BlueCross BlueShield of Texas 2023 Plan Guide

Texas Plans

On and Off Exchange


What’s new: 

  • MyBlue Health is expanding to include: Collin, Denton, Tarrant, El Paso, Hidalgo, and Cameron counties

  • Nine new plans offered in 2023 (5 Bronze, 2 Silver and 2 Gold), including eight CMS Standardized plans with four prescription drug payment level tiers

  • New dental 1c option available

BCBSTX Access:

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


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


  • 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



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 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:

    6 Bronze, 4 Silver, 4 Gold

    • Network: Blue Advantage HMO (BAV)
    • Approximately 372 hospitals and 97,234 providers
    • New plans:
      • Blue Advantage Bronze HMO: 702, 704, 707
      • Blue Advantage Silver HMO: 705
      • Blue Advantage Gold HMO: 706
    • Helps keep costs lower and more predictable
    • Personalized with a primary care provider (PCP) who coordinates all health care

    Blue Advantage Plus:

    6 Bronze, 4 Silver, 2 Gold

    • Network: Blue Advantage HMO
    • Approximately 372 hospitals and 97,234 providers
    • Greater flexibility
    • Leverages the HMO network
    • Some out-of-network benefits available
    • Blue Advantage Plus Bronze: 704, 707
    • Blue Advantage Plus Silver: 705
    • Blue Advantage Plus Gold: 706

    MyBlue Health:

    1 Bronze, 1 Silver, 1 Gold

    • Network: MyBlue HealthSM (BFT)
    • Approximately 45 hospitals, 24,947 providers**
    • Now available in Collin, Denton, Tarrant, El Paso, Hidalgo, and Cameron 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 - 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
    Contracted Health Systems by Network
    Market Name / BCBSTX Network Blue Advantage Network MyBlue health hmo
    Abilene Hendrick Medical Center N/A
    Amarillo Ardent Health Services N/A
    Austin-Round Rock Baylor Scott & White, HCA Southwest, Seton Healthcare HCA Southwest
    Beaumont-Port Arthur CHRISTUS, Steward Health N/A
    Bryan-College Station-Lufkin Baylor Scott & White, Catholic Health Initiatives N/A
    Corpus Christi CHRISTUS, HCA Southwest N/A
    Dallas Baylor Scott & White, HCA North, Methodist HCA North, Methodist
    El Paso HCA Southwest, Tenet PSN Services
    Forth Worth-Arlington Baylor Scott & White, HCA North, Methodist,
    Texas Health Resources
    HCA North, Methodist
    Greenville-Denton Baylor Scott & White, CHRISTUS, HCA North,
    LifePoint, Texas Health Resources
    Houston Catholic Health Initiatives, Memorial Hermann,
    Methodist Houston, Steward, Tenet 
    Catholic Health Initiatives, Harris County Hospital District
    HCA Southwest, Steward, Tenet 
    Kileen-Temple-Waco Baylor Scott & White, Providence Health Alliance, Seton N/A
    Laredo-McAllen HCA Southwest, Prime, Tenet,
    Universal Health Systems 
    HCA Southwest
    Lubbock Surgery Partners N/A
    Odessa-San Angelo Hendrick MC, Shannon Clinic, Steward N/A
    Pasadena-Bellaire Catholic Health Initiatives, HCA Southeast
    Memorial Hermann UTMB 
    Catholic Health Initiatives, HCA Southeast
    San Antonio CHRISTUS, HCA Southwest, Tenet HCA Southwest
    Texarkana-Tyler-Longview Baylor Scott & White, CHRISTUS, Steward
    UT Health East Texas 
    Victoria Community Health Systems, Seton N/A
    Wichita Falls Kell West Regional, United Regional,
    Clay County Memorial Hospital, Texas Health Resources
    BCBSTX Dental/Vision Plans

    Members currently enrolled MUST re-enroll for 2023.  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
    • New lower-cost 1c family plan offered

    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.

    • Most plans have six prescription drug payment level tiers: preferred generic, non-preferred generic, preferred brand, non-preferred brand, preferred specialty, non-preferred specialty
    • Standardized plans have four prescription drug payment level tiers: generic, preferred brand, non-preferred brand, and specialty
    • 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

    *Estimates as of 7/31/2022

    **A “preferred” or “participating” pharmacy has a contract with BCBSTX’s pharmacy benefit manager (Prime Therapeutics) to provide pharmacy services at a negotiated rate. A pharmacy benefit
    manager administers prescription drug benefits for a health plan. The terms “preferred” and “participating” should not be construed as a recommendation, referral or any other statement as
    to the ability or quality of such pharmacy.


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