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With the 2017 open enrollment period now behind us and a new administration in the White House, we thought this would be a good time for a quick update. Here are few items that you’ll want to be aware of:

Special Enrollment Periods

While the Affordable Care Act’s open enrollment period ended January 31, you can still make changes to your health coverage if you have a “qualifying event.” For instance, if you or your spouse loses coverage through an employer, you have a change in marital status, you have a baby or adopt a child, or you move to a new zip code, you may be eligible for a “special enrollment period.” Please give us a call at 972.245.0266 if any of these apply, but please don’t procrastinate – the government only gives you a small window of time to sign up for another health plan.

Virtual Visits

Great news for Blue Cross Blue Shield of Texas members! If you have an ACA “metallic” plan (a non-grandfathered plan), you now have access to “virtual visits” through MDLIVE. This means that instead of driving to the doctor’s office and sitting in a waiting room full of sick people, you can call a doctor and get a prescription if necessary.

This new service will offer members live consultations with board-certified MDLIVE doctors 24 hours a day, seven days a week for non-emergency medical needs such as allergies, cold/flu, sinus infections and more. Additionally, MDLIVE therapists are available by appointment for behavioral health consultations. Virtual visits can help reduce high-cost urgent care center and emergency room visits.

  • Members can conveniently connect with a MDLIVE doctor via mobile app, online video or by telephone.* (Behavioral health consults are available by mobile app and online video only.)
  • MDLIVE doctors can send prescriptions electronically to the member’s pharmacy of choice (when appropriate).
  • Virtual visits are integrated with Provider Finder® and Blue Access for MembersSM.

Read this brochure for more information. If you do not have Blue Cross Blue Shield of Texas but are interested in purchasing a telehealth benefit, let us know – we may be able to help.

MDLIVE is an independent company that provides virtual visit services for Blue Cross and Blue Shield of Texas. MDLIVE operates and administers the virtual visit program and is solely responsible for its operations and that of its contracted providers. MDLIVE is not an insurance product nor a prescription fulfillment warehouse. MDLIVE operates subject to state regulations and may not be available in certain states. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services.

New Vision Provider

For years, Blue Cross Blue Shield of Texas health plan members have had access to vision discounts through Davis Vision®. That has now changed.

While Davis Vision is still an option through Blue 365, your new vision provider when using your BCBSTX ID card is EyeMed Vision Care. You can learn more about this benefit here.

New BCBSTX Preferred Pharmacy Network

Beginning January 1, 2017, all Blue Cross Blue Shield of Texas individual policyholders experienced a change to their Preferred Retail Pharmacy Network.  Members now pay the lowest copayment/cost at a network of pharmacies designated as “preferred.” The preferred pharmacy network includes:

  • Walgreens
  • Walmart (including Sam’s Club Pharmacy)
  • Albertsons (including Tom Thumb, Market Street, Randall’s, United Pharmacy, Amigos, Safeway, Vons, Super Saver and many other grocery stores under the Albertsons corporate banner)*
  • HEB
  • Access Health (a group of independent pharmacies)*

Click Here to View a Complete List of Contracted Pharmacies

*A list of all participating pharmacy locations can also be viewed at www.bcbstx.com.

Blue365

Blue365 offers access to health and wellness deals exclusive to Blue Cross Blue Shield members. Through the site, you have access to a wide range of savings from top health and wellness brands around the country plus some of your favorite local companies. You’ll see weekly “Featured Deals” and long term “Ongoing Deals” on healthy products, along with discounts on health and fitness clubs, weight-loss programs, healthy travel experiences and so much more. You can even sign up for weekly emails to learn about the latest deals to hit Blue365. Best of all, it’s FREE to sign up!

To learn more, click here.

Health Reform and the New Administration

We know a lot of you have questions about President Trump’s executive order and the possible changes to the Affordable Care Act. Right now, we can only guess what might happen – none of the proposed changes have yet been implemented. The best advice we can give you is not to make assumptions. For now, the ACA is the law, and if that changes we’ll be sure to let you know.

How Can We Help?

As always, JME is here to assist if you have questions or need help with your plan. Just give us a call at 972.245.0266 or email us at jme@jmeinsurance.com.