Kelsey-Seybold Limited Provider Network

If you live in the Houston area and select a primary care provider (PCP) in the Kelsey-Seybold Limited Provider Network, you can see any provider within the Kelsey-Seybold network without a referral on file with Blue Cross and Blue Shield of Texas (BCBSTX). However, it’s important you stay within the Kelsey-Seybold network for all of your care, including specialist appointments, radiology services and outpatient lab work. Exceptions to this include on-site and virtual Catapult Health clinics and Virtual Visits (see below).

Occasionally, a Kelsey-Seybold provider may recommend a referral to a provider outside of the Kelsey-Seybold network. If this occurs, the Kelsey-Seybold provider must submit a referral to BCBSTX. Participants should confirm they have an approved referral on file with BCBSTX before seeing the provider they were referred to. If a referral is not on file when the participant sees the non-Kelsey-Seybold provider, the participant will receive out-of-network benefits, which can result in higher out-of-pocket costs.

If you have a Kelsey-Seybold PCP and want to see a doctor or other provider in the BCBSTX HealthSelect^SM medical plan network who is not affiliated with Kelsey-Seybold, you can call BCBSTX to change your PCP. It will be effective immediately.

HealthSelect medical plan benefits

HealthSelect participants with a Kelsey-Seybold PCP can take advantage of the following programs outside of the Kelsey-Seybold network without a referral if they meet eligibility and other program requirements:

• Buena Vida (coming soon)
• Catapult Health onsite clinics and at-home virtual checkups
• Fitness Program
• Hello Heart
• Hinge Health^®
• Learn to Live
• Real Appeal^® and Wondr^TM
• Virtual Visits with MDLIVE^® and Doctor On Demand^®

Kelsey-Seybold benefits

Kelsey-Seybold offers many benefits, including:

• no referrals required to see Kelsey-Seybold specialists (must have a Kelsey-Seybold PCP),
• a 24-hour Nurse Hotline,
• online orders for pharmacy refills,
• MyKelseyOnline – free personalized online portal,
• online self-scheduling appointments,
• video visits for 50 different medical conditions,
• Kelsey Concierge dedicated to ERS participants at (713) 442-5373 and
• Saturday hours for pediatric care at Fort Bend, Clear Lake, Spring and Tanglewood clinics.

To find providers within the Kelsey-Seybold network, visit kelsey-seybold.com/find.

HealthSelect of Texas participants with other PCPs

If you are enrolled in HealthSelect of Texas^® and do not choose a Kelsey-Seybold PCP, you will not be able to see any Kelsey-Seybold provider. Kelsey-Seybold providers do not take referrals from doctors outside Kelsey-Seybold.

You can change your PCP anytime.