BlueCross BlueShield of Texas 2022 Plan Guide

Texas Plans

On and Off Exchange

 

What’s new: 

  • MyBlue Health is expanding to include three new counties: Bexar, Travis and Williamson
  • Increased $0 deductible and copay options on certain CSR-qualified plans
  • Member access to covered benefits through providers with telehealth services
    • With the American Rescue Plan, financial help is now available to even more Texans

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 nine 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 2021, and continuing an industry-wide trend (no major carriers offer PPO plans in Texas), BCBSTX only offers HMO plans in 2022. 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
  • SmartER Care Options – member education campaign on choices for non-emergency care
Mobile App
  • Easy-to-use BCBSTX App – find a doctor, see payment options, access electronic ID card and more
  • Access your claims, coverage and deductible information
  • Access your temporary digital member ID card
  • Secure login with Face ID (iOS only) and Fingerprint ID
Blue365
  • Blue365 member discount program – members save on health club and gym memberships, weight loss programs, dental products and much more

COVID-19 Friendly Resources

  • 24/7 Virtual Visits
  • 24/7 Nurseline (English and Spanish)
Health Plans

    Blue Advantage HMO Plans:

    3 Bronze, 3 Silver, 3 Gold

    • Network: Blue Advantage HMO (BAV)
    • Approximately 409 hospitals, 72,843 providers*
    • New plan: Blue Advantage Silver HMOSM 601
    • Helps keep costs lower and more predictable
    • Personalized with a primary care provider (PCP) who coordinates all health care

    Blue Advantage Plus:

    4 Bronze, 3 Silver, 1 Gold

    • Network: Blue Advantage HMO
    • Approximately 409 hospitals, 72,843 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 27 hospitals, 6,594 providers**
    • Now available in Bexar, Travis and Williamson counties • Retail members who choose a MyBlue Heath Select PCP will have a $0 copay for any scheduled PCP visit
    • Select PCP collaborations for the following areas include: Austin: Community Care and Lone Star Circle of Care; Dallas and Houston: Sanitas Medical Centers; and San Antonio: CentroMed
    • Local, face-to-face BCBSTX Customer Service at Sanitas Medical Centers in Dallas and Harris counties

    *Estimates as of 6/1/2021

    **Estimates as of 6/1/2021. These numbers don’t include network providers and hospital in the expansion counties. During open enrollment, members who enroll in MyBlue Health will be able to choose their primary care physician for 2022 through Provider Finder®.

    BCBSTX Dental/Vision Plans

    Members currently enrolled MUST re-enroll for 2022.  Check out our dental plan guide.  or quote, enroll, and apply for more enhanced dental plans

     

    BlueCare Dental

    • Coverage for cleanings, preventive services and much more
    • Preventive dental services deductible waived

    Pediatric Vision Benefits

    • Offers one exam, frames or contacts at $0/no cost on most plans
    Prescription & Pharmacy

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

    • Six prescription payment level tiers for all ACA plans – generic, brand and specialty drugs 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.

    *Estimates as of 6/1/2021 

    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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    Questions?

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