Anthem vs. Blue Cross Blue Shield: 2026 Comparison

Anthem operates in 13 states with a complete range of plan structures. Across 36 states, BCBS makes itself accessible to far more Americans shopping on the Health Insurance Marketplace. Direct competition exists in just four states: California, Missouri, New York and Colorado. In 32 states, BCBS holds exclusive coverage, while Anthem remains the only option in nine markets where it operates.    

Both carriers provide identical plan type offerings, so your choice in overlapping markets won't be limited by network structure:   

• HMO (Health Maintenance Organization): Your primary doctor manages all your care and writes referrals when you need specialists. You'll stay in-network for everything except emergency care.
• EPO (Exclusive Provider Organization): See specialists directly without getting permission from a primary doctor first, though you still need to use network providers for covered care.
• POS (Point of Service): Works like an HMO with a coordinating primary doctor, but you can go outside the network if you're willing to pay higher costs.
• PPO (Preferred Provider Organization): Visit any doctor or specialist without referrals and get partial coverage even for out-of-network care, though staying in-network saves money.

On HMO and POS plans, BCBS offers more competitive pricing. BCBS's HMO coverage averages $683 per month, undercutting Anthem by $74 and coming in below the national benchmark. At $720 versus $806, BCBS's POS plans run $86 cheaper monthly than Anthem's. 

For EPO pricing, Anthem wins by charging $777 monthly compared to BCBS's $854 average. That $77 difference translates to $924 in annual savings for EPO shoppers. A wider gap appears in PPO plans, with Anthem averaging $874 per month and BCBS at $803, putting BCBS $71 ahead monthly or $852 per year. 

Which network structure fits your needs determines your best premium value. On the more restrictive HMO plans and the hybrid POS option, BCBS provides savings, while Anthem costs less for EPO coverage.

In member experience, BCBS pulls ahead decisively, scoring 95.91 versus Anthem's 88.99. Better customer service interactions and overall satisfaction appear in BCBS member reports, even if medical care quality metrics trail Anthem.    

For policyholders, claims approval represents a meaningful difference. While BCBS denies 19% of claims, Anthem rejects 22.7%, meaning BCBS members are roughly 16% less likely to have claims denied. Both rates exceed the 18% national average, but your chances of having claims approved on the first submission improve with BCBS.

Closer competition appears in Plan A and Plan N pricing. For Plan A at age 65, BCBS costs $279 monthly versus Anthem's $360, an $81 advantage for BCBS. At age 65, Plan N is virtually tied, with BCBS at $204 and Anthem at $198, but by age 75 BCBS pulls ahead at $274 versus $254.     

With BCBS offering lower rates on most plans, the key question becomes whether Anthem's presence in your exclusive market outweighs BCBS's pricing advantage.

For HMO plans, BCBS offers more $0 premium options at 55% versus Anthem's 40%, though monthly premiums are nearly identical when charges apply. In maximum out-of-pocket limits, the meaningful difference appears, where BCBS's $5,292 average sits $2,598 below Anthem's $7,890, providing much better catastrophic protection. 

The pricing pattern reverses with HMO-POS plans. On 68% of plans compared to just 26% for BCBS, Anthem provides $0 premiums, with average monthly costs of $13 versus $64. 

Between carriers, out-of-pocket maximums are comparable. With PPO plans, Anthem shows lower average premiums at $37 versus $67 for BCBS, but zero Anthem plans carry no premium while 38% of BCBS PPO plans do. Better out-of-pocket protection is provided by BCBS, capping costs at $6,289 versus Anthem's $7,183.

Overall, BCBS earns better quality marks, averaging 3.79 CMS stars against Anthem's 3.56. The starkest contrast shows in HMO-POS coverage, with BCBS rating 4.09 stars and Anthem just 3.3, almost a full star apart. At the 4.0-star threshold, plans unlock special enrollment windows and include more supplemental benefits. 

Only on standard HMO plans does Anthem perform better, earning 3.89 stars compared to BCBS's 3.73. Between the carriers, PPO ratings are essentially equivalent, with Anthem at 3.8 and BCBS at 3.76. BCBS's PFFS plans, which Anthem doesn't offer, average 3.5 stars.