Haris Ashley
Blue Cross Blue Shield (BCBS) is a private insurer that offers health insurance coverage in every US state. It was formed in 1982 from the merger of two namesake organisations: Blue Cross, founded in 1929, and Blue Shield, which emerged in 1939. BCBS offers a range of Medicare Advantage plans, including HMO and PPO options, as well as prescription drug plans through Medicare Part D. The company has a beneficiary base of around 118 million people and partners with 2 million healthcare professionals. BCBS is an independent licensee and is made up of 33 independent and locally operated companies that offer insurance plans within defined regions.
| Characteristics | Values |
|---|---|
| Type | Private insurer |
| Coverage | Health insurance, Medicare Advantage (Part C) plans, prescription drug coverage, dental, vision, hearing insurance |
| Number of Members | 115-118 million |
| Companies | 33 independent companies, including Blue Cross Blue Shield of Minnesota, Blue Cross Blue Shield of Mississippi, Blue Cross Blue Shield of Nebraska, Excellus BlueCross BlueShield, Anthem Blue Cross Blue Shield |
| Location | All 50 states, Washington, D.C., Puerto Rico, and some foreign countries |
| Pros | Easy access to healthcare coverage, affordable, nationwide coverage through BlueCard provider network, variety of plans, large network of doctors |
| Cons | Limited number of Special Needs Plans, prices may change yearly, variable copayments and coinsurance amounts |
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What You'll Learn
History of Blue Cross Blue Shield
Blue Cross Blue Shield (BCBS) is a federation of 33 independent and locally operated companies that provide health insurance to over 115 million people in the United States. BCBS companies also act as administrators of Medicare in many states and offer insurance plans in all 50 states, Washington, D.C., and Puerto Rico. The federation was formed in 1982 from the merger of its two predecessor organizations: Blue Cross and Blue Shield.
Blue Cross was developed by Justin Ford Kimball in 1929 while he was vice president of Baylor University's healthcare facilities in Dallas, Texas. The first Blue Cross plan guaranteed teachers 21 days of hospital care for $6 a year and was soon extended to other employee groups in Dallas and then nationally. In 1939, the American Hospital Association (AHA) adopted the Blue Cross symbol for plans meeting certain standards. The Blue Cross Association superseded the AHA commission in 1960, and Blue Cross cut ties with the AHA in 1972.
Blue Shield emerged from employers in the lumber and mining camps of the Pacific Northwest, who organized plans to provide medical services for their employees for a monthly fee. In 1939, the first official Blue Shield plan was founded in California, and in 1948, the symbol was informally adopted by nine plans called the Associated Medical Care Plan, later renamed the National Association of Blue Shield Plans.
In 1960, the U.S. government partnered with Blue Cross and Blue Shield companies to administer Medicare. When Medicare was signed into law in 1966, BCBS companies processed the claims of nearly 5 million Medicare patients. In 1978, the Blue Cross Blue Shield Association consolidated its staff and operations, and in 1982, Blue Shield merged with The Blue Cross Association to form the Blue Cross and Blue Shield Association.
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Pros and cons of Blue Cross Blue Shield
Blue Cross Blue Shield (BCBS) is a health insurance company that has been operating since 1929 and has a beneficiary base of around 118 million people. It is an association of 33 companies and licensees that allows it to administer healthcare coverage in every state.
Pros
BCBS offers a wide range of Medicare Advantage plans, including Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), and Fee-for-Service (FFS) plans. They also offer prescription drug coverage through Medicare Part D. BCBS has a large network of doctors and other healthcare professionals, with over 1.7 million in-network providers, and their plans are accepted in all 50 states, making it easier to find an in-network provider. BCBS also provides global coverage options through BCBS Global and GeoBlue, with a network of over 11,000 overseas providers. Additionally, BCBS offers a BlueCard program that allows beneficiaries to access coverage anywhere in the country, with treatment charged at local rates.
Cons
The number of Special Needs Plans offered by BCBS is limited, and prices may change yearly, depending on the plan. BCBS's affordability and consumer experience can vary by region, and it is important to note that they are independent licensees, so the specific offerings and availability of plans may vary depending on the region and the specific BCBS company. While BCBS claims that 100% of hospitals and 99% of physicians accept their coverage, this may not always be the case, and there have been conflicts over a lack of covered care in certain states.
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Blue Cross Blue Shield's Medicare Advantage plans
Blue Cross Blue Shield (BCBS) is a federation of 33 independent and locally operated companies that provide health insurance to over 115 million people in the US. It was formed in 1982 from the merger of two namesake organisations: Blue Cross, founded in 1929, and Blue Shield, which emerged in 1939.
BCBS offers Medicare Advantage plans, also known as Medicare Part C plans, which provide Medicare coverage through private health insurance companies approved by Medicare. These plans can include HMOs, PPOs, Regional PPOs, or Private Fee-for-Service plans.
Medicare Advantage plans from BCBS offer all the benefits of Original Medicare (Part A and Part B), while also including additional services such as wellness programs, hearing aids, and vision services. These plans tend to have lower overall costs and maximum out-of-pocket expenses for each calendar year, a feature not available in Original Medicare.
To enrol in a Medicare Advantage plan, you must continue paying your Part B insurance premium, and you may also have to pay a separate monthly premium for the plan itself. Some plans may have deductibles, and copayments may apply to specific services like doctor office visits.
Medicare Advantage plans from BCBS offer a broad network of physicians and hospitals where you can receive care. You can explore the plans available in your area by entering your ZIP Code on the BCBS website.
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Blue Cross Blue Shield's partnerships
Blue Cross Blue Shield Association, also known as BCBS, is a US-based federation with 33 independent and locally operated companies that provide health insurance to over 115 million people in the US. The association acts as a licensee and manages communications between its members and the operating policies required to be a licensee of the trademarks. This allows each BCBS company to offer nationwide insurance coverage through its BlueCard provider network and claims reimbursement program, despite only operating in its designated service area.
Blue Cross and Blue Shield insurance companies are licensees, independent of the association and traditionally of each other, offering insurance plans within defined regions under one or both association brands. Blue Cross Blue Shield insurers offer health insurance coverage in every US state and act as administrators of Medicare in many states or regions. The association also offers coverage to individuals and employers who live, work, and travel internationally through Blue Cross Blue Shield Global.
Blue Cross Blue Shield of Nebraska formed GoodLife Partners Inc., a mutual holding company, to conduct its non-insurance businesses in 2018. The company retained the Blue Cross brand and converted from mutual ownership to a stock company wholly owned by GoodLife.
Excellus BlueCross BlueShield is a non-profit health insurance company headquartered in Rochester, New York. It is part of the Blue Cross Blue Shield Association and merged with Univera Healthcare in 2001.
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Blue Cross Blue Shield's presence in California
Blue Cross Blue Shield (BCBS) is a federation of 33 independent and locally operated companies that provide health insurance to over 115 million people in the United States. BCBS companies offer health insurance coverage in every US state, including California, and are also present in Washington, D.C., Puerto Rico, and several foreign countries.
In California, the Blue Cross Blue Shield Association is represented by Blue Shield of California, which was founded in 1939 by the California Medical Association. Blue Shield of California is a mutual benefit corporation and health plan, serving approximately 4.5 million health plan members and more than 65,000 physicians across the state. The organisation is headquartered in Oakland, California, and offers a range of health insurance plans, including Medicare and Medicaid options.
Blue Shield of California has a long history in the state, dating back to 1938 when it was known as the California Physicians' Service. In 1946, the organisation was among the founders of the National Association of Blue Shield Plans, which later became the Blue Cross Blue Shield Association. By 1961, Blue Shield of California had one million subscribers, and in 1984, it began covering heart transplantations offered at Stanford University Medical Center.
Today, Blue Shield of California continues to be a major player in the state's healthcare landscape. In 2019, the company launched the healthcare company Altais, which acquired the San Francisco practice Brown & Tolland. Blue Shield of California also formed an Accountable Care Organisation in collaboration with Dignity Health and Hill Physicians Medical Group, covering 41,000 individuals in the California Public Employees Retirement System (CalPERS). This program has successfully reduced inpatient use and healthcare costs.
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Frequently asked questions
Blue Shield Insurance is a private insurer that offers Medicare Advantage plans. It is part of the Blue Cross Blue Shield Association (BCBSA), a federation of 33 independent and locally operated companies that provide health insurance to over 100 million people in the US.
The Blue Cross Blue Shield Association (BCBSA) is a US-based federation that was formed in 1982 from the merger of Blue Cross and Blue Shield. It manages communications between its members and the operating policies required to be a licensee of the trademarks.
Blue Cross was founded in 1929 by Justin Ford Kimball, vice president of Baylor University's healthcare facilities in Dallas, Texas. Blue Shield emerged a decade later in 1939. The two organisations merged in 1982 to form the Blue Cross Blue Shield Association.
Blue Cross Blue Shield insurance companies offer some form of health insurance coverage in every US state. They also act as administrators of Medicare in many states. BCBS offers a variety of Medicare Advantage HMO and PPO plans, as well as prescription drug plans through Medicare Part D. Their policies often cover hearing aids and routine dental and vision care.
