Discover Why the Blue Cross Blue Shield Healthcare Marketplace is the Solution for Your Health Insurance Needs
Blue Cross Blue Shield (BCBS) has a rich history of offering worry-free health care since 1929. With nationwide coverage that extends to all 50 states, you can have peace of mind wherever life takes you. Have confidence knowing you’re backed by a network of over 1.7 million doctors and hospitals. This ensures quality care that is both accessible and inexpensive.
Who is Blue Cross Blue Shield?
If you spent any amount of time searching for affordable health insurance, you’ve come across Blue Cross Blue Shield.
BCBS is an insurance provider that is managed by the Blue Cross Blue Shield Association (BCBSA). The BCBSA is a network of 36 independent, community-operated companies. They provide health insurance to over 100+ million Americans.
Locally, they are known as Blue Cross Blue Shield and they offer a variety of plans. These plans include HMOs, PPOs, and EPOs. The type of plan you pick will determine out-of-pocket costs, the network of providers, and other benefits.
Two of the biggest benefits that customers love are:
- Extensive Provider Network: Access to a large network where you can find an in-network provider no matter where you live.
- Comprehensive Health Management Tools: A range of tools and resources to help you take charge of your health. Online portals allow you to view claims, locate doctors, and schedule appointments. Some BCBS companies also offer wellness programs, such as gym memberships and smoking cessation programs, to help you stay healthy.
In summary, you can feel reassured that with over 100 million Americans being covered, you’re in good hands.
But, in order to take advantage of the benefits we must also understand…
What is the Health Insurance Marketplace?
The Health Insurance Marketplace (also known as, the “Marketplace” or the “Exchange”) is a platform where you can compare & enroll in plans from different insurance companies. The federal government operates the Marketplace through HealthCare.gov, while most states have their own Marketplaces. These exchanges offer convenient services for health plan shopping & enrollment through websites, call centers, and in-person assistance.
- Financial Assistance: Savings like premium tax credits that make health insurance plans affordable.
- Complete Coverage: Getting covered through Medicaid and Children's Health Insurance Program (CHIP)
Essential Health Benefits
All healthcare plans offered ion the Marketplace must cover 10 essential health benefits. These benefits include:
- Ambulatory patient services (outpatient care)
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance abuse disorder services
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Eligibility and Income-based Subsidies Through the BCBS Marketplace
To be eligible for financial assistance you must meet certain requirements. The Affordable Care Act (ACA) sets income limits for subsidies. If your income is within these limits, you may be eligible for help with paying your monthly health insurance bill.
Requirements for Eligibility:
- Household income is at least equal to the Federal Poverty Level (FPL)
- No access to health coverage through an employer (includes a family member's employer)
- Not eligible for Medicare, Medicaid, or the Children's Health Insurance Program
- Have U.S. citizenship or proof of legal residency
- If your married you must file taxes jointly
Federal Poverty Level Chart (FPL)
| Family Size | 2022 Income Numbers | 2023 Income Numbers |
|---|---|---|
|
Individuals |
$13,590 |
$14,580 |
|
A family of 2 |
$18,310 |
$19,720 |
|
A family of 3 |
$23,030 |
$24,860 |
|
A family of 4 |
$27,750 |
$30,000 |
|
A family of 5 |
$32,470 |
$35,140 |
|
A family of 6 |
$37,190 |
$40,280 |
|
A family of 7 |
$41,910 |
$45,420 |
|
A family of 8 |
$46,630 |
$50,560 |
|
A family of 9+ |
Add $4,720 for each extra person |
Add $5,140 for each extra person |
Year 2022 numbers are used to calculate savings on insurance plans for 2023.
How Federal Poverty Levels Help Decide Who Qualifies for Discounted Health Coverage
- Above 400% FPL: If it is higher than 400% of the federal poverty level (FPL), you may now qualify for premium tax credits.
- Between 100% and 400% FPL: If it falls within this range, you're eligible for premium tax credits in all states.
- At or below 150% FPL: If it is at or below 150% of the federal poverty level (FPL) in your state and you're not eligible for Medicaid or CHIP, you may qualify for a Special Enrollment Period to enroll in or change Marketplace coverage.
- Below 138% FPL: If it is lower than 138% of the federal poverty level (FPL) and your state has expanded Medicaid coverage, you qualify for Medicaid based solely on your income.
- Below 100% FPL: If it is below 100% of the federal poverty level (FPL), you likely won't be eligible for savings or income-based Medicaid.
Keeping up with the where you fall on the federal poverty level is important. Getting care that covers what you need while not breaking the bank is top priority.
A good supplement to saving money is the additional…
Blue Cross and Blue Shield: Member Services
and Benefits
Interactive Search
Use your local Blue Cross Blue Shield website to:
- Change coverage
- File / Check A Claim
- Review Balances
- Get an estimated cost for a medical procedure
- Order a replacement member ID Card
- View plan details
Member ID Card
Your ID card is an important tool that allows you access to great benefits and services. The identification number can help you find a doctor or hospital in your network.
Member Discounts
Being a member is like having exclusive admission to discounts on health & wellness products and services. You’ll find discounts for:
- Financial Health
- Fitness
- Healthy Eating
- Lifestyle
- Personal Care
- Wellness
In addition to the member benefits, don’t forget to see what they offer as…
Healthcare Coverage
We know Blue Cross Blue Shield’s extensive network of hospitals and doctors has you covered. But what is included with their plans?
Blue Cross Blue Shield has a range of patient care options. This includes coverage for mental health and substance abuse treatment, as well as preventative care services like annual check-ups and screenings. They also offer coverage for prescription medications, so you can get the medications you need at an affordable price.
For coverage options, they offer individual and family plans. Within those plans you can choose different levels of coverage, including bronze, silver, gold, and platinum plans. Each level offers different levels of coverage and out-of-pocket costs, so you can choose the what best fits your needs and budget.
Not to mention, dental and vision insurance. This will help you save money on:
- Routine eye exams
- Glasses
- Dental procedures
Depending on the chosen plan, you may be eligible for orthodontic coverage. Saving on this will help offset the cost of braces and other orthodontic treatments.
Whether you need coverage for routine check-ups or more serious medical conditions, they have something that can meet your needs.
Helpful Tips for the Blue Cross Blue Shield Marketplace
Here are a few tips that can help make the process easier for you:
- Compare plans: Before choosing a plan, it's important to compare the different options available to you. Take note of the premiums, deductibles, and out-of-pocket maximums for each plan, as well as the network of doctors and hospitals that are covered. This will help you find a plan that fits your budget and healthcare needs.
- Check for subsidies: Depending on your income, you can apply for financial assistance low-cost healthcare. Check if you qualify for premium tax credits or a cost-sharing reduction.
- Understand the marketplace and enrollment periods: The Healthcare Marketplace has specific enrollment periods each year, during which you can enroll in a plan or make changes to your existing coverage. Be sure to understand these enrollment periods and deadlines, so you don't miss your chance to enroll or make changes. Annual open enrollment begins November 1. You should receive advance notice when the exchanges are open for your state.
- Use available tools: Get a quote and use the plan finder to compare plans & estimate your costs. Once you're a Blue Cross Blue Shield member, use the doctor finder tool to find doctors and hospitals in your network.
- Take advantage of preventive care: There are many plans that offer preventive care services at no additional cost to you. This includes annual check-ups, immunizations, and cancer screenings. Be sure to use these services to stay healthy and catch any potential health issues early on.
Answering Your
Blue Cross Blue Shield Coverage Questions
Yes, pre-existing conditions are covered. Blue Cross Blue Shield or any other health insurance provider can’t deny you coverage under the Affordable Care Act.
- Always carry your current BCBS ID card.
- Contact the appropriate hotline if you need to locate a doctor or hospital while abroad.
If your income goes down or you gain a household member, it’s important to update your insurance application immediately. You may qualify for more savings or free or low–cost coverage through Medicaid or CHIP.
Reporting changes late may result in having to pay money back when you file your federal tax return.
- Respiratory and sinus infections
- Colds
- Flu
- Seasonal allergies
- Eye irritation or redness
- Strains or sprains
- If you use more advance payments than you qualify for you must repay the difference. This is based on your final yearly income when you file your federal income tax return.
- If you use less of your premium tax credits you will get the difference as a refundable credit.
- Losing coverage
- Moving
- Getting married
- Having a baby
- Adopting a child
Need health insurance?
Call our Marketplace Call Center for free assistance* from licensed health agents.
Find the best health insurance coverage in your state.
Get up-to-date plans and prices for individual & family health insurance.
Find the best health insurance coverage in your state.
*Agents may be compensated based on enrollment in your health plan by the insurance company.