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HealthSelect of Texas participants: avoid unexpected health costs

04/03/2018

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.
  • or
  • Log in to Blue Access for MembersSM
    1. Once you’re logged in, go to the “Doctors and Hospitals” tab.
    2. 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.

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

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