HealthSelect of Texas participants: avoid unexpected health costs
Choose a primary care physician today
Having an in-network PCP can help you keep your health care costs down. HealthSelectSM of Texas participants must choose an in-network primary care physician (PCP) to get the highest level of benefits and save the most money. (If you are in Consumer Directed HealthSelectSM, HealthSelectSM Out-of-State or HealthSelectSM Secondary you may also benefit from having an in-network PCP, even though PCPs aren’t required.)
You have a 60 day grace period, from the first day your HealthSelect of Texas insurance coverage is effective, to choose an in-network PCP. If you don’t, you’ll have to pay out-of-network charges for PCP visits, even if you see a provider who is in the HealthSelect network. This means you will pay more. You will have to meet an out-of-network deductible ($500 individual/$1,500 family) before the plan begins to pay and then your coinsurance payment will be 40% of the charge. If you see your in-network PCP, you will pay only a $25 PCP copay. In addition, your preventive care will not be covered at 100%, as it is when you have chosen an in-network PCP.
Beyond saving you money, your PCP is your go-to person for your health care needs. Your PCP takes care of your preventive health needs and many non-emergency health issues, including colds, the flu, rashes and allergies. They manage your overall care and can connect you with in-network specialists when you need them.
Referrals from your in-network PCP are required for certain services under HealthSelect of Texas. If you don’t choose an in-network PCP and you see a specialist, you will be billed for out-of-network care, even if the specialist is in the HealthSelect network: instead of a $40 copay for a specialist office visit, you will pay 40% coinsurance after you meet the annual out-of-network deductible. (Members of Consumer Directed HealthSelect, HealthSelect Out-of-State and HealthSelect Secondary do not have to get referrals for specialty care and other services.)
Remember, you can change your PCP at any time. If you have not selected a PCP or if you want to change your PCP, you have two ways of doing so:
- Call BCBSTX’s Personal Health Assistants toll-free at (800) 252-8039, Monday–Friday, 7 a.m. - 7 p.m. and Saturday, 7 a.m. - 3 p.m. central time.
- Log in to Blue Access for MembersSM
- Once you’re logged in, go to the “Doctors and Hospitals” tab.
- Click “Select Primary Care Physician” and enter information about your location and what you’re looking for in a PCP.
Don’t wait—take a few minutes and choose a PCP from the more than 14,000 in-network PCPs across the State of Texas today. Keep in mind that, even if you have a PCP, virtual visits can be a convenient and money-saving option for some types of care. You don’t need a referral to use virtual visits and it costs you nothing if you are enrolled in HealthSelect of Texas or HealthSelect Out-of-State.