Blue Cross Blue Shield Medicare Advantage Plans Review

Fact Checked
Medicare rating: 3.4 stars A.M. Best financial strength rating: A-B++ BBB rating: A+ NCQA rating: 2.5 to 4.5 stars Consumer Affairs rating: 3.9
J.D. Power ranking: 6th and 8th out of 10

Quick Blue Cross Blue Shield Medicare Plans review: Blue Cross Blue Shield is a household name in health care with good reason for seniors to trust the company for their Medicare needs.

Blue Cross Blue Shield has been a pioneer in securing quality medical care for employees, creating the first health insurance plan for teachers in Dallas in 1929. Since then, it has grown to 34 regional companies, covering every state and Puerto Rico. The company is committed to offering diversity and meeting a wide variety of health-related needs. Still, its many health plans often cause confusion. Choice and flexibility are some of the reigning features of Blue Cross Blue Shield’s Medicare plans, but it takes some patience to understand what this insurance giant has to offer.

Pros and Cons of Blue Cross Blue Shield Medicare Plans

What we like about Blue Cross Blue Shield Medicare plans: The drawbacks of Blue Cross Blue Shield Medicare plans:
  • Low premiums with optional coverage upgrades for Medicare Advantage Plans
  • Optional out-of-state coverage when traveling
  • Reputable company with a large provider network
  • Coverage and plans vary from state-to-state
  • Plan details can be confusing

What Do Blue Cross Blue Shield Medicare Plans Cover?

Also called Medicare Part C, Medicare Advantage Plans combine Part A and B benefits with various extra services. Most Blue Cross Blue Shield Medicare Advantage Plans include:

  • Prescription drug coverage
  • Vision
  • Dental
  • Hearing
  • Wellness benefits, such as free gym memberships
  • Medical transportation (some plans)
  • Wellness over-the-counter medications (some plans).

If you have certain chronic medical conditions, such as cancer or Alzheimer’s, you may qualify for a Medicare Advantage Special Needs Plan that serves a specific population group. With Medicare Advantage, you continue to pay your Original Medicare premiums. In many cases, there’s no additional cost.

The company’s Medigap plans work with your Original Medicare Parts A and B. You can use this supplemental insurance to help pay for copays and deductibles. Blue Cross Blue Shield’s Part D, or prescription drug coverage, is another add-on plan for seniors with Original Medicare, specifically designed to help pay for prescription medication.

Blue Cross Blue Shield Medicare Plan Options

Blue Cross Blue Shield has three primary Medicare options: Medigap, Medicare Advantage Plans, and stand-alone prescription drug plans. Under the Medicare supplement umbrella are ten possible plans, each with unique coverages and availability differing by state.

The Medicare Advantage Plans are mostly HMOs and PPOs with similar coverage in both types. The main difference between the two is that PPO plans allow policyholders to visit out-of-network providers for additional fees while HMO plans do not. If you have a PPO plan, you can see specialists without referrals. A few states have unique Blue Cross Blue Shield Medicare Advantage Plans, such as the private fee for services (PFFS) plan, which is only available in Arkansas.

The company’s prescription drug plans are state-specific, and most states have a basic and an enhanced plan type.

Check your state for your Blue Cross Blue Shield Medicare 2022 plan options:

Plan name Monthly premium Annual deductible Office visits Annual maximum out-of-pocket cost
Medicare PPO Blue Saver RX (PPO) $ 0 Health: $ 0

Drug: $0

Primary: $ 0

Specialist: $45

$5,600 in network; $8,950 in and out of network
Medicare HMO ValueRX (HMO) $ 75 – 85 Health: $ 0

Drug: $40

Primary: $ 0

Specialist: $ 0 – 45

$4,900 in network
Medicare PPO Blue PlusRX #254 Health: $0

Drug: $200 per year (Tiers 3, 4, 5)

Primary: $0
Specialist: $35
$3,400 in network;
$5,100 in and out of network

*Based on pricing in Boston, MA
**Medicare Supplement Insurance Plans are standardized differently in Massachusetts. Rates shown are for 2023

Blue Cross Blue Shield Medicare Plans Reviews and Ratings

Reviews for Blue Cross Blue Shield are mixed, primarily because each regional branch is a separate company. Ratings, customer service satisfaction, and reviews can vary greatly depending on your location.

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how Medicare, A.M. Best, the Better Business Bureau and more rate Blue Cross Blue Shield (BCBS) Medicare plans.

Medicare rating: 3.8 stars BCBS’s Medicare Advantage Plans have an overall quality rating of 3.8. Prescription drug plans have an overall rating of 3.7. Both are from the Centers for Medicare & Medicaid Services.
A.M. Best financial strength rating: A+ – B++ A.M. Best is a credit rating agency specializing in the insurance industry. In July 2021, A.M. Best affirmed its Financial Strength Rating of A+ (Superior) to B++ (good) for some Blue Cross Firms. There is a range of ratings because BCBS is a collection of companies.

An A+ rating indicates stability to meet ongoing obligations An A rating translates to “excellent,” and a B++ rating to “good.”

BBB rating: A+ Blue Cross Blue Shield has an A+ rating with the Better Business Bureau (BBB), but it’s not accredited. Fifty-nine customer complaints have been closed in the last three years and 12 have been closed in the last 12 months.
NCQA rating: 2.5 to 4.5 stars Only a few states have data reported by The National Committee for Quality Insurance (NCQA), which gives Blue Cross Blue Shield the highest score in the area of prevention. Ratings range from 2.5 to 4.5 with an average of 3.0.
Consumer Affairs rating: 3.5 A few states have ratings on Consumer Affairs. The highest is Blue Cross Blue Shield of Florida with 3.5 out of 5 stars based on 400 reviews. Many reviewers expressed appreciation for having Medicare coverage through a name that they know and trust.
J.D. Power ranking: 6th and 9th out of 10 In its 2021 Medicare Advantage Study, J.D. Power measured Medicare Advantage Plan satisfaction based on coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. Anthem BCBS scored 797 and BCBS of Michigan scored 788 points out of 1,000, coming sixth and ninth out of the top 10 Medicare Advantage providers.
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Certified Senior Advisor (CSA)®

As a health care professional since 1987, Kelly Blackwell has walked alongside and cared for seniors as they journey through the season of their fourth quarter of life. Blackwell holds a Bachelor of Science in nursing from the University of Northern Colorado, a Master of Science in health care administration from Grand Canyon University, an interprofessional graduate certificate in palliative care from the University of Colorado Anschutz Medical Campus and holds a Certified Senior Advisor® credential from the Society of Certified Senior Advisors.

Blackwell contributes to the University of Colorado-Anschutz blog and has been published in “The Human Touch” distributed by the University of Colorado Center for Bioethics and Humanities. She cowrote “Dying Is” for Pathways Hospice.

A registered nurse, Blackwell understands health insurance choices influence quality of life and are driven by values, goals, and beliefs. She’s passionate about engaging with, educating, and empowering seniors as they navigate the health care system. She’s equipped to lend an experienced, compassionate voice to beneficiaries seeking information about Medicare Advantage Plans.

As a CSA®, Blackwell has access to valuable resources for Medicare beneficiaries. Her work as a bedside nurse and clinical manager has given her the opportunity to see how Medicare rules, regulations, and benefits work when patients need them. With a passion to learn and to make a difference in the lives of seniors, Blackwell supports seniors through Medicare and fourth-quarter life decisions.

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