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Blue Cross vs Blue Shield in California: Provider Network is the Key Difference

by John Hansen

Anthem Blue Cross and Blue Shield of California Compete on Many Levels, but the Deciding Factor is Usually Network

Blue Shield of California has Sutter in their network. Anthem does not. Regarding Stanford, Anthem offers coverage through the hospital but not the medical group. Blue Shield has both.

In Santa Barbara, the Cottage Hospital and Sansum networks are with Anthem Blue Cross, but Blue Shield does not have them. Blue Shield has questioned, “Is it worth adding a network when you’d have to increase your rates in that region by 10% to do so?”

Anthem and Blue Shield Offered through Covered California

Both Anthem Blue Cross and Blue Shield of California offer Obamacare California health plans through Covered California, the state exchange. In the Health Insurance Marketplace in 2016, the top selling medical policies were the Covered California Blue Shield plans. However, in 2014 and 2015, Anthem Blue Cross Covered California plans were #1 sellers on the Covered California Exchange.

Provider Networks Make the Difference

With these two health insurance California competitors, their premiums tend to be very comparable. Depending on your region, the cheapest California health plan might be offered by Anthem Blue Cross or by Blue Shield of California. However, the rates tend to be about the same. The big difference is network.

Which plan offers the most doctors, hospitals and medical provider networks? Or, more importantly, which plan does your primary care physician or specialist take? At the end of the day, most California consumers care more about whether or not their personal doctor is covered then they care how many doctors are in-network.

Connect with Doctors Remotely through Anthem’s Live Health Online or Blue Shield’s “Tell a Doc”

Anthem Blue Cross has “Live Health Online”, where members can connect with doctors through a computer or mobile device. Consumers can do web chats in English 24/7 with physicians online. They can connect with doctors in Spanish from 7:00 am to 11:00 pm. Members can talk with a physician while traveling anywhere in the world as long as they have internet service. They can even get prescriptions for pharmaceutical medications (in most states) while outside of California. 

Live Health Online is a great service, and with this service Anthem Blue Cross has Blue Shield beat. But not for long. In 2017, Blue Shield of California is coming out with “Tell a Doc”, which will basically do the same thing as Anthem’s Live Health Online.

Anthem Blue Cross Includes the Blue Card

Also, now Anthem is offering their Blue Card for individual and family plans again. The Blue Card offers some health care services to Blue Cross members while traveling out-of-state. This may give a bit of a competitive edge to Anthem Blue Cross over Blue Shield. However, the main competitive edge of these California health plans, which differs by region, remains the size of the medical provider networks.