Blue Advantage Plus Plans

Blue Advantage Plus HMO

 

  • Network Type: HMO with Out-of-Network Options
  • Coverage Area: Statewide across Texas
  • Provider Access: Members have access to the same network as Blue Advantage HMO but can also choose out-of-network providers at a higher out-of-pocket cost.
  • Primary Care Physician (PCP): Selection of a PCP is required for in-network services; referrals are needed for specialists.
  • Out-of-Network Coverage: Available at a higher cost-sharing rate, providing more flexibility.
Blue Advantage Plus Bronze

Bronze Plan Summaries:

Bronze plans may be for you if you have fewer medical needs, would rather have a low monthly payment, and don’t take prescription drugs regularly. Below is a quick summary of available Blue Advantage Plus bronze plans:

Plan Name Max Out-of-Pocket (Ind/Fam) PCP Office / Virtual Visit Prescription Drugs (Preferred)
Blue Advantage Plus Bronze 201  $8,300/ $16,600  40% / 40% 20% / 25% / 30% / 35% / 45% / 50%
Blue Advantage Plus Bronze 303  $10,150 / $20,300  $75 / 50% $5 / $15 / $130 / 35% / 45% / 50%
Blue Advantage Plus Bronze 305  $10,600/ $21,200  40% / 50% 20% / 25% / 30% / 35% / 45% / 50%
Blue Advantage Plus Bronze Standard $10,000/ $20,000 $50 / $100 $25 / $50 / $100 / $500

 

 

Blue Advantage Plus Silver

Silver Plan Summaries:

Silver plans may be for you if you want to pay less out-of-pocket for care, qualify for a premium tax credit (also known as a subsidy), have a spouse/children on your health plan, or have regular medical needs. Below is a quick summary of available Blue Advantage Plus Silver Plans:

Plan Name Max Out-of-Pocket (Ind/Fam) PCP Office / Specialist Prescription Drugs (Preferred)
Blue Advantage Plus Silver 202  $9,200 / $18,400  $25 / 50% $5 / $15 / 30% / 35% / 45% / 50%
Blue Advantage Plus Silver 306 Off exchange  $9,950 / $19,900  $15 / 50% $0 / $5 / $75 / 35% / 45% / 50%
Blue Advantage Plus Silver 605  $10,150/ $20,300  $115 / $125 $40 / $45 / 20% / 45% / 50% / 60%
Blue Advantage Plus Silver Standard  $8,900 / $17,800  $40 / $80 $20 / $40 / $80 / $350

 

 

Blue Advantage Plus Gold

Gold Plan Summaries:

Gold plans may be for you if you have more health care needs than most, have a spouse/children on your plan or want to grow your family soon, or prefer to pay more each month but have lower out-of-pocket expenses. Below is a quick summary of available Gold plans

Plan Name Max Out-of-Pocket (Ind/Fam) PCP Office / Specialist Prescription Drugs (Preferred)
Blue Advantage Plus Gold 203  $10,150/ $20,300  $20 / $45 $0 / $10 / $50 / 35% / 45% / 50%
Blue Advantage Plus Gold 303  $10,400/ $20,800  $0 / $35 $0 / $10 / $50 / 35% / 45% / 50%
Blue Advantage Plus Gold Standard $8,200/ $16,400 $30 / $60 $15 / $30 / $60 / $250

 

 

Popular Hospital Network Guide
Market MyBlue Health – HMO Blue Advantage HMO / Blue Advantage Plus POS
Abilene N / A Hendrick Medical Center
Amarillo N / A Ardent Health Services, NW Tx Healthcare
Austin-Round Rock HCA Southwest Baylor Scott & White, HCA Southwest, Seton Healthcare
Beaumont-Port Arthur Baptist Beaumont Hospital CHRISTUS, Steward Health
Bryan-College Station-Lufkin N / A Baylor Scott & White, Catholic Health Initiatives
Corpus Christi HCA Southwest CHRISTUS, HCA Southwest
Dallas HCA North, Methodist Health, THR Baylor Scott & White, HCA North, Methodist Health
El Paso Tenet HCA Southwest, Tenet, University Medical Center El Paso
Fort Worth-Arlington HCA North, Methodist Health, THR Baylor Scott & White, HCA North, Methodist Health, Texas Health Resources
Greenville-Denton N / A Baylor Scott & White, CHRISTUS, HCA North, LifePoint, Texas Health Resources
Houston/Pasadena/Bellaire
(Harris County only)
Catholic Health Initiatives, Harris County Hospital District, HCA
Southeast, Steward
Catholic Health Initiatives, HCA Houston, Memorial
Hermann, Steward**
Jefferson Baptist Beaumont & CHRISTUS & Triangle Area Network and
Legacy Community Health Systems Facilities*
N/A
Killeen-Temple-Waco N / A Baylor Scott & White, Providence Health Alliance, Seton
Laredo N / A Doctors Hospital of Laredo, Laredo Medical Center
Brownsville-McAllen Tenet (Cameron County), Universal Health System (Hidalgo County) HCA Southwest, Prime, Tenet, Universal Health Systems
Lubbock N / A University Medical Center – Lubbock, Texas Tech Health Sciences Center, Lubbock Heart Hospital
Midland-Odessa-San Angelo N / A Midland Memorial Hospital, Medical Center Hospital – Odessa, Shannon Clinic, Steward
Nueces HCA Southwest Catholic Health Initiatives, HCA Southeast, Memorial Hermann UTMB
San Antonio HCA Southwest CHRISTUS, HCA Southwest, Tenet
Texarkana-Tyler-Longview N / A Baylor Scott & White, CHRISTUS, Steward UT Health East Texas
Victoria N / A Community Health Systems, Seton
Wichita Falls N / A United Regional, Kell West Regional Hospital, Momentum Specialty Surgery Center

*N/A represents not offered in this county
** Blue Advantage HMO and Blue Advantage Plus POS (Catholic Health Initiatives, HCA Houston, Memorial Hermann, Steward): ONLY available in Houston

BCBSTX Dental Plans

Dental Plans Brochure  Application With the BCBSTX dental plan, you’ll get dental coverage on day one with no deductible deductible required for check-ups, cleanings and other preventive services. Most important, costs are typically reduced when you receive care from any of our participating network dentists. However, you also have the option to see any dentist not in the network, but your out-of-pocket costs may be higher. Some highlights of Dental Indemnity USA coverage:

  • Coverage can be used to provide dental benefits to an individual, spouse, children or any combination of dependents.
  • A $50 deductible, based on fee schedule allowances, applies for dental procedures or services received by a covered individual during each benefit year.
  • Maximum deductible amount of $150 for family coverage.
  • Deductibles do not apply to oral exams, cleanings, fluoride treatments, sealants and X-rays.
  • $1,000 orthodontia benefit for children under 19 years old

For more information on coverage and benefits, view the Dental Outline of Coverage  You must enroll in a BCBSTX health plan in order to enroll in the dental plan (you have up to 31 days from the effective date of your policy to enroll). Shop for a plan now.

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Ryan Kennelly authorized agent for Blue Cross and Blue Shield of Texas Blue Cross and Blue Shield of Texas: A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.