Blue Cross Blue Shield (BCBSA) offers plans to more than 110 million persons through 34 separate companies, and on nearly all State and Federal Health Insurance Exchanges. Open Enrollment of individuals, families and businesses begins in November each year, although plans are offered year-round with an SEP exception. Medical coverage is offered through a network of brokers and reputable websites like ours in every state. Coverage can also be purchased directly through the local carrier. 170 additional countries throughout the world are part of the BCBS trademark and many ancillary products are offered.
Group policies are offered through large and small employers, and Senior Medicare plans (Advantage (MA), Medicare Supplement, and Part D prescription drug) are available in all states. Their Federal Employee program covers an additional 5 million persons. More than 95% of the nation’s hospitals accept network coverage, and provide substantial discounts to existing customers. The same percentage of doctors and specialists participate in a network, and are able to offer significant cost reductions. International coverage is also available.
Previously absent from most of the Marketplaces were Aetna, Cigna, Humana, and UnitedHealthcare, four of the largest health insurers in the US. Currently, they are active in every state, offering consumers choices of many types of private and Senior Medigap policies. Aetna, UnitedHealthcare, and Cigna have expanded their Exchange coverage area and offer 2022 plans in many states. Ambetter (Centene) also offers Marketplace plans in several states.
Another giant carrier, Kaiser, is only active in several states, while many smaller carriers, such as Ambetter and Oscar operate in a handful of states. Oscar, a newer company, is slowly expanding into additional states, and increasing their service area in Ohio. Medicare Supplement (Medigap) plans have not been significantly impacted by legislative changes. Most of the recent changes affect applicants under age 65.
History of BCBS
The Blues companies are the most recognizable name of all carriers. They insure more persons than any other company and offer plans to children, adults, Seniors, self-employed persons, small companies, and large corporations. They will continue to succeed if they offer affordable health insurance prices and of course, put some profit in their pocket. Can this continue? Yes. Especially if healthy young persons enroll in the Marketplace…and of course, stay out of the hospital! By negotiating lower pricing from physicians, specialists, medical facilities, and hospitals, consumers that purchase their products often enjoy lower out-of-pocket costs.
Their track record is impressive. For about 80 years, policies have been offered in all states, and just about every county in the US. Although some Blues companies are “for profit,” and others aren’t, it’s still the most recognizable name in the industry. Between call centers and retail sales locations, you can purchase a policy from multiple locations, including our website which gives you direct pricing. Although temporary coverage is generally no longer offered by BCBS, ancillary plans, such as dental, vision, and hearing, are available privately or through an employer. Large group and small group healthcare coverage can be easily customized to match employee needs.
US Blue Cross Blue Shield Companies
Alabama – BCBS of Alabama
Alaska – Premera BCBS of Alaska
Arizona – BCBS of Arizona
Arkansas – Arkansas BCBS
California – Blue Shield of California and Anthem Blue Cross
Colorado – Anthem BC and BS of Colorado
Connecticut – Anthem BCBS Connecticut
Delaware – Highmark BCBS Delaware
District of Columbia – CareFirst BCBS
Florida – Florida Blue
Georgia – BCBS of Georgia
Hawaii – BCBS of Hawaii
Idaho – Regence Blue Shield of Idaho and Blue Cross of Idaho
Illinois – BCBS of Illinois
Indiana – Anthem BCBS of Indiana
Iowa – Wellmark BCBS
Kansas – BCBS of Kansas
Kentucky – Anthem BCBS Kentucky
Louisiana – BCBS of Louisiana
Maine – Anthem BCBS Maine
Maryland – CareFirst BCBS
Massachusetts – BCBS of Massachusetts
Michigan – BCBS of Michigan
Minnesota – BCBS of Minnesota
Mississippi – BCBS of Mississippi
Missouri – BCBS of Kansas City and Anthem BCBS of Missouri
Montana – BCBS of Montana
Nebraska – BCBS of Nebraska
Nevada – Anthem BCBS Nevada
New Hampshire – Anthem BCBS New Hampshire
New Jersey – Horizon BCBS of New Jersey
New Mexico – BCBS of New Mexico
New York – Excellus BCBS, Highmark BlueShield of Northeastern New York, Highmark BCBS of Western New York, and Empire BCBS
North Carolina – BCBS of North Carolina
North Dakota – BCBS of North Dakota
Ohio – Anthem BCBS Ohio
Oklahoma – BCBS of Oklahoma
Oregon – Regence BCBS
Pennsylvania – Independence Blue Cross, Highmark BCBS, Highmark Blue Shield, and Capital BlueCross
Puerto Rico – BSBS of Puerto Rico
Rhode Island – BCBS of Rhode Island
South Carolina – BCBS of South Carolina
South Dakota – Wellmark BCBS
Tennessee – BCBS of Tennessee
Texas – BCBS of Texas
Utah – Regence BCBS
Vermont – BCBS of Vermont
Virginia – Anthem BCBS Virginia and CareFirst BCBS
Washington – Premera Blue Cross and Regence BlueShield
West Virginia – Highmark BCBS West Virginia
Wisconsin – Anthem BCBS Wisconsin
Wyoming – BCBS of Wyoming
US Market Share
In many areas, they are still the biggest player, including large states California, Florida, New Jersey, Michigan, New York, Pennsylvania, and Ohio. Several of the states that they are not the largest provider include Hawaii, Maryland, Nevada, Oregon and Utah. In secondary medical coverage, they are still not the major force that they would like to be. But that could change by the end of the decade, as additional ancillary products are introduced. Short-term plans have been offered in many areas with limited covered pre-existing conditions. Although not ACA-compliant, temporary plans are offered outside of Open Enrollment periods.
Although BCBS is seeking to to expand their market share, growth, and potential, other big carriers, such as Humana, Aetna, and UnitedHealthcare, are taking a more cautious approach. They’ll carefully study Marketplace results in their target states, and determine which areas to offer plans for 2023. It’s also possible these carriers will continue to underwrite additionally non-Exchange plans. Short-term coverage continues to expand, and if profitability remains high, the Blues companies may expand offerings in additional states. Recently, in Ohio and Indiana, temporary plans began to be offered with some pre-existing conditions covered.
Since BCBS can not increase Exchange plan premiums because of pre-existing conditions (other than smoking), there have been many unhealthy applicants that have been required to be approved, that were perhaps declined seven years earlier. So to offset the large anticipated increase in claims, it’s critical, as mentioned earlier, that a large amount of persons under age 30 purchase coverage, since they are unlikely to have many claims. Catastrophic plans are offered that provide three (or more) pcp office visits with a low copay.
So how can the Blues reach out to the younger segment of the population and convince them to purchase a policy, especially when many of them have never bought coverage before. One way is educating consumers about the specifics of benefits they will receive, and the federal tax subsidy that could drastically reduce their premium. Maternity and treatment and counseling for mental illness are covered, which is appealing to many younger applicants. Federal subsidies increase each year, which as helped keep premiums steady, and in some states, occasionally reduce.
In several states, there already are community outreach programs in place, which include churches, local business organizations, soup kitchens and volunteer groups. These groups of people not only potentially increase the number of customers Blue Cross Blue Shield will write, but they provide easier access of information to many persons that aren’t aware of their healthcare options or are not actively utilizing the internet. The free education for consumers is available online and often in-person also.
Formation Of State Exchanges
Each State Exchange was previously set up one of three ways. The federal government can control the operation. The state government can control the operation. Or, it can be a partnership of both governments (seven states have chosen this option). Currently, 30 states are federally-facilitated, 15 states are state-based, and 6 states utilize a state-based Marketplace federal platform. HHS performs all duties and functions when federally-facilitated. State-based platforms can provide their own customer-assistance, partner platforms allow federal-run functions, and state-based Marketplaces perform most functions.
One of the big advantages of a state-run Marketplace is that the local legislature can enact laws that are pertinent to that particular state, as opposed to parts of the country hundreds of miles away. It’s also possible that a state-operated program will simply be less costly and employ more local residents than a federally-operated program. And of course, most consumers have a bigger influence on a non-federal entity.
20 States With Largest Blue Cross (Or Affiliated Company) Marketplace Enrollments
California – Anthem 741,000
North Carolina – BCBS Of NC 418,000
Arkansas – Arkansas BCBS 271,000
Maryland – CareFirst 251,000
Michigan – BCBS Of Michigan 239,000
South Carolina – BCBS Of SC 239,000
Virginia – Anthem 230,000
Tennessee – BCBS Of Tennessee 220,000
New Jersey – BCBS Of NJ 205,000
Alabama – BCBS Of AL 179,000
Pennsylvania – Independence Blue Cross 174,000
Arizona – BCBS Of Arizona 139,000
Washington – Premera BC 135,000
Minnesota – BCBS Of Minnesota 116,000
Kentucky – Anthem 115,000
Iowa – Wellmark BCBS 115,000
Kansas – BCBS Of Kansas 96,000
Indiana – Anthem 98,000
Nebraska – BCBS Of NE 72,000
Idaho – Blue Cross Of ID 70,000
10 States With Largest Blue Cross (Or Affiliated Company) Group Enrollments
California – Anthem 1,594,664
Michigan – BCBS of Michigan 993,258
Massachusetts – BCBS of Massachusetts 699,811
Pennsylvania – Highmark 609,455
Maryland – CareFirst BCBS 553,854
Virginia – Anthem 480,617
Ohio – Anthem 435, 888
Georgia – Anthem 434,693
Washington – Premera BC 310,637
Wisconsin – Anthem 157,949
Blue Cross Medicare Coverage For Seniors
Advantage Plans (Part C), prescription drug coverage (Part D), Medigap (Supplement), and Cost Plans (cover Parts A and B) are available. Low-income families and single persons, along with applicants with disabilities, may be eligible for both Medicare and Medicaid. BCBS, UnitedHealthcare, and Humana together issue more than half of new Medicare Advantage enrollments. Other carriers that issue a significant number of plans include Kaiser Permanente, Cigna, Aetna, and WellCare.
Blue Cross is well-represented when comparing carrier market share for in-force Medicare Supplement plans. Last year, the top-10 companies accounted for about 70% of the market with approximately 9 million enrollments. These companies are (in order) UnitedHealthcare, Mutual Of Omaha, Aetna, HCSC, Anthem, Cigna, CNO Financial, Humana, BCBS of Massachusetts, and Wellmark BCBS. The nine companies with the largest MA (Medicare Advantage) market share are (in order) Humana, UnitedHealthcare, Aetna, BCBS, Anthem, Centene, Wellcare, Kaiser, and Cigna
BCBS Medicare Supplement plans are offered in the following states: Colorado, California, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, Virginia, and Wisconsin.
Blue Cross Blue Shield offers plans in all states. They will continue to insure more individuals and families in the Exchanges than any other company. They believe that affordable prices can be offered to consumers and still leave room for a profit. It’s in everyone’s best interest that they are right.
Blue Cross Medicare Advantage Plans In Selected States
Alabama – Blue Advantage Complete, and Blue Advantage Premier.
California – Anthem MediBlue Plus, Anthem MediBlue Connect Plus, Anthem MediBlue Coordination Plus, Anthem MediBlue Diabetes Care, Anthem MediBlue Heart Care, Anthem MediBlue Extra, Anthem MediBlue StartSmart Plus, Blue Shield Advantage Optimum, Blue Shield Coordinated Choice, Blue Shield Inspire, Blue Shield 65 Plus, Blue Shield 65 Plus Plan 2, Blue Shield AdvantageOptimum Plan, Blue Shield Balance, Blue Shield TotalDual Plan, and Blue Shield Vital.
Colorado – Anthem MediBlue Access, Anthem MediBlue Care On Site, Anthem MediBlue Diabetes Care, Anthem MediBlue Dual Advantage, Anthem MediBlue Plus, and Anthem MediBlue ESRD Care.
Florida – BlueMedicare Choice, BlueMedicare Classic, BlueMedicare Complete, BlueMedicare Premier, BlueMedicare Saver, BlueMedicare Select, and BlueMedicare Value.
Iowa – Blue Medicare Advantage Enhanced, Blue Medicare Advantage HMO, and Blue Medicare Advantage PPO.
Louisiana – Blue Advantage HMO and Blue Advantage PPO.
Missouri – Anthem MediBlue Access, Anthem MediBlue Access Basic, Anthem MediBlue Dual Advantage, Anthem MediBlue Plus, Anthem MediBlue Service, Blue Medicare Advantage Essential, Blue Medicare Advantage Flex, and Blue Secure.