Anthem Blue Shield and Blue Cross is one entity that offers health insurance coverage in many states.
Not so in California.
Their website notes that the Blue Cross Blue Shield System is made up of 35 independent and locally operated companies. In fact, the various trade names for the Blue Cross Blue Shield Association companies differ in certain states. And, in California, Anthem Blue Cross and Blue Shield of California are actually separate and competing companies.
According to the corporate write-up in Wikipedia,
“Blue Cross Blue Shield Association is a federation of 35 separate United States health insurance companies that provide health insurance in the United States to more than 106 million people.”
A Look at Anthem Blue Cross
As we noted here, Anthem Blue Cross is the trade name of Blue Cross of California, part of the Anthem Blue Cross Blue Shield, or Anthem BCBS, system.
Anthem Blue health insurance offers affordable health coverage for members in California, as well as dental and vision coverage.
As the California subsidiary of Anthem, Inc., Anthem Blue Cross is a separate company from Blue Shield in the state of California. The insurance provider offers HMO, PPO, EPO, and Health Savings Account (HSA) compatible plans for small groups, large groups, and seniors. Employee group members are provided integrated health care and intuitive online tools.
Anthem is the second-largest medical insurance provider in the U.S. for total members, with over 40 million covered, and was given an A rating from A.M. Best in 2021. Their network includes 330 acute care hospitals, as well as 52,874 contracted physicians and specialists.
Anthem’s PPO networks are extensive and include most doctors and hospitals. With over 8.3 million members just in California, Anthem Blue Cross provides coverage for more Californians than any other health insurance provider in the state.
“Anthem has made strides to strengthen physician partnerships, including those serving the rural Amador, Monterey, Shasta, Humboldt, Sutter, and Butte counties. It is also working to improve its provider list so that consumers receive accurate information on current providers that are available and would be covered.
And now, with its BlueCard program, EPO members that travel the U.S. will have access to a wide network of doctors and hospitals.”
In addition, Anthem has been a part of California’s health exchange, Covered California, since the beginning of the Affordable Care Act in 2014.
Considering Blue Shield of California
In contrast to Anthem Blue Cross, a for-profit company, Blue Shield of California is a not-for-profit health plan that was founded in 1939 and headquartered in San Francisco. Blue Shield currently serves over 3 million members in California.
Blue Shield of California is the third-largest health plan in the state after Kaiser and Anthem Blue Cross and earned an A rating from A.M. Best in 2021.
As a not-for-profit corporation operating only in California, Blue Shield of California offers coverage for individuals, small and large groups markets, as well as Medicare supplemental plans and Medicare Advantage plans.
The company points out that,
“With Blue Shield, you can find the coverage at the price that’s affordable for you. Blue Shield also offers financial assistance, and if you qualify, you may receive help with paying your coverage through Covered California.”
Blue Shield’s small group plans are well-priced; however, business owners can only offer a full network or narrow network option, but not both networks.
Blue Shield of California is also one of only two preferred provider organizations to offer plans to all California ZIP codes and counties. According to the company, Blue Shield of California HMO plan members have access to more than 29,700 doctors and 300 hospitals, while their PPO plan members have access to more than 49,700 doctors and 350 hospitals.
As a nonprofit health plan provider, in 2011, the company pledged to take only two percent of their net income as revenue and give the rest back to their members and community. Since making this pledge, Blue Shield has returned more than $560 million.
Anthem Blue Cross Blue Shield – California Style
Because these two health insurance California competitors are part of the same corporate association, their premiums tend to be comparable. Depending on your region, Anthem Blue Cross or Blue Shield of California might offer less expensive health plans.
However, overall, the rates tend to be about the same. The main advantages are the size of their networks.
Remember, too, that you can only see doctors within your HMO’s network with an HMO plan. You will typically have a primary care doctor and a medical group who refers and coordinates your care to specialists when needed.
With PPO plans, on the other hand, you can choose to see out-of-network doctors. However, keep in mind that you are responsible for managing and paying the cost for any out-of-network visits.
Essentially, both Anthem Blue Cross and Blue Shield of California are consistently well-rated, relatively affordable, and both offer extensive coverage in California.
When it comes to the availability of Anthem Blue Cross and Blue Shield of California, both companies are part of the Covered California plans, in the state’s health exchange program, and both offer affordable health insurance plans.
Suppose you are looking to choose between these two major health care insurance providers for yourself and for you and your family. In that case, it is always helpful to seek the advice of an experienced health insurance agent, like the folks here at J.C. Lewis Insurance.
J.C. Lewis Can Help You in Choosing the Best Health Care Coverage
J.C. Lewis Insurance, a long-time local and family-owned firm based in Sonoma County since 1979, is made up of a team of expert brokers that offer individual and family health insurance plans.
We also provide small business and individual health insurance plans from only the leading health insurance carriers that are licensed to do business in California.
In addition to being experienced, professional brokers, we are licensed and certified by each of these insurance carriers to offer coverage to individuals, families, and small group employers in addition to Medicare supplemental and prescription drug plans for seniors.
When you’re shopping for vision, dental, or health insurance for your employees or for you and your family, you probably have several questions and concerns.
At J.C. Lewis Insurance Services, we welcome your questions about insurance coverage, and you can be confident that we will help you find the right solution.