Category Archives: Medigap Insurance

Whatever Happened To The California Blues?

Anthem (Blue Cross) is not the same company as Blue Shield of California

Did you ever wonder about the relationship between Blue Cross and Blue Shield, here in California? This article seeks to help clear up any misunderstandings. No, Anthem Blue Cross and Blue Shield of California were never the same company: They are both independent licensees of the Blue Cross Blue Shield Association (BCBSA), which is a federation of 33 independent and locally-operated BCBS companies that provide health insurance across the United States.

In some states certain “licensees” cooperate on the same plan and this could explain some confusion. Yet, in California there are two distinct Blue-Branded companies:

  • Anthem Blue Cross (part of Elevance Health)
  • Blue Shield of California (an independent company)

They have very different ownership structures. In this article, we are presenting a brief history of each company to help clarify their roles in the California marketplace…especially for seniors age 65 and older, which is the focus of this website.

The History of Blue Shield of California

Blue Shield of California has a storied past that highlights its unwavering dedication to providing high-quality, affordable healthcare to the people of California. Established in 1939 in San Francisco, the organization has evolved into one of the state’s largest health plans, currently serving millions of members. Currently, it is the state’s leading issuer of medigap (Medicare Supplement) insurance policies.

From the outset, Blue Shield of California has been guided by a mission-focused approach rather than the pursuit of profits. This dedication is embodied in their unique 2% Pledge, which limits their net income to 2% of revenue. Any earnings beyond this limit are returned to customers or invested in community initiatives.

Over the years, Blue Shield of California has continually adapted to address the shifting needs of its members and the broader healthcare environment. In 2019, the company moved its headquarters to Oakland, solidifying its deep-rooted connection to the Bay Area.

Financial stability has always been a key aspect of Blue Shield of California’s operations. In 2023, the company reported revenues of $25.1 billion and a net income of $130 million, showcasing its ability to maintain financial health while staying true to its mission-driven ethos.

Throughout its history, Blue Shield of California has earned accolades for its ethical business practices, community involvement, and positive workplace culture. The Ethisphere Institute has named it one of the World’s Most Ethical Companies, and the Civic 50 has recognized it as one of the country’s most community-oriented companies.

The company’s commitment to diversity and inclusion is another significant aspect of its legacy. Blue Shield of California has consistently been honored as a top workplace for LGBTQ+ employees by the Human Rights Campaign and has been listed among DiversityInc’s Top Regional Companies.

Blue Shield of California has remained steadfast in its founding principles while evolving to meet the demands of a changing healthcare landscape. Its ongoing commitment to its mission, financial prudence, and community impact ensures its continued leadership in California’s healthcare system.

The Evolution of Blue Cross of California

1936 – The Beginning

Blue Cross of California was founded in 1936. Over the years, it has evolved to become a trusted name in health insurance.

An Independent Licensee

Blue Cross of California operates independently but is licensed to use the Blue Cross Blue Shield trademarks. This means you get the reliability of a well-known brand with the personalized service of a local entity.

2004 – A New Identity

In 2004, Blue Cross of California rebranded to Anthem Blue Cross. This was part of a broader strategy by its parent company, Anthem Inc., to unify its subsidiaries under the Anthem name.

Mergers and Changes

In 2004, Anthem Insurance Company merged with WellPoint Health Networks Inc., adopting the WellPoint name for a period. By 2014, WellPoint decided to change its name to Anthem, Inc. to streamline its brand identity.

The Latest Chapter

In 2022, another significant change occurred when Anthem, Inc. rebranded as Elevance Health. This new name reflects a broader mission to elevate healthcare and advance well-being. With this change, their stock ticker symbol also changed from “ANTM” to “ELV.”

Looking Forward

Elevance Health continues to own and operate various subsidiaries, including those previously known as WellPoint and Anthem. This latest evolution ensures that the company remains at the forefront of healthcare, committed to providing you with top-notch service and support.

We hope this history helps you understand the legacy and current focus of these companies.

Resources

How To Select A Medigap Plan

Blue Shield Closes Popular Medigap Plan

As of April 2024 Blue Shield of California has stopped accepting applications for one of its most popular medigap plans in Northern California, Plan G Inspire.

Subject to regulatory approval, Blue Shield intends to close the plan to existing members, as well; possibly as early as January 2025.

Blue Shield of California introduced the plan in September of 2020.  By April 6, 2022 Blue Shield issued a press release announcing it took the top position in market share for individual Medicare Supplement (also known as “medigap”) plans in California in 2021.

Blue Shield of California continues to offer the Plan G Extra.  This is a comparable plan to the Inspire, but without the AAA features.

Resources:

Centers For Medicare & Medicaid Services’ 2024 Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare 

Blue Shield of California News Center

AAA Northern California News

How To Select A Medigap Plan

United Healthcare Local Agent Finder Tool: https://www.myuhcagent.com

Self-Insuring Under Original Medicare

Is it a realistic option to self-insure and skip Medigap Insurance?  That depends on the size of your assets and your tolerance for risk (not to mention your willingness to administer payments to a multitude of medical providers).  To address this question, let’s look only at Original Medicare and what it pays.

In 2022, Medicare Part A requires you to share the cost of medical services, as follows:

Hospital Copayments and Deductibles

  • $1,556 deductible for Hospital Services
  • For Days 1-60 of a Hospitalization, there is no additional copayment (besides the deductible)
  • Days 61-90 you are responsible for $389 per day of coinsurance (that’s up to $11,670)
  • Days 91 and beyond your share is $778 daily (up to 60 reserve days over your lifetime)
  • Beyond lifetime reserve days, you are responsible for all Hospital costs.

Medigap Insurance helps with the deductible and copayments, depending on which Medigap plan you choose. That’s quite a bargain, considering the low cost of these plans.

Additional Copayments and Coinsurance

Following a lengthy hospital stay, your doctor may recommend rehabilitative care in a skilled nursing facility.  If this care extends beyond 20 days, you pay a daily copayment of $194.50; then, you pay all costs after 100 days, which can run $500 per day, in many California facilities.  

It should be mentioned that some skilled nursing home stays are not covered by Medicare at all, because they do not meet Medicare eligibility (for example, when your stay is not preceded by a 3-day Hospitalization).  Private long-term care insurance exists to help with this financial exposure.

Share this story with someone turning 65.