Blue Cross Blue Shield Health Insurance Review

#9 in Health Insurance

Blue Cross Blue Shield is a health insurance company that offers a selection of insurance products for individuals, employers and families. This wellness company provides options for medicare and modern healthcare.

What’s Included with Blue Cross Blue Shield?

  • Diagnostic tests and imaging
  • Prescription drugs
  • Immediate medical attention
  • Outpatient surgery
  • Preventive care
  • Primary care visit to treat an injury or illness
  • Special visit and other practitioner office visit
  • Maternity care
  • Rehabilitation and habilitation services
  • Metal health, behavioural health, and substance abuse needs
  • Child needs (dental or eye care)

Types of Health Insurance Plans

Businesses and Organizations

Yes

Individuals and Families

Yes

Short-Term Health Insurance

Yes

Subsidiaries of Blue Cross Blue Shield:

  • CareFirst
  • Anthem
  • Premera
  • Regence
  • Highmark
  • Horizon
  • Excellus
  • Wellmark
  • Independence

Plans Reviewed

Bronze Plan

  • Overall deductible: For inpatient services, a total of $4,400 per individual must be paid for in-network providers and $8,800 for out-of-network providers. Outpatient services amount to $6,350 for every person if the client chooses a participating provider and $12,700 for non-participating providers.
  • Out-of-pocket limit: $12,000 per individual for out-of-network providers and $6,350 for in-network providers
  • No maximum annual limit for specific covered services
  • Balanced-bill charges, health care, and premiums are not included in the out-of-pocket limit
  • Other covered services: Chiropractic care, Infertility treatment, Weight loss program, and bariatric surgery

Silver Plan

  • Out-of-pocket limit: $6,000 per individual for in-network providers and $12,000 for out-of-network providers
  • No overall annual limit for some covered servicesNo other deductibles for specific services
  • Overall deductibles: A total of $1,400 per individual for in-network providers and $2,800 for out-of-network providers. Both do not apply to preventive care services.
  • Other covered services: Infertility treatment, Weight loss programs, Bariatric surgery, and Chiropractic care

Gold Plan

  • Expenses such as balanced-billed charges, health care, and premiums are not included in the out-of-pocket limit
  • Out-of-pocket limit: $5,000 per person for in-network providers and $10,200 for out-of-network providers
  • Overall deductibles: $150 per individual for participating providers and $300 for non-participating providers. Both do not apply to preventive care services.
  • No maximum annual limit and other deductibles for specific covered services
  • Other covered services: Weight loss programs, Bariatric surgery, Chiropractic care, Infertility treatment

Platinum with Dental and Vision Plan

  • Overall deductibles: None for both in-network and out-of-network providers. Does not include preventive care services.
  • No annual limit on selected covered services
  • Out-of-pocket limit: $6,000 per individual for in-network providers and $12,000 for out-of-network providers
  • Out-of-limit does not include expenses such as health care, premiums, and balanced-billed charges
  • Other covered services: Dental care for both child and adult, Infertility treatment, Routine eye care for adults, Weight loss programs, Bariatric surgery, Glasses for adults, and Chiropractic care

How Much Does It Save You?

 

Bronze

Silver

Gold

Platinum

Services

In-Network

(Your cost)

Out-of –Network

(Your cost)

In-Network

(Your cost)

Out-of –Network

(Your cost)

In-Network

(Your cost)

Out-of –Network

(Your cost)

In-Network

(Your cost)

Out-of –Network

(Your cost)

Primary Care Services

None

Not covered

$30 co-pay

Not covered

$30 co-pay

Not covered

10% co-insurance

Not covered

Diagnostic Test and Imaging

Inpatient: 40% co-insurance

Outpatient: No charge

Inpatient: 60% co-insurance

Outpatient:

No charge

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Generic Drugs

None

80% of BCBSM-approved amount for covered drugs

$15 co-pay

80% of BCBSM-approved amount for covered drugs

$15 co-pay

80% of BCBSM-approved amount for covered drugs

$15 co-pay

80% of BCBSM-approved amount for covered drugs

Specialty Drugs

None

80% of BCBSM-approved amount for covered drugs

20% for preferred coinsurance and 25% for non-preferred co-insurance

80% of BCBSM-approved amount for covered drugs

20% for preferred coinsurance and 25% for non-preferred co-insurance

80% of BCBSM-approved amount for covered drugs

20% for preferred coinsurance and 25% for non-preferred co-insurance

80% of BCBSM-approved amount for covered drugs

Outpatient Surgery

None

None

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Hospital Stay

40% co-insurance

60% co-insurance

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Prenatal and Postnatal Care

Prenatal: None

Postnatal: 40% co-insurance for inpatient and none for outpatient

60% for inpatient and none for outpatient

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Preventive Care Services

None

Not covered

None

Not covered

None

Not covered

None

Not covered

Emergency Room Service and Transportation

None

None

20% co-insurance

20% co-insurance

20% co-insurance

20% co-insurance

10% co-insurance

10% co-insurance

Urgent Care

None

None

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Rehabilitation and Habilitation Services

None

None

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Mental/Behavior Health Outpatient Service

None

None

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Mental/Behavior Health Inpatient Service

40% co-insurance

60% co-insurance

20% co-insurance

40% co-insurance

20% co-insurance

40% co-insurance

10% co-insurance

30% co-insurance

Substance Use Disorder Outpatient Service

None

Not covered

20% co-insurance

Not covered

20% co-insurance

40% co-insurance

10% co-insurance

Not covered

Substance Use Disorder Inpatient Service

40% co-insurance

Not covered

20% co-insurance

Not covered

20% co-insurance

Not covered

10% co-insurance

Not covered

Annual Maximum Limit

Bronze

None

Silver

None

Gold

None

Platinum

None

*Only on specific covered services

Summary

Blue Cross Blue Shield is a well-established company with strong financial ratings. Wide acceptance among health professionals, comprehensive coverage and discounts on medical treatments makes Blue Cross Shield an excellent choice for health insurance.

 

 

 

 

 

 

 

Latest Reviews

Start your review for Blue Cross Blue Shield Health Insurance
Casey Weber
Belleville, New Jersey
Blue Cross Blue Shield Health Insurance review
9/30/2016
BCBS is the best insurance I've ever had. I've had a few jobs in my days and there is always some issue with my insurance no matter what I needed it for. With BCBS, I could call and ask questions and they were quick to get me an answer and explain everything as I needed. When I had a problem, they were able to fix it and take care of it in a timely fashion. I'm really satisfied with their work and and I will stay with them for as long as I can!