Anthem

4.7/5 stars[12]

4.8/5 stars[13]

Blue Cross and Blue Shield of Illinois

3.3/5[14]

3.2/5[15]

Blue Shield of California

4/5[16]

4.8/5[17]

Florida Blue

4.6/5[18]

4.8/5[19]

Anthem vs. Blue Cross Blue Shield: Coverage Limits

Anthem and Blue Cross Blue Shield, like all health insurance companies, can't set financial limits on essential medical services, which include outpatient and inpatient care, urgent needs, lab tests, mental health, child and maternal care, medications, chronic condition management and rehab devices.

Anthem vs. Blue Cross Blue Shield: Medical Loss Ratio

The Medical Loss Ratio (MLR) is a metric used to determine how much of the premium income collected by a health insurance company is actually spent on medical care and improving the quality of services. By law, insurers are required to spend at least 80% of the premiums collected from individual health insurance plans and 85% from group plans on healthcare services.[20]

Elevance Health reported an 87% MLR for 2023 so policyholders will not be receiving any rebates for that reporting year.[21] As for BCBS, whether rebates will be issued will depend on which entity serves your region. Several BCBS companies are still gathering data for the 2023 reporting year but there were some instances when 2022 MLR rebates were issued. For example, BCBS of Montana did not issue any 2022 MLR rebates but BCBS of Massachusetts did.[22][23]

Anthem vs. Blue Cross Blue Shield: Enrollment Process

The annual open enrollment period for buying individual health plans from your state’s marketplace starts November 1st, allowing you to choose from Anthem and Blue Cross Blue Shield plans on the health insurance marketplace depending on where you live.[24] It may be possible to enroll outside of the individual sign-up period if a significant life event occurs, such as gaining U.S. citizenship, starting a new job or getting married. Meanwhile, the first opportunity to switch from Original Medicare to a Medicare Advantage plan each year is on October 15.[25]

Anthem vs. Blue Cross Blue Shield: Policyholder Experience

Of the three review platforms reviewed, BCBS ranked higher than Anthem on two of them and equally on one of them:

Company

Anthem Rating

Blue Cross Blue Shield Rating

BestCompany

1/5[26]

3.0/5[27]

Affordable Health Insurance

4.6/5[28]

4.6/5[29]

BBB

1.08/5[30]

1.12/5[31]

A J.D. Power and Associates 2023 study of customer satisfaction with commercial member health plans compared several healthcare providers, including Anthem and BCBS, in several regions. In the eight regions where both a BCBS company and Anthem were among the top companies, a BCBS company outperformed Anthem in four of those regions.[32]

However, there were some regions where Anthem was ranked lower than one BCBS company but higher than another, which was the case in the east south central and heartland regions. Both Anthem and a BCBS company were tied as the top-ranked health insurance companies in the northeastern region.[32]

How To File Claims With Anthem and Blue Cross Blue Shield

For both companies, in-network providers will file a claim with your health insurance company on your behalf when you receive services. However, if you opt for out-of-network care, you'll typically be responsible for submitting the claim yourself.

To seek reimbursem*nt, Anthem members should either obtain a claim form by request or download it from the available forms section on their website, then follow the provided filing guidelines.

BCBS members can submit claims electronically or by mail. Customers can use the Real-Time Claims web tool for electronic claims submissions or by signing up for the Electronic Data Interchange (EDI).

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FAQs

Does Blue Cross cover Lasik?

In general, health insurance does not cover LASIK surgery if it’s a voluntary procedure but it may cover it if it’s considered medically necessary. That said, some LASIK providers offer discounts on LASIK procedures to individuals with a BCBS vision plan.[33]

Is Anthem the same as Blue Cross?

Anthem is licensed with the Blue Cross Blue Shield Association. In some locations, you may see both companies listed in the company name, such as “Anthem Blue Cross and Blue Shield Missouri.”

What is a flexible spending account by Blue Cross?

A Blue Cross flexible spending account allows you to designate money for medical, dental and vision expenses or dependent care. You accumulate money in your account through pre-tax deductions from your paycheck.[34]

Sources

  1. Library of Congress. “Anthem, Inc.” Accessed April 25, 2024.
  2. Los Angeles Times. “Anthem, WellPoint Merger Is Complete.” Accessed April 25, 2024.
  3. Elevance Health. “Corporate Rebranding to New Name, Elevance Health, Inc.” Accessed April 25, 2024.
  4. Fortune. “Elevance Health.” Accessed April 25, 2024.
  5. Blue Cross Blue Shield. “The Blue Cross Blue Shield System.” Accessed April 25, 2024.
  6. Blue Cross Blue Shield. “Largest Network.” Accessed April 25, 2024.
  7. Blue Cross Blue Shield Association. “2023 Medicare Advantage and Prescription Drug Plans Offered by Blue Cross and Blue Shield Companies,” Pages 1-23. Accessed April 25, 2024.
  8. Anthem. “Individual & Family Health Insurance Plans.” Accessed April 25, 2024.
  9. Anthem. “About Us: Anthem Blue Cross and Blue Shield.” Accessed April 25, 2024.
  10. Anthem. “Individual & Family Health Insurance Plans.” Accessed April 25, 2024.
  11. Blue Cross Blue Shield. “The Blue Cross Blue Shield System.” Accessed April 25, 2024.
  12. Google Play. “Sydney Health.” Accessed April 25, 2024.
  13. Apple App Store. “Sydney Health.” Accessed April 25, 2024.
  14. Google Play Store. “BCBSIL.” Accessed April 25, 2024.
  15. Apple App Store. “BCBSIL.” Accessed April 25, 2024.
  16. Google Play Store. “Blue Shield of California.” Accessed April 25, 2024.
  17. Apple App Store. “Blue Shield of California.” Accessed April 25, 2024.
  18. Google Play Store. “Florida Blue.” Accessed April 25, 2024.
  19. Apple App Store. “Florida Blue.” Accessed April 25, 2024.
  20. Centers for Medicare and Medicaid Services. “Medical Loss Ratio.” Accessed April 25, 2024.
  21. Elevance Health. “Elevance Health Reports Results for Fourth Quarter and Full Year 2023; Sets Full Year 2024 Outlook.” Accessed April 25, 2024.
  22. Blue Cross Blue Shield of Montana. “Affordable Care Act (ACA) 2022 Medical Loss Ratio (MLR) Rebates.” Accessed April 25, 2024.
  23. Blue Cross Blue Shield of Massachusetts. “Medical Loss Ratio (MLR) Rebate 2023 FAQ,” Page 1. Accessed April 25, 2024.
  24. Healthcare.gov. “When Can You Get Health Insurance?” Accessed April 25, 2024.
  25. Medicare. Joining a Plan.” Accessed April 25, 2024.
  26. BestCompany. “Anthem.” Accessed April 25, 2024.
  27. BestCompany. “Blue Cross Blue Shield.” Accessed April 25, 2024.
  28. Affordable Health Insurance. “Anthem Health Insurance Review.” Accessed April 25, 2024.
  29. Affordable Health Insurance. “Blue Cross Blue Shield Review.” Accessed April 25, 2024.
  30. Better Business Bureau. “Anthem Blue Cross Blue Shield.” Accessed April 25, 2024.
  31. Better Business Bureau. “Blue Cross & Blue Shield.” Accessed April 25, 2024.
  32. J.D. Power. “Commercial Health Plan Member Satisfaction Declines in Key Areas, J.D. Power Finds.” Accessed April 25, 2024.
  33. Kelly Vision Center. “Is Cataract Surgery Covered by Blue Cross Blue Shield?” Accessed April 25, 2024.
  34. Excellus BlueCross BlueShield. “Flexible Spending Account (FSA).” Accessed April 25, 2024.
Anthem vs. Blue Cross Blue Shield: What's the Difference? | SmartFinancial (2024)

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