Your company offers eligible full-time employees who have satisfied the new-hire waiting period the opportunity to enroll in health insurance benefits through Blue Cross Blue Shield of Texas. On this page, you’ll learn about those benefits.
This benefits portal contains important and helpful information about your employer-sponsored health insurance benefits. Be sure to review the entire page. To jump to a specific section, click the links below.
When you are eligible to enroll in the employee benefits plan (and each year during your annual open enrollment period), your employer will provide you with the material you need to sign up for health coverage, including information about the plans available, your share of the employee and dependent premium for each plan option, and any required forms.
Summary of Benefits and Coverage
You’ll also receive a Summary of Benefits and Coverage (SBC) for each plan offered. The SBC provides more detailed information about the plan benefits. You may want to print and save the SBC for the plan you choose so you can refer back to it throughout the year.
Be sure to read the instructions carefully so that you understand which forms you need to complete and return as well as the deadline for submitting the required documents.
Your plan provides up-front preventive care at no cost. In this section, you’ll learn what preventive and wellness benefits are covered. Topics include Adult, Children, and Perinatal Wellness Guidelines, Women’s Health and your contraceptive benefit, a 24/7 Nurse Line, and a great Personal Health Manager service.
Your group health plan covers certain preventive services as a benefit of membership, at no cost to the member when they use a provider in your plan’s network. There is no copay, deductible or coinsurance, even if the individual or family deductible or out-of-pocket maximum has not been met. This flyer, designed for employers, provides a great list of the different preventive services you have access to.
Preventive care is very important for adults. By making some good basic health choices, women and men can boost their own health and well-being. Learn about ways you can improve your health as well as recommended screenings and immunizations. En Espanol
Good health is a gift anyone would wish for a child, but it doesn’t happen without your help. This document lists some of things you can do to help keep your child well and reminds you to schedule a Well Child visit with your child’s health care provider following immunization guidelines. It also includes a routine immunization schedule for children and adolescents. En Espanol
It is never too early to start taking care of your baby. That’s why you should join the Special Beginnings program as soon as you know you are pregnant. The Special Beginnings maternity program supports you from early pregnancy until six weeks after delivery.
Your health plan may provide certain preventive screenings and contraceptive coverage at no cost to you when you use a pharmacy or doctor in your health plan’s network. This flyer will help you understand that benefit.
As a BCBSTX member, you get around-the-clock access to experienced Registered Nurses who understand your health care concerns, an Audio Health Library with more than 1,200 pre-recorded health topics in English and Spanish, and a Personal Health Manager that gives you the support and resources you need to manage your health online.
The 24/7 Nurseline is available at no out-of-pocket expense to you. All it takes is a simple call to the toll-free phone number listed on the back of your ID card, or you can call the universal phone number through BCBSTX at 1-866-412-8795. Note: This service is not a substitute for medical care. You should consult a health professional for diagnosis and treatment.
In this section, you’ll learn how to search for network providers, select a Primary Care Physician (HMO members only), and sign in to the Blue Access for Members (BAM) web portal. You’ll also learn about the MDLive “Virtual Visits” benefit, which allows you to consult with physicians by phone and get a prescription if medically necessary. Also included is a list of treatment options and prices as well as a listing of preferred pharmacies.
This link allows you to view or print regional provider directories so you can easily see all of the available providers in your area for your selected plan. You’ll begin by selecting Blue Choice PPO or Blue Advantage HMO. Then select your region on the next page (for example, if you’re in North Texas, you could select Dallas, Fort Worth, or Entire Northeast Territory). To find a specific provider, you can go to the page for the type of provider you’re searching for (i.e. primary or specialist), then scroll to the city – providers are listed alphabetically. There is also an index toward the end. Another option is to hit Ctrl + F on your keyboard and type in the provider’s last name.
BEST VIEWED ON A COMPUTER, NOTEBOOK, OR IPAD. If you are searching on your phone, you may want to use the search tool below.
Another way to search for providers is to use the traditional provider search tool. Start by clicking “search as guest.” This method can be a bit tricky, so you may want to begin by reading the instructions. If you have trouble, please click on the “Finding a BCBSTX provider” link above to access the regional provider directories. If you are selecting an HMO plan, you’ll need to note the PCP number and include it on your enrollment form.
Through BAM, you can review your benefits, compare prescription prices, view and organize claims info, print temporary ID cards, and more. You can also download the BAM app so you’ll always have access right from your mobile phone. Get the download links from this one-page flyer OR text* BCBSTXAPP to 33633 to get the BCBSTX App that lets you use BAM while you’re on the go. (*Message and data rates may apply.)
Save time and money by consulting a doctor over the phone. Whether you’re at home or traveling, access to a board-certified doctor is available 24 hours a day, seven days a week. You can speak to a doctor immediately or schedule an appointment based on your availability. Virtual visits can also be a better alternative than going to the emergency room or urgent care center. The cost is just $44 if you’re on an HSA plan. If you’re on a copay plan, the cost of the virtual visit is the same as the copayment for your primary physician.
Preauthorization (also known as ‘prior authorization’) means that approval is needed from your health plan before you have certain health tests or services. To help make sure your care is appropriate and avoid unexpected costs, it’s important that approval is received before you get these services. Usually, your network provider will take care of preauthorization before the service is performed. But it is always a good idea to check if your doctor has gotten the needed approval.
You have a lot of options for medical care, but some of those options cost more than others. This one-pager will help you save money on medical care by learning about your various treatment options. It also includes important reminders that can save you time and money.
BCBSTX has a lot of network pharmacies to choose from. However, whether you are on a plan that has copayments for prescription drugs or an HSA-compatible plan that offers a discounted price prior to the plan deductible, you will save money by using a preferred pharmacy: 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, or Access Health (a group of independent pharmacies). Check Blue Access for Members for a list of all participating pharmacy locations. Note that Blue Cross Blue Shield of Texas does not work with CVS for your health plan.
Express Scripts® Pharmacy delivers your long-term (or maintenance) medicines right where you want them. No driving to the pharmacy. No waiting in line for your prescriptions to be filled.
As a BCBSTX member, you have access to a number of additional perks, including vision discounts, dental discounts, hearing discounts, and weight loss discounts. You can also save money on fitness apparel, gym memberships, and more. In this section, you’ll learn about all the perks of the Blue365 program.
Check out your child’s vision care program. As a member of a qualified health plan with Blue Cross and Blue Shield of Texas (BCBSTX), members up to 19 years old are eligible for pediatric vision care benefits administered by EyeMed Vision Care.
Save on vision exams and eyeglasses when you use a contracted EyeMed provider.
Save on vision, dental, hearing, and weight loss with this complementary discount program. Also save on gym memberships, fitness apparel, healthy foods, and more.
When you travel outside the country, your health plan only provides emergency coverage and you will be required to pay out of pocket, file a claim, and wait to get reimbursed. With a very affordable GeoBlue travel medical insurance policy, you can travel with peace of mind. Review the flyer to learn about all of the benefits.
Learn about GeoBlue and the importance of purchasing Travel Medical Insurance when you’re traveling outside the United States.
Comparison of the Blue Cross Blue Shield international solutions available through GeoBlue.
Here’s just one review from a happy customer: “BEST INVESTMENT EVER MADE. Traveling overseas without medical insurance is just not smart…We’ve used GeoBlue for a number of years and have been very happy with the price and the service (we’ve had to use their coverage twice). HIGHLY RECOMMEND!!!”
Getting a quote is fast and easy, and you can apply online. Before your trip, be sure to download the GeoBlue App so you have everything you need right on your phone.
GeoBlue Video Overview and Testimonials
This is a short clip of a member who GeoBlue evacuated to Dubai after he contracted Malaria in the Congo.
Medicare limitations and pre-existing conditions should not stop seniors from being able to travel the globe. Hear advice from a seasoned traveler on why you should buy GeoBlue.
With the convenient mobile app, GeoBlue is in your hand and by your side no matter where you go. See how you can find and pay for care and file a claim all from your mobile device!
In this section, you’ll find information about your special enrollment and continuation rights, government programs you or your children may qualify for, and more.
To assist you as you evaluate options for you and your family, this notice provides some basic information about the health insurance Marketplace (Healthcare.gov) and employment-based health coverage offered by your employer. Because you have health coverage available to you through your employer, you and your family members may not qualify for a premium tax credit for an individual health plan. If you ever lose your employer-based coverage, you may qualify for a 60-day special enrollment period in the individual market.
A federal law called Health Insurance Portability and Accountability Act (HIPAA) requires that we notify you about very important provisions in the plan. You have the right to enroll in the plan under its “special enrollment provision” without being considered a late enrollee if you acquire a new dependent or if you decline coverage under this plan for yourself or an eligible dependent while other coverage is in effect and later lose that other coverage for certain qualifying reasons.
If you have a non-grandfathered health plan (the plan or plans offered through your employer are non-grandfathered), federal laws require we notify you of additional provisions of your plan. This notice provides information about your rights on plans that require the designation of a primary care provider (PCP). Generally, this only applies to HMO plans.
This notice contains important information about your right to Texas State Continuation, which is a temporary extension of coverage under the Plan. This notice generally explains Texas State Continuation coverage, when it may become available to you and your family, and what you need to do to protect your right to receive it.
If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply.
Your company has selected JME Insurance Agency to help with your employee benefits. We provide a lot of behind-the-scenes services, but we’re also available to help if you have questions about your benefits or need assistance with an elevated claims issue. You can reach our office at 972.245.0266 or by emailing firstname.lastname@example.org.