Review of Blue Shield Health Insurance
October 7, 2021Individual & Family Health Insurance
October 12, 2021Anthem Health Insurance Review
A wide range of insurance types are available at reasonable prices, however a high percentage of coverage denials should be avoided.
Anthem insurance is one of the largest insurance firms in the country, with 42 million health insurance customers spread across 14 states. There are several options available, and members get access to helpful materials and digital tools. Furthermore, monthly costs are often reasonable, and the firm has a broad network of providers.
However, the firm has a bad reputation for customer service, has been penalized on many occasions for breaching consumer grievance standards, and has a high percentage of claim denials.
Consider Our Ideas.
For the most part, Anthem is a decent health insurance provider. Policies are often reasonably priced, even if they are not the lowest health insurance policies in the state. There are also several plans to choose from, allowing you to find the greatest fit for your budget and medical needs.
Anthem's scale is a major differentiator, and the business is a subsidiary of the even larger Blue Cross Blue Shield Association, which has more than 90% of doctors and hospitals in its network of providers.
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Many individuals are shocked at how much life insurance they actually require to safeguard the people and things they care about the most. However, if you can't afford the plan you desire, it's a mistake to forego any coverage at all.
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Anthem's scale provides advantages like as being well-known and having the financial clout to supply members with cutting-edge technology and valuable medical resources. There are several drawbacks, such as bad customer service and a lack of customization.
Furthermore, Anthem has a history of coverage breaches that benefit its profit line, including as significant claim rejections and discontinuing coverage for people who submit large medical bills. According to our findings, Anthem denies claims at double the industry average.
If you are afraid that insurance coverage for pricey procedures may be refused, or if you require continuous medical care, a policy from UnitedHealthcare may be a better choice because it has relatively few complaints and above-average customer satisfaction.
Plan Types & Choices
Anthem was rated one of our best insurance companies due to its extensive network of providers, which provides you with several options for receiving medical services. Anthem offers a selection of health insurance plans for individuals, families, Medicare, Medicaid, and group insurance.
Health Insurance For Individuals And Families
Health insurance plans can be obtained via an employer, the marketplace, or directly from Anthem. Plan types for medical coverage include:
•HMO (health maintenance organization): Only in-network medical care is covered, and referrals from a primary care physician are necessary.
•EPO (exclusive provider organization): Only in-network medical treatment is covered, but you can see specialists without a referral.
•PPO(preferred provider organisation): Costlier plans that cover both in-network and out-of-network medical care.
When purchasing health insurance through the marketplace, the scale of Anthem health insurance implies that multiple plan types may be available in your area, and possibilities may include Catastrophic, Bronze, Silver, Gold, and Platinum.
Through its website, Anthem also provides various forms of insurance, such as:
•Prescription medication coverage
•Dental coverage
•Short-term medical Eye insurance
•insurance
•Supplemental coverage (accident, critical illness, hospital recovery)
Medicare
Anthem provides numerous coverage alternatives for seniors and those qualifying for Medicare.
•Medicare Advantage (Part C): These plans combine Part A and B Original Medicare benefits with alternatives for prescription medication coverage, vision and dental insurance, and wellness benefits. Although Anthem's Medicare Advantage plans did not make our list of the top Medicare Advantage plans, the health coverage options remain good, with both HMO and PPO plans available.
•Prescription medications (Part D): Anthem offers three Part D plan alternatives for stand-alone prescription drug coverage: MediBlue Rx Enhanced, Plus, and Standard.
•Medicare supplement (Medigap): Complement plans can supplement Original Medicare coverage by helping to pay deductibles and coinsurance. Anthem offers many plans, including Plan F, Plan G, and Plan N.
•Dentistry and vision insurance: Anthem offers dental and vision insurance as a separate plan or as part of Medicare Advantage Part C plans. This flexibility allows you to supplement your coverage or combine it with other aspects of Medicare.
Medicaid
Anthem collaborates with state partners to offer Medicaid coverage and manage health insurance for those with low incomes, disabilities, or other qualifying conditions. In California, Indiana, Kentucky, Nevada, Virginia, and Wisconsin, Anthem Medicaid plans are offered.
Even if you enroll in Medicaid through the government, you may be able to obtain Anthem health insurance.
Anthem Insurance Premiums
Individual Anthem health insurance policies are often priced somewhat lower than several rivals. You may be able to discover some excellent bargains on plans, and in Kentucky, the Anthem Blue Cross and Blue Shield plan is the most affordable.
Average monthly cost of Anthem insurance |
|
| Catastrophic | $288 |
| Bronze | $362 |
| Expanded Bronze | $382 |
| Silver | $477 |
| Gold | $487 |
Averages based on a 40-year-old in Virginia.
When comparing Anthem's average cost to that of other insurance providers, the $477 monthly cost for a Silver Anthem coverage is somewhat more than Cigna's and far cheaper than Oscar's.
The cost of insurance will vary depending on your personal information, where you reside, and the amount of coverage you choose. Individual health insurance policies are anticipated to be somewhat more expensive in 2022, with the rate of increase varying by state.
Anthem Insurance Rates Are Projected To Rise In 2022.
•12.3 percent in Connecticut
•Colorado: 0.3 percent -7.3%
•2.8 percent in Indiana
•8.5 percent in Maine
•10.2 percent in New York
In Connecticut, where prices are anticipated to rise 12.3 percent, this may amount to an additional $60 per month for Silver-tier insurance coverage. The easiest approach to prepare for impending health insurance rate hikes is to compare health insurance quotes to ensure you're getting the best cost for the level of coverage you require.
How Much Is The Anthem Copay?
According to Anthem's claims data, the average cost for a primary care visit, including copays and coinsurance, is $60 and $150 for an urgent care visit. The price you pay when seeing the doctor or receiving medical services, on the other hand, will vary according to your plan.
A Gold plan, for example, may have a $30 cost for a primary care physician visit, but a Bronze plan may have a $75 payment for the same service. In general, having a higher monthly premium for health insurance results in reduced copays and coinsurance when you require medical care.
Anthem Insurance Premiums
Individual Anthem health insurance policies are often priced somewhat lower than several rivals. You may be able to discover some excellent bargains on plans, and in Kentucky, the Anthem Blue Cross and Blue Shield plans are the most affordable.
Anthem Is Accessible Where?
Anthem health insurance plans are offered in 14 states across the United States. The Northeast, Midwest, and Pacific states are among the states with the most geographic diversity.
Anthem is generally a big participant in the health insurance market in the states where it operates, and in nine states, Anthem is one of the top three firms with the greatest enrollments in the individual market.
Anthem has a complicated corporate structure of companies, and determining Anthem vs Blue Cross Blue Shield is not always straightforward. The names of Anthem health insurance plans vary depending on the state, and some Anthem subsidiaries do not include the word "Anthem." HMO Colorado, Empire plans in New York, and Compcare plans in Wisconsin are all common examples.
State |
Anthem insurance subsidiary |
| California | Anthem Blue Cross Blue Cross of California |
| Colorado | HMO Colorado Inc.Rocky Mountain Hospital and Medical Service Inc. |
| Connecticut | Anthem Health Plans Inc. |
| Georgia | Blue Cross Blue Shield Healthcare Plan of Georgia Inc.Blue Cross Blue Shield of Georgia |
| Indiana | Anthem Insurance Cos. Inc. |
| Kentucky | Anthem Health Plans of Kentucky Inc. |
| Maine | Anthem Health Plans of Maine Inc. |
| Missouri | Rightchoice Managed Care Inc.Healthy Alliance Life Insurance Co HMO Missouri Inc. |
| Nevada | HMO Nevada/HMO Colorado Inc.Rocky Mountain Hospital and Medical Service Inc. |
| New Hampshire | Anthem Health Plans of New Hampshire Inc.Matthew Thornton Health Plan Inc. |
| New York | Empire BlueCross BlueShield Empire HealthChoice Assurance HealthPlus HP LLC |
| Ohio | Community Insurance Co. |
| Virginia | Anthem Health Plans of Virginia Inc.Anthem Blue Cross and Blue Shield HealthKeepers Inc. |
| Wisconsin | Blue Cross Blue Shield of Wisconsin Compcare Health Services Insurance Corp.Wisconsin Collaborative Insurance Corp.Anthem Insurance Cos. Inc. |
Member Resources And Features That Are Unique
•Optional coverage: Anthem provides separate vision and dental insurance. Adding these policies to your health insurance plan might be an easy way to combine different types of coverage while only using one insurer.
•Telehealth:Anthem offers numerous telemedicine alternatives, including the 24/7 NurseLine, LiveHealth Online for virtual doctor appointments, and telehealth systems provided directly by their doctor or hospital.
•Services for healthy living and mental health: Members get access to resources such as weight loss programs, coaching, reduced gym memberships, stress management, mental health assistance, and SilverSneakers memberships.
•Anthem mobile app: You can use the Anthem app to access digital ID cards, find a doctor, check your plan's benefits and prices, ask questions, sync your account with a fitness tracker, and more.
Customer Feedback & Concerns
Anthem insurance has a track record of rejecting coverage and terminating plans for those who require pricey medical treatment.
Anthem has had several high-profile claim denials in recent years, and the insurance company has been fined millions of dollars for issues such as failing to resolve consumer complaints, failing to address claims grievances within a reasonable time frame, and dropping health insurance coverage for those who submitted expensive medical bills.
Furthermore, we discovered that Anthem insurance refuses claims twice as frequently as the industry average. We discovered that Anthem denied 36% of medical claims for calendar year 2019 by using publicly accessible data on individual health insurance policies purchased through the marketplace. In comparison, the average claim denial rate throughout the health insurance marketplace was 17%.
The reasons why Anthem refuses claims might shed light on why this percentage is so high. One-quarter of Anthem in-network claim denials are due to the service being excluded from coverage, and 9% are due to a referral being necessary. The majority, 60 percent, are described as having "other" reasons.
Furthermore, Anthem Medicare Advantage enrollees are somewhat less happy than the national average. According to a J.D. Power poll from 2021, Anthem's Medicare Advantage plans received 797 out of 1,000 points, which is somewhat lower than the industry average of 806. Kaiser Foundation Health Plan was the highest-ranking firm, with an 846.
Other metrics indicate Anthem insurance receiving mixed evaluations. For example, dependent on the Anthem division or subsidiary, Anthem is scored either very highly or very poorly on the National Association of Insurance Commissioners (NAIC) complaint index.
The large multistate organizations have a low number of complaints, while California, New York, Maine, Georgia, and New Hampshire have a high rate of complaints at the state level. Similarly, the Better Business Bureau (BBB) has different evaluations depending on the company and state.
Anthem is a Blue Cross Blue Shield Association subsidiary that is publicly traded. It is financially solid, and AM Best offers it an A ("Excellent") rating, suggesting that it has the financial wherewithal to pay claims.
Commonly Asked Questions
Is Anthem A Decent Insurance Company?
For the most part, Anthem is an excellent insurance provider. In places where they are accessible, the plans are typically popular, and the firm has a vast network of medical providers. Keep in mind that Anthem has a history of refusing claims, and you may be able to avoid issues by carefully examining plan paperwork or contacting the insurance company before getting care.
Anthem Provides What Kind Of Insurance?
Anthem provides a variety of health insurance plans, including HMOs, PPOs, EPOs, prescription drug plans, vision, dentistry, short-term insurance, and supplementary insurance. Individual and family policies are available. Seniors can enroll in Medicare programs, while individuals with low incomes can enroll in Anthem-managed Medicaid plans.
Is Anthem Blue Cross Available In Other States?
Your Anthem insurance policy's health care network will decide whether you have access to in-network doctors in other states. You must contact Anthem's customer support department when making an out-of-state claim since the process may change.
Sources And Methodology
The insurance policy costs were obtained from the Centers for Medicare and Medicaid Services (CMS) and applied to a sample of 40-year-olds in Virginia. The averages were computed depending on the tier and insurer. The CMS Health Insurance Exchange Public Use Files for Transparency in Coverage were used to compute claim rejections.
Anthem insurance has numerous features that can improve your coverage, help you get more value out of your plan, and help you manage your health care better.