BlueCross BlueShield of Texas 2021 Plan Guide

Texas Plans

On and Off Exchange

What’s new: 

  • Increased $0 deductible and copay options on certain CSR qualified plans
  • Member access to covered benefits through providers with telehealth services

BCBSTX Access:

  • Health plans on and off exchange in every county
  • Comprehensive, year-round coverage
  • High-quality, efficient networks with focus on preventive care

Affordability: 

  • Affordable plan options
  • Monthly payments as low as $0 for qualified on exchange applicants

Stability:

  • Serving Texas communities for more than 90 years.
  • In the eight years of ACA open enrollment, BCBSTX has been proud to offer multiple qualified health plans in every county across Texas.

Blue Advantage HMO & Blue Advantage Plus plans/networks are available statewide. MyBlue Health plans available in Dallas and Harris Counties.

HMO Plans

Just like 2020, and continuing an industry-wide trend (no major carriers offer PPO plans in Texas), BCBSTX only offer HMO plans in 2021. However, Blue Advantage Plus plans offer some out of network benefits, unlike traditional HMOs.

  • HMOs help keep upfront costs low
  • Tax credits and cost-sharing assistance may be available to help lower premiums and out-of-pocket costs
  • Managed care on a personalized level with care coordinated by one doctor
  • Physician care extenders – allows physician assistants and advanced registered nurse practitioners to be PCPs

Perks

Helpful Resources 24/7
  • Cost Estimator Tool on Blue Access for Members
  • Easy-to-use BCBSTX App – find a doctor, see payment options, access electronic ID card and more, just text BCBSTXAPP to 33633 Blue365®
  • Blue365 member discount program – members save on health club and gym memberships, weight loss programs, dental products and much more
  • Health and Wellness Tools – BCBSTX provides tools and resources like Well onTarget® to help guide you toward your health and wellness goals. You can also access the portal through the AlwaysOn app.

COVID-19 Friendly Resources

  • 24/7 Virtual Visits powered by MDLIVE®
  • 24/7 Nurseline (English and Spanish)
  • Telehealth – Some primary care and other doctors may offer phone and online services which are covered at the same member share as a regular office visit or in-person equivalent.
Health Plans

    Blue Advantage HMO Plans:

    3 Bronze, 2 Silver, 2 Gold

    • Network: Blue Advantage HMO (BAV)
    • Approximately 476 hospitals, 73,981 providers*
    • Helps keep costs lower and more predictable
    • Personalized with a primary care provider (PCP) who coordinates all health care

    Blue Advantage Plus:

    4 Bronze, 2 Silver, 1 Gold

    • Network: Blue Advantage HMO
    • Approximately 476 hospitals, 73,981 providers*
    • Greater flexibility
    • Leverages the HMO network
    • Some out-of-network benefits available

    MyBlue Health:

    1 Bronze, 1 Silver, 1 Gold

    • Network: MyBlue HealthSM (BFT)
    • Approximately 29 hospitals, 6,116 providers*
    • $0 copay for primary care in-person and primary care telehealth appointments at Sanitas Medical Centers – exclusively for Blue Cross and Blue Shield members
    • Neighborhood access to primary and urgent care medical centers (4 locations in Dallas County and 6 locations in Harris County)
    • Local, face-to-face BCBSTX Customer Service

    *Estimates as of 9/17/2020

     

    BCBSTX Dental Plans
    Prescription & Pharmacy

    BCBSTX switched from a 4 tier formulary to a 6 tier formulary in 2019.

    • 6 prescription benefit tiers for most plans – generic, brand and specialty drugs now have preferred and non-preferred benefit levels

    • All plans include a drug list and Preferred Pharmacy Network

    BCBSTX also offers ways for you to save time and money on your prescriptions.

    • Cost savings: You may pay less when you choose generic medicines from our drug list. You also may save when you get up to a 30-day supply of a covered prescription drug from an in-network pharmacy. Talk to your doctor about what is right for you
    • Time savings: Maintenance medications are those drugs you take on a regular basis. You can have up to a 90-day supply of these medications delivered directly to you through the mail order program or at a retail preferred pharmacy participating in the Preferred Pharmacy Network.5
    • Online resources: You can search the drug list, find a pharmacy, see your claims, order home delivery, and get an estimate of your costs for a medication 24/7 by logging in to Blue Access for MembersSM (BAMSM) at bcbstx.com.
    Contact Us
    Phone: (312) 726-6565 Email: [email protected]
    Popular Hospital Network Guide
    Hospital Included in Advantage HMO Network?
    Doctors Hospital At Renaissance (Edinburg) YES
    University Health System (San Antonio) NO
    Medical City Hospital (Dallas) YES
    Memorial Hermann Hospital (Sugar Land) YES
    Mother Frances Hospital (Tyler) NO
    Scott & White Hospital (Round Rock) NO
    North Austin Medical Center (Austin) YES
    Seton Medical Center (Austin) YES
    Hill Country Memorial Hospital (Fredericksburg) YES
    Texas Health Harris Methodist (Fort Worth) YES
    UT Southwestern Medical Center (Dallas) NO
    Memorial Hermann Texas Medical Center (Houston) YES
    St. Lukes Episcopal Hospital (Houston) YES
    Baylor University Medical Center (Dallas) YES
    The Methodist Hospital (Houston) YES

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    BlueCross BlueShield Texas

    Individual Plan Guides

    Questions?

    Talk to a Licensed Agent

    (312) 726-6565

    Monday - Friday
    8am - 6pm CST

     

     

     

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