Blue Cross Blue Shield Medicare Review

Fact Checked
Expert reviewed by: Tammy Burns, insurance and healthcare consultant
Published: 4/9/2021


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Tammy Burns
Medicare advisor and nursing consultant
Tammy Burns
Medicare advisor and nursing consultant

Tammy Burns is an experienced health insurance advisor specializing in  Medicare and senior health issues, including Medicare Advantage Plans and prescription drug plans, as well as ACA certified for health insurance and other ancillary, life and annuity products.

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 36 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:

  • Low premiums with optional coverage upgrades for Medicare Advantage Plans
  • Optional out-of-state coverage when traveling
  • Reputable company with a large provider network

The drawbacks of Blue Cross Blue Shield Medicare plans:

  • Coverage and plans vary from state-to-state
  • Plan details can be confusing

What do Blue Cross Blue Shield Medicare Plans Cover?

Medicare Advantage plans are known as Medicare Part C. The plans offer the same coverage as Original Medicare and may include additional benefits such as vision or dental. Medicare supplement plans, also known as Medigap, are only available to seniors who have Medicare and cover all or part of what Original Medicare doesn’t include. Blue Cross Blue Shield doesn’t include prescription drug coverage in its Medicare supplement plans. Still, it does offer Part D coverage as a separate option to Medicare policyholders and includes drug coverage in its Medicare Advantage plans.

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 plan options:

Plan Name Monthly premium Annual deductible Office visits Telehealth Emergency room Annual maximum out-of-pocket cost
Medicare Supplement Senior Security A, C, D, F, G, N From $86.88 Varies with plans Copays apply for plan N Cost-share currently waived Copays apply for plan N None
Medicare Supplement Senior Preferred C, D, G, N From $80.44 Varies with plans Copays apply for plan N Cost-share currently waived Copays apply for plan N None
Medicare Advantage BluePathway PPO 1, 2, 3
Medicare Advantage BluePathway HMO 1, 2, 3
1, 2: $0
3: $32
$0 $0 for PCP for all plans
2: $30 for Specialist
1, 3: $20 for Specialist
$0 for all plans $120 for all plans 1: $2,900
2: $3,400
3: $2,900
Medicare Advantage BlueJourney PPO $59 $0 PCP: $0 in-network/$40 out-of-network
Specialist: $40 in-network/$80 out-of-network
$0 for all plans $90 $5,000 in-network
$10,000 in and out of network
Blue MedicareRX Value $31.50 $445 n/a n/a n/a $6,550

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.

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.

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.

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.

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