The Blue Cross Blue Shield (BCBS) Association is a federation of thirty-six health insurance organizations and companies. The traces of the Association go back to 1929, with the founding of Blue Cross. Blue Cross became an association in 1960 and merged with the Blue Shield Association in 1982, forming one of the largest health insurance providers in the United States. Major BCBS health insurance companies include Anthem, CareFirst, Regence, and Highmark.
Every health insurance plan is required to provide essential benefits, as defined by the Affordable Care Act. These essential benefits fall into ten categories of services:
The specific services offered within those categories may vary from state to state, but these categories represent the minimum that all health insurance plans are required to cover. No matter where you purchase your health insurance plan from – federal, state, or private marketplace – it must cover these ten essential benefits.
Plans may choose to cover additional services. State, federal, and private exchanges will give you the full list of the exact services each plan covers before you apply.
Blue Cross Blue Shield and its associated companies form one of the largest health insurance providers in the country, currently providing insurance in all fifty states and abroad. Because of its wide reach, Blue Cross Blue Shield customers have access to many health care providers in their local areas. According to Blue Cross Blue Shield statistics, 96% of all U.S. hospitals and 93% of U.S. physicians are included in Blue Cross Blue Shield plans.
Prescriptions & Drugs
In general, Blue Cross Blue Shield provides coverage for both generic and brand name drugs. The exact drugs covered by an individual Blue Cross Blue Shield plan will depend on the state you live in and the type of plan; you can find your state’s drug list (also called a formulary) on your local company’s website. In general, if a drug is not covered by your plan’s formulary, you may be able to purchase it at a higher price.
PolicyGenius offers anonymous, no-obligation shopping of all marketplace health insurance plans, as well as “off-exchange” plans that you won’t find on Healthcare.gov or the state marketplaces. You can browse all plans, and sort and filter those plans based on your preferences and budget.
Once you’ve selected a health insurance plan, enrolling in that plan is easy. You fill out a short online form, then complete the final step with a quick enrollment phone call with a licensed agent. On that call, the licensed agent will verify your identity, double-check eligibility and answer any questions you may have. For certain insurers, who don’t permit private brokers (like PolicyGenius) to enroll customers, you’ll have to enroll directly with the insurer or on your state’s marketplace (these plans will be noted).
After you enroll in a health insurance plan, you will get your membership materials (including your member ID card) and the first premium bill directly from the health insurance company. You are responsible for paying the bill to ensure that your coverage goes into effect, and to keep current on those payments.
If you get care through a Blue Cross Blue Shield network provider, they should file your claim for you. If they do not file your claim, you need to file your claim with your local Blue Cross Blue Shield company. Click here for the full list of Blue Cross Blue Shield companies and links to their websites. On this site, look for the claim form. Generally, you need to send this form along with your original bill to your local company. If you have questions, call the number on the back of your insurance card.