Maintenance Notification: Understanding Health Care Costs and Quality, Provider Finder -Network Selection Criteria, HMO Provider Network Important Information, Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, important message about hospital-based physicians. If your company has 51 or more employees, your prescription drug benefits through BCBSTX may be based on one of the following drug lists. If you would like a Provider Directory mailed to you, you may call customer service at 1-877-774-8592 TTY/TDD 711, or complete the online request form, Looking for a unique and genuine insurance experience? Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Llame al 1-877-774-8592 (TTY: 711). To view this file, you may need to install a PDF reader program. You may still have one of these plans if you were on them before 2012, however. These drug lists are a list of drugs considered to be safe and effective. Texas Health Agents is an agency partner of Independent Health Agents Inc. 2023 NPN: 14924332, Doctors Hospital At Renaissance (Edinburg), Hill Country Memorial Hospital (Fredericksburg), Texas Health Harris Methodist (Fort Worth), Memorial Hermann Texas Medical Center (Houston), Baylor University Medical Center (Dallas), Mutual Of Omaha Texas Medicare Supplement Plans, Bronze HMO 005 $5,000 deductible and 80% coinsurance, Bronze HMO 005 $6,000 deductible and 100% coinsurance, You must select a netowrk primary care physician (PCP), who coordinates your care within the network, Reduced doctor visit payments for using Blue Advantage HMO Network primary care physicans (PCPs) and specialists, Access to the BlueCard PPO network when traveling out-of-state, Are willing to have a primary care physican (PCP) coordinate your care, Would like the lowest cost plan to protect yourself against major accidents and want to keep your insurance costs down, Are in generally good health and not expecting to have surgery or major services in the near future, Blue Choice Gold Plan 001 $3,250 individual deductible and 100% coinsurance, Blue Choice Gold Plan 002 $1,500 individual deductible and 80% coinsurance, Blue Choice Gold Plan 011 $1,000 individual deductible and 80% coinsurance, $30 doctor visit copayment for Blue Choice Gold Plan 001 and Blue Choice Gold Plan 011, $10 doctor visit copayment for Blue Choice Gold Plan 002, Seeks coverage comparable to what is offered by employers, Blue Choice Silver Plan 003 $6,000 individual deductible and 100% coinsurance, $30 doctor visit copayment for Blue Choice Silver Plan 003, $35 doctor visit copayment for Blue Choice Silver Plan 004, Bronze Plan 005 $5,000 individual deductible and 80% coinsurance, Bronze Plan 006 $6,000 individual deductible and 100% coinsurance, 80% coinsurance after deductible for the Bronze Plan 005, 100% coinsurance after deductible for the Bronze Plan 006, Prescription drug coverage after deductible is met, Well-adult care covered at 100%, no deductible, Well-child care, covered at 100%, no deductible. Review the 2022 changes. WebGet information on coverage, deductibles, copays, and premiums for the Blue Advantage Gold HMO 206 medical plan. A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. Copyright 2014 Health Care Service Corporation. Blue Advantage HMO . Find a Doctor or Provider in Your Network Most PDF readers are a free download. We have sent coverage information to the email you specified. Thank you for always answering our questions, calls and emails. The differences are how much your premium costs each month, what portion of the bill you pay for things like hospital visits or prescription medications, and how much your total out-of-pocket costs are. Blue Cross Blue Shield Doctors Near Me Blue Cross and Blue Shield of Texas WebFor any other Avsis vision plans, search the Avsis directory to find a provider near you. For more detailed information on the benefit designs available, covered benefits, services or supplies that are limited or excluded, general administration of the plan, or any other questions you may have regarding our products and services, visit the Contact Us page for the phone number of the regional sales office near you. Now, you can find the MyBlue Health plan in 11 counties across Texas. Review Plan and Network Information. These health plans are not a "metallic" health plan and were effective before January 1, 2014. All benefits shown indicate member responsibility. Legal Disclaimer | Privacy Statement | Code of Conduct, Introduction to West TX Blue Advantage HMO, Important message about hospital-based physicians, Entire Find a doctor Register Now, Returning Shopper? Even if youre not a member, you can search for doctors, hospitals and other providers. Log In to the Shopping Cart. Provider Finder Search Tool - Teacher Retirement System of Texas Vlvulas y productos resistentes a la corrosin y ambientes agresivos, donde el metal no puede garantizar la durabilidad requerida. If your company has 150 employees, your prescription drug benefits through BCBSTX are based on a Drug List, which is a list of drugs considered to be safe and effective. I would highly recommend her to my friends. We apologize for any inconvenience. WebTo find providers that accept Medicare Assignment, please visit: www.medicare.gov. If you need help, weve created these helpful guides: Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). Youll find doctors and health care professionals from a wide variety of specialties like: As a reminder, remember to schedule an appointment with your primary care doctor soon after your coverage effective date. Your doctor should consult the Drug List when prescribing drugs for you. Search for doctors, hospitals and other specialists within the Premera Blue Cross Medicare Advantage Provider Network. Toll-free: (877) 275-4377 TTY: 711 Fax: (512) 867-7438. Blue Advantage HMO HealthSelect Medicare Advantage (Medicare) you can go to any doctor who accepts Medicare. To learn more about vision benefits, see the STAR Member Handbook. There are 3 Blue Choice PPO Gold Plan Options: Key Blue Choice Gold plan features include: Use the Provider Finder to search for physicians and hospitals in the BlueChoice network. External link You are leaving this website/app (site). All you have to do is: Go to bcbstx.com; Click on Find Care at the top BCBSTX will let you, your prescriber (or authorized representative) knowthe coverage decision within 24 hours after they receive your request for an expedited review. External link You are leaving this website/app (site). Provider Finder - Blue Advantage HMO West Territory Blue Advantage WebThe following resources provide you with the information needed to administer Blue Cross and Blue Shield of Texas (BCBSTX) plans for your patients. Find a Blue Distinction Center Information Note Find a provider or hospital recognized by Blue Cross and Blue Shield for changing health care to be more patient-focused, coordinated and, in many cases, affordable. To find out if your plan includes pediatric dental coverage, please check your Summary of Benefits and Coverage (SBC). 4.10. It is not a complete list of what is covered or excluded. Visit the Find Care section to see for yourself how easy it is to find in-network providers withProvider Finder. This directory contains . WebThe image illustrates the interface of the Blue Cross and Blue Shield of Texas Provider Finder search tool. Most PDF readers are a free download. Blue The MyBlue Health plan may also give you access to: With three levels of coverage available, the MyBlue Health plan offers you a more affordable monthly payment with the same great support youve come to expect from BCBSTX. WebFor questions about your BCBSTX health plan, call Customer Service at the number on the back of your ID card. If the coverage request is denied, BCBSTX will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). These drug lists are a list of drugs considered to be safe and effective. Maintenance Notification: Please fill out the form below and a licensed agent will contact you to help answer your questions. Texas Medicare Advantage for HMO, PPO and DSNP: Blue Cross Medicare Advantage PPO plans provided by HCSC Insurance Services Company (HISC), and HMO plans provided by GHS Insurance Company (GHS), Independent Licensees of the Blue Cross and Blue Shield Association. Find a Doctor A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. If you provide a phone number, an agent may call you to make sure you received the information and to answer any questions you might have. 1 For Individual and Family and Medicare plans, Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). Blue Cross Blue Shield of Texas Medical Care Management P. O. Thank you. Note:If you or a covered family member require the services of a hospital-based anesthesiologist, radiologist, pathologist, emergency room physician or neonatologist, see this important message about hospital-based physicians. Blue Cross and Blue Shield of Texas complies with applicable Federal civil rights laws and does not discriminate on the basis of How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. If you're looking for a health plan that's easy to understand, easy to use and easy on your wallet, an HMO may be just what you need. Blue Choice Gold may be right for you if you are an individual or family who: Blue Choice Silver PPO Plans< are the second most popular BCBSTX individual plans. You, your prescribing health care provider, or your authorized representative, can ask for a Drug List exception if your drug is not on (or is being removed from) the Drug List, or the drug required as part of step therapy or dispensing limits has been found to be (or likely to be) not right for you or does not work as well in treating your condition. Blue Advantage Now, even more Texans can access an affordable HMO plan backed by Blue Cross and Blue Shield of Texas's (BCBSTX) 92 years of service. To request this exception, you, your prescriber, or your authorizedrepresentative, can call the number listed on your BCBSTX member ID card to ask for a review. WebServices include: An enhanced benefit for fashion eyewear for kids. There are 2 Blue Choice PPO Bronze Plan Options: Key Blue PPO Bronze plan features include: Blue PPO Bronze may be right for you if you are an individual or family who: To find if your doctor or hospital is part of the Blue Choice Network Provider Finder. If your Blue Cross and Blue Shield of Texas (BCBSTX) plan includes pediatric dental coverage, choose BlueCare Dental SM as your network. Updated 04-11-2023 Page B (d) 3. Even if you didnt qualify in the past, you could receive one this year. Blue Cross Blue Shield of Texas 2021 Plan Guide Before having a procedure or test performed, PPO members can compare cost estimates and quality information to help find the best doctor for their needs and budget. M - F, 8am - 8pm CT Sat, 8am - 6pm CT Sun, 10am - 6pm CT. Cost estimates for up to 1,600 procedures, treatments and tests, including member and employer costs, Cost data for more than 6.6 billion covered procedures performed annually, Information on more than 1.9 million providers. Brokers & Affiliates. A laboratory must be in network in the state where the referring provider is located. Health Care Fraud Prevention and Reporting, Texas Six (6) Month State Continuation of Coverage (Post COBRA). Blue External link You are leaving this website/app (site). Provider Finder There are 2 BCBSTX Bronze HMO Plan Options: The The Bronze HMO Plans use the Blue Advantage HMO network, one the largest HMO networks in Texas. By choosing Blue Advantage HMO, clients choose more than just a health plan. This new site may be offered by a vendor or an independent third party. *In addition to staying in network, you or your doctor may need to get benefit approval or prior authorization before you get treatment for certain services for them to be covered. For the most current information call the HMO Enrollment Hotline 800-892-2803.
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