Anthem vs. Blue Cross Blue Shield: What's the Difference?

 Advantages of Anthem

• Medical care quality QRS score of 82.23 out of 100, about eight points above BCBS's 73.96
• EPO plans average $77 less per month than BCBS EPO plans
• More than two-thirds of HMO-POS Medicare Advantage plans carry a $0 premium
• Plan N Medigap costs less than BCBS at both age 65 and age 75
• The only Medicare Advantage option in Connecticut
• AM Best A (Excellent) financial strength rating, affirmed December 2025

Disadvantages of Anthem

• ACA plans available in only 14 states; BCBS covers all 50
• Higher ACA claims denial rate than BCBS, increasing out-of-pocket billing risk
• Average CMS star rating of 3.56, below the 4-star threshold for expanded Medicare Advantage benefits
• HMO Medicare Advantage out-of-pocket maximum of $7,890 vs. BCBS's $5,292
• Only four Medigap plan types vs. 10 with BCBS
• No PFFS Medicare Advantage plans

Advantages of BCBS

• ACA plans available in all 50 states vs. Anthem's 14
• Lower ACA claims denial rate means fewer out-of-pocket billing surprises on first submission
• HMO-POS plans average 4.09 CMS stars, nearly a full star above Anthem's 3.3
• Ten Medigap plan types available, including high-deductible Plans F and G
• Lower HMO Medicare Advantage out-of-pocket maximum ($5,292 vs. Anthem's $7,890)
• PFFS plans available for members who want no network restrictions

Disadvantages of BCBS

• HMO-POS Medicare Advantage averages $64 per month; Anthem averages $13
• Medical care quality QRS score (73.96) is about eight points below Anthem's
• Quality and service vary across 33 independent state companies operating separately
• No Medicare Advantage coverage in Connecticut; Anthem is the only option there
• BCBS EPO plans deny more ACA claims per submission than any other BCBS plan type

Anthem is part of the Blue Cross Blue Shield Association and its members access the same national provider network as every other BCBS company. That network covers more than 1.7 million doctors and hospitals, the largest provider network in U.S. health insurance.   

Network access is not a deciding factor between Anthem and BCBS. If your doctor is in-network with one carrier in your area, they are almost certainly in-network with the other. The decision comes down to price, plan type, and how each carrier processes claims in your state.

Anthem is a poor fit for most buyers simply because of geography. It sells ACA plans in 14 states. In 36 others, BCBS is your only choice between the two. 

Where both carriers compete, BCBS approves more ACA claims on first submission. If you have a chronic condition, visit specialists regularly or take medications requiring prior authorization, the lower BCBS denial rate is the more important variable. Anthem's medical care quality advantage only matters if your claims clear. With a higher denial rate than BCBS, Anthem members are more likely to pay for care that a BCBS member would have covered.

BCBS is the wrong choice if chronic disease management is your primary concern. Anthem's medical care quality score is about eight points higher on the QRS. For someone whose plan selection depends on clinical outcomes, Anthem's higher medical care score is the more relevant number.

Hold off on BCBS EPO plans if claim approval rate matters. BCBS EPO plans deny more ACA claims per submission than any of BCBS's other plan types, and at a higher rate than Anthem's overall average. If you want BCBS coverage and want the lowest denial rate, choose its PPO or POS plan.

BCBS's member experience score is higher than Anthem's, but that difference is also partly a product of BCBS's 33-company structure. In some states, BCBS member experience is well above the national average. In others, it falls below average. Anthem's score is more consistent across markets because it operates as one company.

Across 36 states, BCBS sells Medigap policies. Its coverage spans most of the country, with no presence in New York, Hawaii, Illinois, Washington, D.C. or Wyoming. Anthem serves only 12 states, concentrated in the West, Northeast, and parts of the South and Midwest. Overlap exists in two states: California, where both sell Plans A, F, G and N; and Wisconsin, where both offer the state-specific Medigap Basic Plan instead of standard lettered options.

Anthem holds exclusive Medigap coverage in Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire and Ohio. Across a much broader geography, BCBS operates with comprehensive plan selections in major markets like Florida, Maryland, Virginia and South Carolina.

BCBS costs less than Anthem on every Medigap plan type except Plan N, based on MoneyGeek's analysis of 2026 HealthCare.gov plan data. At age 65, BCBS's Plan G is $48 less per month, and Plan F is $79 less. Those monthly gaps translate to $576 and $948 in annual savings, respectively.

By age 75, BCBS's Plan G advantage is unchanged at $48 per month. Its Plan F advantage grows to $94 per month, a difference worth $1,128 per year. Because both carriers use Attained Age pricing, premiums rise with age for both, but BCBS's pricing remains lower at every age point against Anthem's.   

Plan N is the one exception. Anthem costs $6 less at age 65 and $20 less at age 75. The cost difference grows as you age, which is the opposite of the pattern on Plans G and F. Plan N covers most out-of-pocket costs but charges small copays for office visits and emergency room trips. For healthier enrollees who use care rarely, Anthem's Plan N pricing is the better deal.

Anthem Medigap is not an option in most of the country. It operates in 12 states, all in the West or Northeast, leaving the South, Midwest, and most of the Atlantic Coast without access. If you live outside Anthem's coverage area, BCBS is your only choice between the two for Medigap.

Within those 12 states, Anthem costs more than BCBS on Plans A, F, and G at both age 65 and age 75. Plan G is the most widely purchased Medigap plan because it covers virtually all out-of-pocket costs after the annual Part B deductible. If you want Plan G coverage and both carriers are available in your state, BCBS will cost less every month for the foreseeable future.

Anthem also doesn't offer Plans B, C, D, K, L and M, which BCBS includes in its lineup. If your coverage needs fit one of those plan types, or if you want the high-deductible versions of Plans F or G, you can't choose Anthem.

BCBS costs more than Anthem on Plan N Medigap at both age 65 and age 75. Plan N is among the more affordable Medigap options because it covers most costs but adds small copays at office visits and the emergency room. If Plan N fits your health use and budget, Anthem's lower Plan N pricing makes it the better deal.

In the 10 states where Anthem operates exclusively, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, and Ohio, BCBS doesn't sell Medigap at all. If you're in one of those states, Anthem is your only option between the two, regardless of pricing.

Across 31 states, BCBS operates Medicare Advantage plans, reaching major population centers from Florida to California. In 12 states, Anthem sells plans, all of which overlap with BCBS territory except Connecticut. Direct comparisons between both carriers work in 11 markets, but in 20 additional states, BCBS remains your only option.   

• Anthem Availability: California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Missouri, Nevada, New York, Ohio, Virginia, Wisconsin   
• Blue Cross Blue Shield Availability: Alabama, Arizona, Arkansas, California, Delaware, Florida, Georgia, Idaho, Illinois, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Washington, West Virginia

HMO-POS Medicare Advantage is where Anthem falls shortest on quality. Its plans average 3.3 CMS stars against BCBS averages 4.09 for the same plan type. Plans below 4 stars don't qualify for the enrollment windows and supplemental benefit options that 4-star plans can include. For an HMO-POS enrollee, that's not a marginal quality gap. It changes what the plan can include.

Anthem's HMO Medicare Advantage out-of-pocket maximum is $2,598 higher than BCBS's for the same plan type. For healthy members who rarely reach the MOOP, this doesn't matter. For anyone managing a condition that generates regular inpatient or specialist costs, BCBS's lower ceiling caps your annual costs at $5,292, compared to Anthem's $7,890.

Skip Anthem if you want a plan with no provider network restrictions. BCBS's PFFS plans carry no network restriction. Anthem has no equivalent plan type.

BCBS is the wrong call for Medicare enrollees who want HMO-POS coverage at the lowest possible monthly cost. Anthem's HMO-POS average is $13 per month; BCBS's is $64. More than two-thirds of Anthem's HMO-POS plans carry a $0 premium. If you're in good health and choose this plan type, paying $51 more per month for BCBS buys you higher star ratings but not necessarily more care.

On standard HMO plans, the cost comparison narrows to $2 per month ($29 Anthem vs. $31 BCBS). At that margin, the decision shifts to quality and network rather than premium. BCBS's lower HMO out-of-pocket maximum ($5,292 vs. Anthem's $7,890) is the more relevant factor if you anticipate using care.

BCBS doesn't operate Medicare Advantage in Connecticut. If you're a Connecticut enrollee comparing these two carriers for Medicare Advantage, Anthem is your only option.