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(On and Off Exchange)

Check HMO providers | Rx

(On and Off Exchange)

(Must have compatible plan)

(Must have compatible plan)

for Marketplace plans

through UnitedHealth One

through BCBSTX

through GeoBlue

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.

To search for providers, click on the Provider Search Tool button and click “search as guest.” The search tool can be a bit tricky, so you may want to begin by reading the instructions. The most important thing to know is which provider network to select after you’ve entered your zip code. If you have a PPO plan, select “Blue Choice PPO [BCA].” If you have an HMO plan, select “Blue Advavantage HMO [BAV}.” If you are selecting an HMO plan, you’ll need to note the PCP number and include it on your enrollment form and/or PCP selection form.

If you have trouble finding a network provider, you can call the customer service number on the back of your ID card and they can assist you.

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.

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