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Kaiser Permanente vs. Blue Cross Blue Shield: Medicare Advantage Comparison
BCBS is available in more states, but ratings vary by company and in some cases Kaiser outperforms.
Kate Ashford, CSA® Lead Writer | Medicare, retirement, personal finance
Kate Ashford is a writer and NerdWallet authority on Medicare. She is a certified senior advisor (CSA)® and has more than 20 years of experience writing about personal finance. Previously, she was a freelance writer for both consumer and business publications, and her work has been published by the BBC, Forbes, Money, AARP, LearnVest and Parents, among others. She has a degree from the University of Virginia and a master’s degree in journalism from Northwestern’s Medill School of Journalism. Kate has appeared as a Medicare expert on the PennyWise podcast by Lee Enterprises, and she's been quoted in national publications including Healthline, Real Simple and SingleCare. She is based in New York.
Holly Carey joined NerdWallet in 2021 as an editor on the team responsible for expanding content to additional topics within personal finance. She currently leads the Medicare team. Previously, Holly wrote and edited content and developed digital media strategies as a public affairs officer for the U.S. Navy. She is based in Virginia Beach, Virginia.
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Kaiser Permanente’s Medicare Advantage plans are available in eight states and Washington, D.C., and Kaiser uses an integrated care model, so all providers are connected.
Blue Cross Blue Shield is a collective of 33 different companies, and many are geographically specific, offering benefits targeted to local members.
Here’s a look at how Kaiser Permanente and BCBS Medicare Advantage compare.
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Kaiser Permanente Medicare Advantage
Kaiser Permanente
3.93
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Kaiser Permanente plans get slightly below-average ratings, and the provider sells plans in only eight states and Washington, D.C.
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
Medium (50% to 89%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
2.30 (Below average)
Pros
Earns above-average customer satisfaction scores in California, one of the major Medicare markets studied by J.D. Power.
Eight in 10 members are in a highly-rated plan.
Most plans include drug coverage.
Cons
Available in only eight states and Washington, D.C.
Offers mostly HMO plans, so most members must work within Kaiser’s network of medical providers.
Member experience ratings overall are below average.
States available
8 states and Washington, D.C.
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
Medium (50% to 89%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
2.30 (Below average)
Pros
Earns above-average customer satisfaction scores in California, one of the major Medicare markets studied by J.D. Power.
Eight in 10 members are in a highly-rated plan.
Most plans include drug coverage.
Cons
Available in only eight states and Washington, D.C.
Offers mostly HMO plans, so most members must work within Kaiser’s network of medical providers.
Member experience ratings overall are below average.
CMS Star RatingAverage Medicare star rating, weighted by enrollment. Star ratings are determined by the Centers for Medicare & Medicaid Services (CMS).
Blue Cross Blue Shield plans are widely available and affordable, but some companies earn higher marks than others on member satisfaction.
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
Medium (50% to 89%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
3.41 (Average)
Pros
BCBS companies offer plans in 48 states and Puerto Rico.
$0-premium BCBS plans are available in 44 states and Puerto Rico.
BCBS plans offer extra benefits like chronic condition management and preloaded debit cards for over-the-counter items.
Cons
Ratings and member satisfaction vary among BCBS companies, and some score lower than others. You may not have access to a highly rated BCBS company.
BCBS companies offer special needs plans in only half of U.S. states.
States available
48 states and Puerto Rico
Members in high-rated plansPercentage of members who are in rated contracts with a Medicare star rating of 4 or higher.
Medium (50% to 89%)
Member experienceThe average of CMS' star ratings for quality measures in the domain "Member Experience with the Health Plan," weighted by contract enrollment.
3.41 (Average)
Pros
BCBS companies offer plans in 48 states and Puerto Rico.
$0-premium BCBS plans are available in 44 states and Puerto Rico.
BCBS plans offer extra benefits like chronic condition management and preloaded debit cards for over-the-counter items.
Cons
Ratings and member satisfaction vary among BCBS companies, and some score lower than others. You may not have access to a highly rated BCBS company.
BCBS companies offer special needs plans in only half of U.S. states.
What are the plan’s costs? Do you understand what the plan’s premium, deductibles, copays and/or coinsurance will be? Can you afford them?
Is your doctor in-network? If you have a preferred medical provider or providers, make sure they participate in the plan’s network.
Are your prescriptions covered? If you’re on medication, it’s crucial to understand how the plan covers it. What tier are your prescription drugs on, and are there any coverage rules that apply to them?
Is there dental coverage? Does the plan offer routine coverage for vision, dental and hearing needs?
Are there extras? Does the plan offer any extra benefits, such as fitness memberships, transportation benefits or meal delivery?
If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
Medicare Advantage review methodology
The Medicare Advantage marketplace is concentrated among just a handful of companies; in many places, one insurer serves more than half of the market. NerdWallet reviewed 26 Medicare Advantage brands, with some insurers having more than one brand under their umbrella. (For example, Blue Cross Blue Shield includes the brands Anthem and Highmark.) At the national level, these reviews include nine of the 10 largest brands by enrollment. At the state level, our research includes at least one major insurer in 47 of the 49 states that offer Medicare Advantage plans, and includes the top two insurers in 35 of those states. (Alaska doesn't offer Medicare Advantage plans.) We also look at online search volume to identify regional and other notable players in the space.
NerdWallet’s Medicare Advantage reviews are based on ratings data from the Centers for Medicare & Medicaid Services, as well as pricing, plan availability by state, plan types available, consumer experience, extra benefits offered and more. These reviews are a guide, but we encourage you to shop around and compare several plans to find the best coverage and rate for you. NerdWallet does not receive compensation for any reviews. Read our editorial guidelines for additional information.
