Kaiser Permanente vs. Blue Cross Blue Shield

When you’re shopping for health insurance, you may be closely comparing different providers. SSGI is an independent broker that has worked with many different insurance companies and has in-depth knowledge of the industry. One of our goals is to help our clients find the best insurance coverage for them.

When it comes to health insurance, there are many options, including national and regional providers. Here’s a comparison of Kaiser Permanente and Blue Cross Blue Shield, two carriers that have many coverage options for employer-sponsored coverage or private health insurance. Use this as a guide to help you decide which provider is right for you and your family, or your employees.

Kaiser Permanente

Kaiser Permanente is a private health insurer that operates in a limited number of states:

  • California

  • Colorado

  • Georgia

  • Hawaii

  • District of Columbia

  • Maryland

  • Virginia

  • Oregon

  • Washington

Kaiser Permanente has a unique business model in that it provides insurance coverage and medical care. Kaiser has its own health facilities and employs physicians. This allows them to focus on the overall health and wellbeing of patients. In fact, Kaiser bases its doctor incentives on member wellness and improvement rather than service volume. This provides extra assurance for clients that their doctors will work toward achieving overall health and wellness.

Kaiser also leases a national network called PHCS. This national network allows employers headquartered in those eight states to offer Kaiser Permanente coverage even if they have employees that do not reside in those states. If their employer is headquartered in one of those eight states, Kaiser can give employees access to providers nationwide.

Highlights of Kaiser Permanente:

  • Focused on member wellness

  • High customer service ratings

  • “One-stop shop” for all healthcare needs within the Kaiser network of providers

  • Allows for multi-state, multi-location employers, so those who are headquartered in one of the states that Kaiser is currently located in can offer an out-of-area network plan

  • Offers designed plans that allow members to seek care outside of their centers

  • Leases a network called Private Healthcare Systems, Inc. (PHCS), in which over 4,600 hospitals, 80,000 ancillary care facilities, and 700,000 healthcare professionals in every state participate

Blue Cross Blue Shield Pros

Blue Cross Blue Shield is a large, well-known health insurance company with a national network of providers. They offer a variety of health insurance plans. Blue Cross Blue Shield (BCBS) actually operates through 35 different insurance companies, which means quality of customer service can vary depending on which company you work with for your own insurance plan. However, it also means BCBS is able to operate in every state and provide a lot of different health plan options.

Highlights of Blue Cross Blue Shield:

  • Large, national network of providers

  • Available in virtually every zip code across the United States

  • Wide variety of plans available, including options with health savings accounts (HSA)

Should I Choose Kaiser Permanente or Blue Cross Blue Shield as an Individual?

Overall, you should choose whichever health insurance provider best serves your unique situation. Here are some things to consider as you compare Kaiser and Blue Cross Blue Shield:

Where are you geographically located? 

If you live in one of the eight states serviced by Kaiser or close to the District of Columbia (Washington, D.C.), then this insurance provider may be a good fit. On the other hand, if you reside in another state not covered by Kaiser, Blue Cross Blue Shield is the better option. 

What are your priorities? 

If you’re looking for high-quality care and convenience, Kaiser’s wellness-focused incentives and “one-stop shop” model of care could be the right fit. For those interested in having more choices in providers and greater flexibility in their care, BCBS is a good choice.

How is your health? 

If you are in relatively good health, your out-of-pocket costs will likely be lower no matter which provider you choose. Those with chronic, pre-existing conditions will need to carefully compare the details of each health insurance plan to determine where they can maximize coverage and savings. Also consider other special health needs such as mental/behavioral healthcare and any specialists you see.

Do you have a spouse and/or dependents? 

This will also factor into the provider you choose. You will want to carefully compare the benefits for your family to see which company can best provide for their health needs. If you’re planning to start a family in the future, you should also factor this into your decision.

Which Provider Should I Choose as a Business?

Businesses have a more complex task when choosing health insurance for employees since each individual employee will have different needs. Here are some unique factors businesses must consider:

What is your budget for benefits?

Every business needs to balance its budget. It’s important to have a firm number in mind for what you can spend on benefits and choose a provider that fits in that spending range.

What is your employee demographic?

Businesses with mainly young, single employees will have very different needs than a large corporation with members of varying ages who may have spouses and children depending on them. You want to choose the plan that provides adequate coverage for the majority of your employees.

Where do you operate?

Do you have employees located in just one state, or scattered across the country? You’ll want to make sure that all employees can utilize your benefits - not just ones located near your office or corporate headquarters.

Do you want a healthier workforce?

Both insurers provide flexible solutions and best-in-class support for employer-sponsored coverage and individual coverage. In addition, Blue Cross Blue Shield and Kaiser Permanente offer consumer-directed health plans, which empower employees to be their own advocates. Such plans put employees in control of their health and purchasing decisions. These types of plans can also help to manage costs for employers over the long-term.

Get an In-Depth Consultation with Our Experienced Brokers

Still not sure which provider to choose? We can help you compare Kaiser and Blue Cross Blue Shield. We have relationships with major insurers like Blue Cross Blue Shield. We are also a preferred broker of Kaiser Permanente. This means our brokers have a thorough understanding of insurance providers plans and will take the time to explain your options. Schedule a free consultation with SSGI to learn more.

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