Blue Cross Blue Shield of Texas Reviews and Guide
It's the dominant player in our State, especially at the individual and family level.
Let's walk through why this is and see how to get the most out of BCBS of Texas' different options and networks.
Of course, applying the subsidy towards BCBS plans can save you 1000's and we'll share 10 years+ experience on how to get the most out of it!
We're going to assume you already know BCBS has the majority of the individual family market and the broadest doctor networks.
Let's get strategic and practical (as in...save money)!
A behind-the-scenes look at how to really compare the plans from BCBS is key.
First, our reviews:
This is what we'll cover:
- BCBS of Texas and Obamacare
- Texas Blue Cross Blue Shield Pricing Comparison
- The HMO and POS networks with BCBS of Texas
- How to compare the BCBS Tx plans
- Quoting and enrolling in BCBS of Texas Obamacare plans
We'll save Medicare for a separate breakout.
Let's get started.
BCBS of Texas and Obamacare
First, Obamacare just references any individual family plan since 2014. It can be either on or off-exchange (direct with the carrier).
They have the same networks, benefits, and pricing.
There's one big difference (2 really).
On-exchange, we can get very large subsidies based on income which bring down your monthly cost of insurance.
BCBS of Texas, being the dominant carrier in the individual family market, has fully participated in the Exchange so any subsidy will apply equally to their plans.
This really is the first question to address since it has the biggest effect on cost. By far!
We have a whole guide on how to get the most subsidy and even a guide to the income chart that drives it.
Let's look at that first:
A few notes.
Income directly drives how much our premium will be reduced and also if we're eligible for the enhanced silver plans.
The silver 87 and 94 are platinum level plans for the same price of the normal silver!
Blue Cross Blue Shield will offer these if you're eligible, and really, there's no reason to look at any richer plans.
The income is where we see most people get tripped up and miss out on subsidy:
- Household is based on everyone that files on a 1040 tax form together, next April's filing
- Income estimate is the AGI on that 1040 tax form
We help people with this all day long since income can be very unique to each person (think self-employed, etc).
Reach out to us at help@texasplans.com or 800-320-6269. Pick a time to chat here.
There's zero cost for our assistance and we want the maximum subsidy towards our BCBS of Texas coverage.
Since the subsidy applies equally to all plans and carriers, how does BCBS' pricing stack up?
Texas Blue Cross Blue Shield Pricing Comparison
This is really why BCBS still dominates the individual family market.
They're pricing is consistantly some of the best in the two most popular plan levels; bronze and silver.
The majority of the market goes with the silver level.
Part of this just simple value comparision (gold and platinum get too
expensive) while the bigger piece is the enhanced silver plans (more
on that below...it's a big deal).
We run quote all day long and you'll be able to see your rates below. Scanning the big players in the Texas market (BCBS, Aetna, Ambetter, Oscar, United) at the silver level can quickly give you give a good feel on BCBS' pricing strength.
This is the standardized silver plan (more on that later), age 54, NO SUBSIDY (prices can come way down from here based on income).
Identical benefits. Networks can differ (HMO, EPO, POS). Prices on the right.
BCBS is #2 in this situation but keep in mind that pricing changes by area and age. The subsidy would apply equally to all these plans if enrolled correct which we can help with below.
Only United is slightly better but BCBS's network may be the deciding factor there.
Once we nail down the subsidy piece and whether we're eligible for the enhanced silver plans, let's turn to networks.
The HMO and POS networks with BCBS of Texas
BCBS of Texas has two basic networks available to individuals or families whether on or off exchange (on and off are identical networks by the way).
- HMO - based on medical group in your local area; care is more managed
- POS - HMO network plus some flexibility out of network but at higher cost
The POS is closer to the old PPO networks we had before and some people still enjoy with employers.
Here's the deal...the HMO plan can be $200-300 cheaper per month for one person than the POS for the same benefits.
Here's an example of a single person, age 54 in Austin (no subsidy so higher prices):
$780 versus $1118 (plan #1 and #60) for the exact same benefits at the silver level.
For this reason, the HMO is much more popular but how do we really evaluate these two options?
First, when you run your quote below, you'll see a Doctor Finder link by each plan. Check your doctors across both.
You can also ask your doctors "what Obamacare plans do you participate with"? If the doctors are in both (not uncommon), that makes it easier.
Practically, what does the POS give you?
- You can refer yourself out to specialists
- You have a wider network with benefits outside the narrow HMO
Here's the issue and we see this only getting worse...
It can be really expensive to get services out of the primary network. The plan is going to pay what they would pay in the network which usually has a big discount.
Even with the PPOs these days, going out of network can result in some serious sticker shock when the claims come in.
For those who demand maximum flexibility, the POS with BCBS is the only real choice on the individual family market these days.
Some carriers have EPOs (Oscar and Ambetter) but the POS is the only one that has benefits out of the core network.
Whether it's worth a few hundred per month per person to you is the real question.
We don't really have a true PPO option unfortunately.
Happy to walk through this with you based on how you use healthcare!
Then there's the plans themselves.
How to compare the BCBS Tx plans
We have big guides on how to pick the best Obamacare plan or how to compare the metallic plans.
A few key notes to make it easier.
There are 4 basic levels:
- Bronze: high deductible plan; high max
- Silver: mid deductible with copays for office and RX; high max
- Gold: low deductible with richer copays; still high max
- Platinum: low/no deductible; richest copays; mid level max
Learn more about those components at the Metallic plan guide.
Again, if you get richer versions of the silver (especially 87 and 94), that's really hard to look at anything else.
The quote below will show you what level of silver you're offered.
Another key takeaway is that the benefits are all standardized to a benchmark.
This means that a Gold plan will be pretty comparable to another Gold plan +/- 2%!
Here's the benchmark plans:
Once we've dialed in the HMO versus POS network piece and our general plan level (for example...silver which is the most popular by far), we can usually go with the lowest priced plan and do pretty well.
You'll notice in the sample quote above, there are many plans at the silver level within Blue Cross Blue Shield.
Knowing that they all have to walk and talk pretty similarly, the lowest price is a good bet.
This can can always get tricky so we're happy to run the quote for you and note if there are good values at help@texasplans.com or 800-320-6269.
Just need dates of birth, zip code, and best estimate for this year's income.
Okay...let's see the rates please.
Quoting and enrolling in BCBS of Texas Obamacare plans
We make this free, fast, and secure here:
A few notes to get the best BCBS of Texas quote.
- Household is everyone that files together on a 1040 tax form even if not enrolling
- Income estimate is for this year; AGI on the 1040 next April's tax filing
Again, the income and subsidy is really the big deal these days. We want to make sure to get this right and we're here to help.
As licensed BCBS of Texas agents, there's zero cost for our assistance and you can see from our reviews that we really try to help people.
We also make enrolling in BCBS TX plans fast and painless here:
Our simplified online app takes 5-10 minutes (saving you almost an hour and a lot of potential errors). Best yet, we go through and scrub to catch any issues that might mess up the subsidy and/or enrollment before processing.
A second pair of very experienced (10's of 1000's of ACA enrollments) eyes. A free service.
How can we help?!