Blue Cross Blue Shield Medicare Review

Pros Explained

• Lowest out-of-pocket maximums of the companies we evaluated: According to 2023 nationally available cost data, BCBS has the lowest out-of-pocket maximums compared to competitors we reviewed.
• Medicare Advantage plans available in most states: BCBS’ Medicare Advantage plans are sold in 42 states. 
• Biggest selection of Medigap plans: BCBS sells 12 Medigap plans, which is more than any other insurer we reviewed: A, B, C, D, F, F-high deductible, G, G-high deductible, K, L, M, and N. BCBS is one of the top companies in our review of the best Medicare supplement plans.
• Good Medicare star ratings: BCBS Medicare Advantage plans have an average Medicare star rating of 4.01 out of 5 stars. It’s not the highest rating, but it’s better than all but two of the nine top Medicare providers with a national presence that we reviewed.

Cons Explained

• Plans differ by state: There are dozens of independent BCBS organizations nationwide, so you have to do your research to learn about plan types, costs, and ratings for your location. 
• High premiums: Based on 2023 data from the Centers for Medicare and Medicaid Services (CMS), BCBS’ average Medicare Advantage premium is much higher than competitors—which makes sense due to the low out-of-pocket maximums.

Third-Party Ratings

The company’s average Medicare Star rating for Medicare Advantage plans is 4.01 stars out of 5. That’s higher than all but two Medicare insurers we compared. BCBS’ Part D plans are also highly rated, with an average rating of 3.45 stars.

However, BCBS’ average rating from the National Committee for Quality Assurance (NCQA), based on features like quality of care and availability, is not as impressive. The organization gives it 3.5 out of 5 stars, putting it behind Kaiser (4.5), Aetna (3.8 stars), and UnitedHealthcare (3.8 stars). 

In J.D. Power’s 2023 U.S. Medicare Advantage Study, which scores insurers in five U.S. regions, BCBS affiliates have mixed ratings. For example, BCBS received the highest overall satisfaction score for plans in Texas and New York. However, the insurer’s companies ranked below average in Florida and California.

Policies Available 

Medicare Advantage (Part C) Plans

Medicare Advantage plans, also called Medicare Part C, include Part A (hospital insurance) and Part B (medical insurance). Many plans also include Part D (prescription insurance).

BCBS offers health management organization (HMO), preferred provider organization (PPO), and private fee-for-service (PFFS) Medicare Advantage plans, as well as a variety within those, such as HMO-POS. Many plans come with prescription drug coverage, and may also provide $0 physician copays.

BCBS’ Medicare Advantage plans tend to pair higher premiums and drug deductibles with lower out-of-pocket (OOP) maximums. This approach can lead to predictable monthly payments and drug deductibles but limits your OOP expenses if you face an expensive emergency.

Special Needs Plans

BCBS sells Medicare Advantage Special Needs Plans (SNPs). Three SNPs are available through BCBS:

• Dual-Eligible SNP: The D-SNP plan is available for people who qualify for Medicare and Medicaid based on their state’s income requirements. This plan includes vision, dental, hearing, and prescription medication coverage.
• Chronic Condition SNP: The C-SNP plan provides higher coverage levels for people diagnosed with chronic medical conditions, like diabetes or heart disease. 
• Institutional SNP: Members are eligible for the I-SNP plan if they need long-term care in a skilled nursing facility for 90 days or longer.

Part D Prescription Drug Plans

BCBS sells standalone Medicare Part D plans for people who have Original Medicare or a Medicare Advantage plan without drug coverage. Part D coverage from BCBS is available in most states. 

In every state where BCBS offers stand-alone prescription plans, it presents two types: basic and enhanced. In some states, more than one enhanced plan is offered. Basic plans offer the standard coverage required, while more expensive enhanced plans may offer lower deductibles and more covered name-brand drugs.

Medicare Supplement Plans 

Medicare supplement plans, also called Medigap plans, can help pay for out-of-pocket expenses that Original Medicare doesn’t cover, like Part A and Part B deductibles, copayments, and coinsurance. 

BCBS offers 12 Medigap plans: Plans A, B, C, D, F, G, K, L, M, and N. You can also purchase a high-deductible Plan F or high-deductible Plan G. Some BCBS Medigap plans come with extras, such as SilverSneakers fitness membership, prescription savings, and other discounts. 

Plan pricing can depend on the state and pricing model.

While Florida’s Plan G might seem expensive, BCBS in Florida uses an issue age cost model, which prices the premium based on your age when you buy the Medigap policy. These premiums stay more stable over time and don’t increase just because you get older. In Illinois, pricing is based on attained age. Premiums are low at first but go up as you get older—and can become the most expensive.

Standalone Dental and Vision Plans

If you have Original Medicare, you may want to add one of Blue Cross’s standalone plans to cover dental and vision care. Medicare Advantage plans often wrap this coverage into the MA plan. These plans come with different coverage levels and pricing, but may include partial or full cost coverage for: 

• Routine cleanings, X-rays and exams
• Fillings
• Periodontal work 
• Crowns and dentures
• Vision exams
• Eyeglass frames or contact lenses

Cost

For costs, here are the BCBS averages nationwide:

• Average Medicare Advantage premium: $52.90
• Average drug deductible: $178.34
• Average out-of-pocket maximum: $4,996.85

BCBS’ plans are expensive when looking at overall average costs. Out of the nine Medicare providers we researched, BCBS has the highest average premium for Medicare Advantage and the third-highest average drug deductible—only lower than Wellcare’s and Humana’s. 

However, its average maximum out-of-pocket amount ($4,996.85) is the lowest among major competitors.

Customer Service

To get in touch with BCBS, you can call the company at (888) 630-2583. You can also search by location to find the local BCBS organization in your area. When you visit your local BCBS chapter’s website, you can see which specific contact options are available. 

How We Review Medicare Companies

To identify which Medicare insurance companies to review, we analyzed business and market insight databases including Statistia, Plunkett, and Gale. We also considered user-generated data from Google to determine public interest and trends in Medicare plans.

We collected data from third-party rating agencies like the credit rating agency AM Best and the National Committee for Quality Assurance (NCQA), an independent organization that rates health insurance plans on quality and customer satisfaction. 

We also gathered data from government websites and databases provided by the Centers for Medicare and Medicaid Services (CMS), such as CMS.gov and HealthCare.gov, and directly from companies via websites, media contacts, and existing partnerships. The data collection process spanned Sept. 15 to Sept. 29, 2023.

We then developed a quantitative model that scores each Medicare Advantage provider based on four major categories and 22 criteria that are crucial in evaluating the company's offerings and benefits.

We weighted the four categories as follows for this article:

• Plan features: 35%
• Plan quality and customer satisfaction: 30%
• Cost: 20%
• Availability: 15%

Read our full methodology for reviewing Medicare insurance providers.