Anthem vs. Blue Cross Blue Shield: 2026 Comparison

Anthem vs. Blue Cross Blue Shield: ACA Health Insurance

Blue Cross Blue Shield covers 36 states compared to Anthem's 13. In our analysis of both carriers' ACA plan data, BCBS is the only option in 33 of the 36 states it covers. In the three states where both carriers operate, California, Missouri and New York, Anthem posts a higher medical care quality score (82.23 vs. 73.96). BCBS has a lower claims denial rate there, 19% vs. Anthem's 22.7%.


Availability	13 States	36 States
Plan Types	HMO, EPO, POS, PPO	HMO, POS, EPO, PPO
Avg. QRS Score	83.3	77.72
Avg. Denial Rate	22.7%	19%


ACA State Availability	California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Wisconsin	Alabama, Alaska, Arizona, Arkansas, California, Delaware, Florida, Idaho, Illinois, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wyoming
Plan Types	HMO, EPO, POS, PPO	HMO, POS, EPO, PPO

BCBS sells ACA plans in 36 states on the Health Insurance Marketplace. Anthem sells in 13. The two carriers compete in only three states: California, Missouri and New York. BCBS is the only option in 33 states; in the other 10, only Anthem sells plans. Both carriers offer all four major plan types, so plan structure won't determine your choice in overlapping markets. Here's what each type means in practice:

HMO (Health Maintenance Organization): Your primary doctor manages all your care and writes referrals for specialists. Coverage is limited to in-network providers except in emergencies.
EPO (Exclusive Provider Organization): No referral required to see a specialist, but covered care requires in-network providers.
POS (Point of Service): Requires a primary doctor to coordinate care like an HMO, but out-of-network care is available at a higher cost.
PPO (Preferred Provider Organization): No referrals required and partial coverage for out-of-network care, though in-network care costs less.

HMO
$609
$683
$678
EPO
$854
$777
$731
POS
$720
$806
$752
PPO
$803
$874
$803
BCBS costs less on HMO and POS plans: $74 per month cheaper on HMO and $86 per month cheaper on POS. Anthem costs less on EPO and PPO plans. The EPO gap favors Anthem by $77 per month ($924 per year). On PPO plans, BCBS is $71 less per month ($852 per year).

Anthem's EPO rate of $777 per month is the only plan type that undercuts BCBS and comes closest to the national average of $731. BCBS's EPO average of $854 per month sits $123 above the national figure; Anthem's sits $46 above. In California, Missouri and New York, Anthem's EPO premiums are lower than BCBS's. That advantage narrows on HMO plans, where BCBS costs $74 less per month.
Overall QRS Score
83.3
77.72
Medical Care QRS Score
82.23
73.96
Member Experience QRS Score
88.99
95.91
Plan Administration QRS Score
81.9
81.36
Avg. Denial Rate
22.7%
19%
Anthem's medical care quality score is 82.23 vs. BCBS's 73.96, an 8.27-point gap. That score covers preventive care and chronic disease management, the areas that affect health outcomes directly. On member experience, BCBS scores 95.91 vs. Anthem's 88.99.

On claims, BCBS denies 19% of submissions vs. Anthem's 22.7%. BCBS members are 16% less likely to have a claim denied on first submission.
Anthem covers only 13 states. In 33 of those states, BCBS is the only option between these two carriers. Both carriers sell plans in only three states: California, Missouri and New York. Anthem's denial rate there is 22.7% vs. BCBS's 19%. That 3.7-percentage-point gap matters most for enrollees who file frequently. Anthem's medical care quality score is 82.23 vs. BCBS's 73.96, but for anyone prioritizing claim approval, BCBS's denial rate is 3.7 points lower.
BCBS's member experience score is 95.91 vs. Anthem's 88.99. The medical care quality gap runs 8.27 points: Anthem at 82.23 and BCBS at 73.96. In the 10 states where only Anthem sells ACA plans, BCBS isn't an option. For enrollees with chronic conditions who need coordinated care, Anthem's 82.23 medical care score is the deciding factor. BCBS's denial rate is 19%, which is 3.7 points below Anthem's 22.7%. Enrollees who file frequently get more first-submission approvals with BCBS.


HMO	$609	$683	$678
EPO	$854	$777	$731
POS	$720	$806	$752
PPO	$803	$874	$803


Overall QRS Score	83.3	77.72
Medical Care QRS Score	82.23	73.96
Member Experience QRS Score	88.99	95.91
Plan Administration QRS Score	81.9	81.36
Avg. Denial Rate	22.7%	19%

Anthem vs. Blue Cross Blue Shield Medicare Supplement

BCBS sells Medicare Supplement (Medigap) coverage in 36 states vs. Anthem's 12, and has 10 standardized plan types compared to Anthem's four. Both carriers use Attained Age pricing, meaning premiums increase each year as you get older. BCBS also includes high-deductible versions of Plans F and G, Anthem doesn't offer either.


Availability	12 States	36 States
Plan Types	A, F, G, N	A, B, C, D, F, G, K, L, M, N
High-Deductible F and G	No	Yes
Dominant Pricing Style	Attained Age	Attained Age

Across 36 states, BCBS sells Medigap policies, covering most of the country outside New York, Hawaii, Illinois, Washington D.C. and Wyoming. Anthem serves only 12 states across the western and northeastern regions. Overlap doesn't exist in any state except Wisconsin, where both offer the state-specific Medigap Basic Plan instead of standard lettered options.

Anthem's state-by-state presence is limited but includes exclusive 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.


Alabama	N/A	A
Alaska	N/A	A, C, G, N
Arizona	N/A	A, C, D, F, G, N
Arkansas	N/A	A, C, F, G, N
California	A, F, G, N	A, F, G, N
Colorado	A, F, G, N	N/A
Connecticut	A, F, G, N	N/A
Delaware	N/A	A, B, C, D, F, G, N
Florida	N/A	A, B, C, D, F, G, K, L, M, N
Georgia	A, F, G, N	N/A
Hawaii	N/A	N/A
Idaho	N/A	A, C, F, G, K, N
Illinois	N/A	N/A
Indiana	A, F, G, N	N/A
Iowa	N/A	A, D, F, G, N
Kansas	N/A	A, F, G, K, L, N
Kentucky	A, F, G, N	N/A
Louisiana	N/A	A, B, F, G, N
Maine	A, F, G, N	N/A
Maryland	N/A	A, B, F, G, L, M, N
Massachusetts	N/A	Meets state standards
Michigan	N/A	A, D, F, G, N
Minnesota	N/A	Meets state standards
Mississippi	N/A	A, B, C, D, F, G
Missouri	A, F, G, N	N/A
Montana	N/A	A, F, G, N
Nebraska	N/A	A, B, C, F, G, L, N
Nevada	A, F, G, N	N/A
New Hampshire	A, F, G, N	N/A
New Jersey	N/A	A, C, D, F, G, K, N
New Mexico	N/A	A, F, G, N
New York	N/A	N/A
North Carolina	N/A	A, G, K, N
North Dakota	N/A	A, C, F, G, L, N
Ohio	A, F, G	N/A
Oklahoma	N/A	A, F, G, N
Oregon	N/A	A, C, F, G, K, N
Pennsylvania	N/A	A, B, F, G, N
Rhode Island	N/A	A, F, G, N
South Carolina	N/A	A, B, C, D, F, G, K, L, N
South Dakota	N/A	A, D, F, G, N
Tennessee	N/A	A, C, D, F, G, N
Texas	N/A	A, F, G, N
Utah	N/A	A, C, F, G, K, N
Vermont	N/A	C, D, F, G, N
Virginia	N/A	A, B, F, G, L, M, N
Washington	N/A	A, C, F, G, K, N
Washington D.C.	N/A	N/A
West Virginia	N/A	A, C, D, F, G, N
Wisconsin	Medigap Basic Plan	Medigap Basic Plan
Wyoming	N/A	N/A

BCBS posts lower premiums across most Medigap plan types per MoneyGeek's analysis of 2026 HealthCare.gov plan data. At age 65, BCBS's Plan G costs $170 per month vs. Anthem's $218, a $48 monthly gap worth $576 per year. Plan F costs $215 per month with BCBS and $294 with Anthem, a difference of $79 per month or $948 per year. BCBS's Plan G is $225 per month vs. Anthem's $273 at age 75. The $48 monthly gap on Plan G is unchanged from age 65. At age 75, Plan F costs $285 per month with BCBS and $379 per month with Anthem, a difference of $94 per month.


A	$360	$279	$406	$360
B	N/A	$287	N/A	$368
C	N/A	$285	N/A	$369
D	N/A	$283	N/A	$372
F	$294	$215	$379	$285
G	$218	$170	$273	$225
K	N/A	$107	N/A	$131
L	N/A	$206	N/A	$273
M	N/A	$307	N/A	$400
N	$198	$204	$254	$274

At age 65, BCBS's Plan A costs $279 per month vs. Anthem's $360. Plan N pricing is nearly tied at age 65 (BCBS at $204, Anthem at $198), but by age 75 Anthem costs less on Plan N at $254 vs. BCBS's $274.

Anthem is cheaper on Plan N at both ages: $198 vs. $204 at 65 and $254 vs. $274 at 75. The gap grows as you age, which is the opposite of what you'd expect given that BCBS costs less on Plan G and Plan F across both age points. Plan N's lower cost comes with a trade-off, it includes small copays for office visits and emergency room trips that the other plans don't charge, but for healthier enrollees who rarely use care, Anthem's Plan N pricing is the better deal in our analysis.
BCBS charges less on most plans. In the 10 states where Anthem operates exclusively, Anthem is the only option.

Anthem's Medigap plan covers only 12 states and has just four plan types (A, F, G and N). Shoppers who want Plan B, C, D, K, L or M have no path through Anthem. On price, BCBS is less expensive on most plans, Plan G runs $48 per month less at age 65 and $48 less at age 75. The gap on Plan F is of $79 per month at age 65 and $94 per month at age 75. Under Attained Age pricing, that $48 monthly gap adds up to $5,760 over 10 years. Anthem is worth choosing only if you're in one of its exclusive states and BCBS isn't available.
BCBS isn't available in New York, Hawaii, Illinois, Washington, D.C. or Wyoming for Medigap coverage. Shoppers in those markets have no BCBS option between these two carriers. Both carriers use Attained Age pricing, so premiums increase annually regardless of which you choose. If you're in a BCBS-covered state and comparing on price alone, BCBS wins on most plans. But if local agent support matters to you and your state has stronger independent agent networks tied to Anthem, the service experience may offset the price difference.

Anthem vs. Blue Cross Blue Shield Medicare Advantage

BCBS covers 31 states for Medicare Advantage vs. Anthem's 12.BCBS earns a higher average CMS star rating (3.79 vs. 3.56) and has PFFS plans that Anthem doesn't. Anthem leads slightly on $0 premium plans (44% vs. 41%), though the gap is narrow and flips by plan type.


Availability	12 States	31 States
Plan Types	HMO, HMO-POS, PPO	HMO, HMO-POS, PPO, PFFS
Avg. CMS Star Rating	3.56	3.79
Drug Benefits	Enhanced	Basic, Enhanced
% $0 Premium Plans	44%	41%

BCBS's PFFS plans let enrollees see any provider without network restrictions. Anthem has no equivalent plan type.

Across 31 states, BCBS operates Medicare Advantage plans, covering major population centers throughout the country. 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	40%	55%	$29	$31	$7,890	$5,292
HMO-POS	68%	26%	$13	$64	$5,205	$5,500
PPO	0%	38%	$37	$67	$7,183	$6,289
PFFS	N/A	0%	N/A	$57	N/A	$7,500

BCBS caps the annual out-of-pocket maximum at $5,292 vs. Anthem's $7,890, a $2,598 gap. It also puts more HMO plans at $0 premium (55% vs. 40%).

Anthem posts $0 premiums on 68% of plans vs. BCBS's 26%, with an average monthly cost of $13 vs. $64. For members who want HMO-POS coverage at the lowest possible monthly cost, Anthem is the clear choice. The out-of-pocket maximums are close: $5,205 for Anthem vs. $5,500 for BCBS.

Anthem's PPO average premium is $37 per month vs. $67 for BCBS, but none of Anthem's PPO plans carry a $0 premium while 38% of BCBS PPO plans do. BCBS caps PPO out-of-pocket costs at $6,289 vs. Anthem's $7,183.

HMO
3.89
3.73
HMO-POS
3.3
4.09
PPO
3.8
3.76
PFFS
N/A
3.5
BCBS's overall 3.79-star average beats Anthem's 3.56. The largest gap is in HMO-POS plans, where BCBS rates 4.09 stars vs. Anthem's 3.3. Plans at 4.0 stars or above get special enrollment windows and can include supplemental benefits that lower-rated plans cannot.

Anthem rates higher on standard HMO plans (3.89 vs. 3.73). PPO ratings are close: Anthem at 3.8, BCBS at 3.76. BCBS's PFFS plans, which Anthem doesn't offer, average 3.5 stars.
Anthem's 3.3 stars vs. BCBS's 4.09 on a single plan type is a 0.79-star difference and it has practical consequences. Plans rated 4.0 or above get special enrollment periods and can include supplemental benefits that lower-rated plans cannot. For an HMO-POS shopper, that's not a marginal quality difference. It changes what the plan can include.
Anthem's average CMS star rating of 3.56 falls below the 4.0 threshold that opens special enrollment windows and expanded supplemental benefits. For HMO-POS coverage specifically, Anthem's 3.3-star rating is nearly a full star below BCBS's 4.09. On HMO plans, Anthem's out-of-pocket maximum of $7,890 is $2,598 higher than BCBS's $5,292, a gap that becomes real money if you need hospitalization or specialty care. Anthem's lower monthly costs on HMO-POS are a genuine advantage if you're healthy and unlikely to hit your MOOP. If you're managing ongoing conditions, the BCBS out-of-pocket ceiling is a stronger protection.
BCBS charges $64 per month on average for HMO-POS plans vs. Anthem's $13, a $51 monthly gap that adds up to $612 per year. For Medicare Advantage members in good health who want HMO-POS coverage at the lowest monthly cost, Anthem is the better fit. On HMO plans, BCBS's $31 average premium is nearly identical to Anthem's $29, so the premium advantage disappears and the decision shifts to network and plan quality. BCBS isn't available in Connecticut, where Anthem holds exclusive coverage among these two carriers.


HMO	3.89	3.73
HMO-POS	3.3	4.09
PPO	3.8	3.76
PFFS	N/A	3.5

Bottom Line

BCBS leads this comparison on most dimensions: broader availability (36 states for ACA and Medigap, 31 for Medicare Advantage), lower ACA claims denial rate (19% vs. 22.7%), better overall Medicare Advantage star ratings (3.79 vs. 3.56) and lower pricing on most Medigap plans. Anthem counters with higher ACA medical care quality scores (82.23 vs. 73.96), lower HMO-POS Medicare Advantage premiums ($13 vs. $64 per month) and the only Medicare Advantage option in Connecticut.

Choose BCBS if you're shopping for ACA coverage in one of the 33 states where it operates exclusively or if you want a broader Medigap plan selection and lower Plan G or Plan F premiums. BCBS also wins on Medicare Advantage quality for HMO-POS shoppers, where its 4.09-star rating is nearly a full star above Anthem's 3.3.
Choose Anthem if it's your only option in your state, if you want HMO-POS Medicare Advantage at the lowest monthly cost or if ACA medical care quality scores matter more to you than claims approval rates. On Plan N Medigap pricing, Anthem is cheaper at both age 65 and 75, the one plan type where it holds a pricing edge over BCBS.

Get quotes from both carriers using your ZIP code before enrolling. Premiums, plan availability and network coverage all vary by location and the statewide averages on this page may not reflect what you'll pay in your county.

Frequently Asked Questions

e've answered common questions about Anthem and Blue Cross Blue Shield health insurance across ACA, Medicare Advantage and Medicare Supplement plans:

Is Anthem the same as Blue Cross Blue Shield?

Anthem and Blue Cross Blue Shield are separate companies, but they are connected. Anthem is the largest independent licensee of the Blue Cross Blue Shield Association, which means Anthem sells BCBS-branded plans in 14 states, including California (Anthem Blue Cross), Georgia, Indiana and Ohio. In those states, Anthem plans carry the BCBS name. Outside those states, Anthem and BCBS operate as distinct carriers with separate networks, plan lineups and pricing.

Which carrier is better for Medicare?

BCBS is the stronger option for most Medicare enrollees based on availability and quality scores. It covers 36 states for Medigap and 31 for Medicare Advantage, compared to Anthem's 12 states for each. BCBS also earns a higher average CMS star rating on Medicare Advantage (3.79 vs. 3.56) and has more Medigap plan types (10 vs. four). Anthem costs less on HMO-POS Medicare Advantage plans ($13 vs. $64 per month) and is the only option for Medicare enrollees in Connecticut.

Which has lower ACA premiums?

It depends on plan type. BCBS costs less on HMO plans ($609 vs. $683 per month) and POS plans ($720 vs. $806). Anthem costs less on EPO plans ($777 vs. $854). On PPO plans, BCBS runs $71 less per month. For most ACA shoppers, BCBS provides lower premiums, but Anthem is cheaper on EPO, which is the plan type that lets you see specialists without a referral while keeping you in-network.

Can I have both Anthem and BCBS coverage?

You can hold separate policies from each carrier, but not for the same coverage type in the same year. ACA rules prohibit overlapping Marketplace coverage. For Medicare, you can carry one Medicare Advantage plan or one Medigap policy at a time, not both. Some enrollees hold an ACA plan from one carrier and a dental or vision plan from the other, since those are separate product lines.

About Mark Fitzpatrick

Mark Fitzpatrick, a Licensed Property and Casualty (P&C) Insurance Producer in Connecticut, is MoneyGeek's resident insurance expert. He has spent nearly a decade analyzing the market, first at LendingTree and now at MoneyGeek, where he has produced original research on hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.

He covers economics and insurance at MoneyGeek, and his work has been featured in The Washington Post, The New York Times and NPR, among other outlets.

Like all MoneyGeek analysts, he draws on independent cost and consumer experience data. No insurance company partnership influences his recommendations.

Fitzpatrick earned his degrees from Johns Hopkins University (M.A. Economics and International Relations) and Boston College (B.A.). He began his career in financial risk management at State Street. He's also a five-time “Jeopardy!” champion.

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Sources

CMS.gov. "About the Quality Rating System (QRS)." Accessed June 18, 2026.
HealthCare.gov.. "Welcome to the Health Insurance Marketplace." Accessed June 18, 2026.
Medicare.gov. "Welcome to Medicare." Accessed June 18, 2026.