What states use Anthem Blue Cross?

Editorial team Published on

Anthem Blue Cross and Blue Shield operates as a licensee of the Blue Cross Blue Shield Association in 14 states.

According to Anthem Individual and Family Plans, the 14 states where Anthem operates are:

  • California (operates specifically as Anthem Blue Cross)
  • Colorado
  • Connecticut
  • Georgia
  • Indiana
  • Kentucky
  • Maine
  • Missouri (excluding 30 counties in the Kansas City area)
  • Nevada
  • New Hampshire
  • New York (operating in the New York City metropolitan area and eastern/southeastern counties)
  • Ohio
  • Virginia (excluding certain northern Virginia counties near D.C. like Arlington and Fairfax)
  • Wisconsin

Can I use my Anthem insurance out of state?

Yes, you can use most Anthem Blue Cross and Blue Shield health plans out of state, but coverage depends entirely on your specific plan type.

How Out-of-State Coverage Works

  • Emergency Care: True medical emergencies are covered anywhere in the United States, even if the hospital or doctor is out-of-network.
  • PPO Plans: Preferred Provider Organization (PPO) plans give you access to the nationwide BlueCard program. This lets you see out-of-state doctors and hospitals that accept Blue Cross Blue Shield, keeping your costs lower.
  • HMO Plans: Health Maintenance Organization (HMO) plans usually only cover emergency care out of state. Routine or non-emergency care outside your local network is typically not covered.
  • Guest Membership: If you plan to stay in another state for a longer period (usually 90 days or more, such as for an extended work trip or school), some Anthem HMO plans offer a "guest membership" option to join a local affiliated HMO.

What You Should Do First

  • Check your insurance card: Look for a small suitcase symbol or an "alpha prefix" (three letters before your ID number), which means you have BlueCard nationwide access.
  • Search the network: Use the Anthem website or app to find participating in-state or out-of-state providers before receiving non-emergency care.

What states are covered by Blue Cross Blue Shield?

Blue Cross Blue Shield (BCBS) provides health insurance coverage in all 50 states, Washington, D.C., Puerto Rico, and the U.S. Virgin Islands.

The Blue Cross Blue Shield System is made up of 36 independent, locally operated companies that manage coverage in different regions.

Coverage by Region

  • All 50 States: Every state has one or more licensed BCBS affiliate plans operating locally.
  • Territories: Coverage extends to Washington, D.C., Puerto Rico, and the U.S. Virgin Islands.
  • Multi-State Operators: Some larger independent companies manage multiple states. For example, Health Care Service Corporation (HCSC) operates in Illinois, Montana, New Mexico, Oklahoma, and Texas. CareFirst operates in Maryland, the District of Columbia, and parts of Virginia. Anthem operates plans in California, New York, Georgia, and several other states.

What's the difference between Blue Cross and Anthem Blue Cross?

Anthem Blue Cross is just one specific, for-profit company that belongs to the larger Blue Cross Blue Shield Association.

Blue Cross Blue Shield (BCBS)

  • The Association: It is a national network of 36 independent, mostly non-profit health insurance companies.
  • Coverage: Each company serves a specific geographic area or state.
  • Shared Network: They share the same trademark and allow members to use the nationwide provider network when traveling.

Anthem Blue Cross

  • An Affiliate: Anthem is the largest for-profit member company within the Blue Cross Blue Shield Association.
  • Service Areas: It operates as the local BCBS licensee in 14 states, including California, New York, and Ohio.
  • Branding: Because it is part of the association, it uses the "Blue Cross" (or Blue Cross Blue Shield) name on its insurance plans, but it is run by Anthem (formerly Elevance Health).

Is Anthem insurance accepted everywhere?

No, Anthem insurance is not accepted everywhere; it is only accepted by doctors and hospitals within its specific network or the broader Blue Cross Blue Shield (BCBS) network.

Where Anthem is Accepted

  • In-Network Providers: Your plan covers routine and planned care only when you visit doctors who accept your specific Anthem network.
  • National Coverage: Most Anthem PPO plans use the BlueCard Program, which lets you see over 2 million in-network providers across the United States.
  • Emergency Care: True medical emergencies are usually covered anywhere in the U.S. and at any emergency room, regardless of whether the hospital is in-network.
  • Remote Employees: Most users on Reddit agree that if you have an employer-sponsored plan, you can typically use your coverage in states where Anthem doesn't directly operate by using the national BCBS network.

Where Anthem is Not Accepted

  • Out-of-Network Doctors: If a doctor or clinic does not participate in the Anthem or BCBS network, they will not accept your insurance for non-emergency visits.
  • HMO Restrictions: If you have an HMO plan, you must see doctors in your local network and get referrals for specialist care; out-of-network care is rarely covered outside of emergencies.

36 Blue Cross Blue Shield Health Insurance Companies Explained

9 related questions found

What 14 states does Anthem cover?

Anthem operates and offers health insurance plans in 14 U.S. states.

Covered States

  • California
  • Colorado
  • Connecticut
  • Georgia
  • Indiana
  • Kentucky
  • Maine
  • Missouri
  • Nevada
  • New Hampshire
  • New York
  • Ohio
  • Virginia
  • Wisconsin

You can view available coverage options or check specific plan types directly through the Anthem Individual and Family Plans page.

Is Anthem a good medical plan?

Anthem medical plans offer extensive nationwide coverage through the Blue Cross Blue Shield network, though customer satisfaction and ratings vary widely by region.

The Pros of Anthem Plans

  • Large Network: Members get access to a massive network of doctors, specialists, and hospitals across the United States.
  • Plan Variety: Anthem provides multiple types of plans, including HMO, PPO, and EPO options, depending on your state.
  • Digital Tools: The Sydney Health app lets you view ID cards, check benefits, chat with support, and find local care providers.
  • Extra Perks: Many plans include $0 preventive care screenings and virtual doctor visits.

The Cons of Anthem Plans

  • Customer Service: User ratings on platforms like Anthem Blue Cross Blue Shield Reviews highlight frequent complaints about long phone wait times and slow claim processing.
  • Approval Delays: Some members report difficulties or long wait times getting specialized procedures or medications approved.
  • Medicare Ratings: According to the Anthem Medicare Advantage Review from NerdWallet, their Medicare plans average a 3.3/5 rating with higher-than-average member complaints.

Is It Right for You?

Anthem is generally a solid choice if your preferred local doctors and hospitals accept their network. However, your experience will depend heavily on the specific tier of coverage you choose (Bronze, Silver, Gold, or Platinum) and your local state rules. Always check their provider directory before signing up.

Can I use BCBS in any state?

✅ Yes, you can use Blue Cross Blue Shield (BCBS) in other states through the BlueCard Program, but coverage depends heavily on your specific plan type.

💡 How Out-of-State Coverage Works

  • PPO Plans: Generally offer nationwide in-network access via local BCBS networks.
  • HMO Plans: Usually restrict routine out-of-state care to emergencies or urgent situations.
  • Individual/Marketplace Plans: Some state plans (like certain individual plans in Illinois) have recently dropped non-emergency out-of-state coverage entirely.
  • Emergency Care: Legally required to be covered nationwide regardless of your specific plan type or location.

🔎 What to Check on Your ID Card

  • Alpha Prefix: The three-letter code at the front of your ID number routes your claims.
  • The Suitcase Logo: A PPO suitcase icon indicates broad national network participation.
  • Customer Service: Call the number on the back of your card before scheduling non-emergency care out of state.

Why are doctors dropping Blue Cross Blue Shield?

Doctors and hospital systems drop Blue Cross Blue Shield (BCBS) mainly due to contract disputes over low reimbursement rates and controversial policy changes like automated downcoding.

Key Reasons for the Split

  • Low Reimbursement Rates: Providers state that BCBS payout rates fail to keep up with high inflation and surging operational costs, including a dramatic rise in drug and medical supply expenses. Some private practices report that BCBS pays a fraction of what other payers or Medicare provide.
  • Controversial Downcoding Policies: Insurance policies like the Blue Cross Blue Shield of Illinois downcoding policy automatically reduce claim payments for longer or more complex medical and mental health visits without a manual chart review.
  • Stalemates in Contract Renewals: Major health systems (such as Michigan Medicine or Memorial Hermann) frequently reach deadlocks with BCBS during routine contract negotiations, where insurers try to cut or freeze payments and hospitals demand higher rates to stay solvent.
  • Medicare Advantage Strain: Many clinics and hospital groups are dropping or narrowing participation in private Medicare Advantage plans backed by major insurers due to excessive administrative denials and financial losses.

What are the top 3 health insurances in the USA?

The top 3 health insurance companies in the USA by market share and enrollment are UnitedHealth Group (UnitedHealthcare), Elevance Health (formerly Anthem), and Centene Corporation (or CVS Health/Aetna depending on commercial vs. government metrics).

📊 Top 3 Health Insurers

  • 🟢 UnitedHealth Group
    • Market Share: ~16%
    • Enrollment: ~49 million members
    • Direct Premiums Written: ~$269.3 billion
    • Strengths: Nationwide availability, massive provider network, integrated tech via Optum.
  • 🔵 Elevance Health
    • Market Share: ~7.1%
    • Enrollment: ~36 million members
    • Direct Premiums Written: ~$107.6 billion
    • Strengths: Operates Blue Cross Blue Shield plans in 14 states, strong commercial and Medicaid presence.
  • 🟠 Centene Corporation
    • Market Share: ~6.8%
    • Enrollment: ~28 million members
    • Direct Premiums Written: ~$102.7 billion
    • Strengths: Leader in government-sponsored programs like Medicaid and Medicare.