All About Blue Cross Blue Shield of Texas

Blue Cross Blue Shield of TexasBlue Cross Blue Shield of Texas

Blue Cross Blue Shield of Texas – Overview

The Blue Cross Blue Shield Association (BCBSA) is a federation of 35 independent United States health insurance firms that insure over 106 million people in the United States.

It was founded in 1982 when two of its namesake organizations merged: Blue Cross was established in the year of 1929 and became the Blue Cross Association in 1960.

Blue Shield was established in 1939 and became the Blue Shield Association in 1948.

Blue Cross Blue Shield was created independently, Blue Cross is providing hospital coverage and Blue Shield covers physician services.

The U.S. government chose to work with Blue Cross Blue Shield firms to administer Medicare in the 1960s.

Blue Cross Blue Shield of Texas always distributes educational materials about the significance of health insurance and enroll at the events.

On-site health insurance educational tools will be available for individuals interested in learning how to get the most out of their health insurance coverage, as well as free health screenings and other community resources.

The Caring will provide free flu shots for the Children Foundation of Texas, free glucose, cholesterol, BMI, and blood pressure screenings by the University of North Texas System College of Pharmacy, and vision exams will be provided by Prevent Blindness Texas.

Blue Cross Blue Shield of Texas provides information and assistance in communities across the state through events, corporate and retail partnerships, traveling mobile assistance centers and R.V.s, online resources, and social media outreach.

Blue Cross Association of the Blue Shield

Blue Cross Blue Shield Association is enabled to provide health care coverage to one out of three Americans.

The BCBS Health Index and Health of America Report series and the national are two of BCBSA’s healthcare resources.

You can visit BCBS.com for additional information on BCBSA and its member companies.

Blue Cross Association of the Blue Shield

Blue Cross Association of the Blue Shield

BCBSTX or Blue Cross Blue Shield of Texas offers a choice of family and individual health insurance coverage alternatives, whether you’re seeking coverage for yourself or your entire family.

Individual health insurance plans, often known as primary medical or comprehensive coverage, are available.

These plans offer a wide range of services and are compliant with the following criteria:

  • It is usually possible to renew a contract and last for a year or more.
  • As mandated by the Affordable Care Act mandate, including the medical services.
  • Maternity, infant, and pediatric care are all available.
  • Hospitalization, emergency services, and preventive care are all available.
  • Laboratory testing, prescription medicines, and disease management are all functional.
  • Treatment for mental illness and substance abuse.
  • Devices and services for rehabilitative purposes

You should be eligible for financial assistance with your Individual and Family plan.

Group Health Insurance Plan

A group health insurance plan is what you get if you get your health insurance via your employer. It’s sometimes referred to as a group policy or a group plan.

Dental

Dental insurance plans can cover everything from primary care to various dental services.

The Dental coverage may be purchased as part of Blue Cross Blue Shield of Texas family and individual health insurance plan or a stand-alone dental plan.



As an Affordable Care Act, some Individual and Family plans include dental coverage for children up to age 21.

Primary dental care to a wide range of dental services is all covered by dental insurance plans.

The Dental coverage is available as part of a family or individual health insurance plan from Blue Cross Blue Shield of Texas or as a separate dental plan.

Some Individual and Family plans include dental care for children up to 21 as part of the Affordable Care Act.

Medicare

Medicare is the government program designed to provide health insurance to people aged 65 years or over and people under 65 with specific medical conditions, disabilities, and illnesses.

At the signing up for Medicare from the government, a person gets a genuine Medicare Part A (hospital) plus the B (medical) coverage as well.

Additionally, subscribers can purchase additional insurance through Medicare-approved insurance companies like Blue Cross Blue Shield of Texas to strengthen their health insurance safety net.

The different insurance plans include the below-mentioned parts:

Part C of Medicare Advantage Plans is considered all-in-one coverage, and some of them include prescription drug coverage.

Part D of Medicare covers prescription medications and pays for them if they are authorized.

Medicare Supplement Insurance Plans.

These plans may help pay for medical expenses not covered by Original Medicare.

Medicare is a government-sponsored health insurance program for those over the age of 65 and people under 65 who have specific disabilities or illnesses.

When you join up Medicare through the government, you get Part A (hospital) and Part B (medical) coverage.

However, you can supplement your health insurance by purchasing supplemental coverage from Medicare-approved insurance companies like BCBSTX. The following items are included under the supplementary insurance:

  • Part C – Medicare Advantage Plans are all-in-one coverage that provides for prescription medication coverage.
  • Part D of Medicare covers prescription medications and pays for them if they are authorized.
  • The Medicare Supplement Insurance Plans may help pay for medical expenses not covered by Original Medicare.

Medicaid and Children’s Insurance Program (CHIP)

Medicaid and CHIP are government-sponsored health insurance programs that provide low-cost or no-cost coverage.

Your eligibility is determined by the government and is dependent on your household size and income.

You are allowed to submit your application at any time of the year. You can apply for Medicaid or CHIP online, and if you qualify, the relevant government office will contact you.

Please note that and keep in mind that if you register in Medicaid or CHIP, you might not be allowed or eligible for a premium tax credit or cost-sharing reduction.

If you currently have Medicaid coverage, you are covered under the healthcare reform and do not need to purchase a plan through the Marketplace.

Program for Medicaid and Children’s Health Insurance (CHIP)

Medicaid and CHIP are government-sponsored health insurance programs that provide low-cost or no-cost coverage.

The government determines your eligibility depending on your household size and income.

You can submit your application at any time of the year. You can apply for Medicaid or CHIP online, and if you qualify, the appropriate government office will contact you.

Please keep in mind that if you enroll in Medicaid or CHIP, you will not be eligible for the premium tax credit or cost-sharing reduction.

If you currently have Medicaid coverage, you are covered under the healthcare reform and do not need to purchase a plan through the Marketplace.

Blue Cross Blue Shield of Texas

Blue Cross Blue Shield of Texas traces its origin to the nonprofit Baylor Plan, founded by Dr. Justin Ford Kimball in 1929 as its first hospital pre-payment plan.

Nowadays, Blue Cross Blue Shield of Texas Is a Texas-based Health Care Service Corporation (HCSC) division, a legal reserve company established and licensed in 1936.

Headquartered in Chicago, HCSC also operates as Blue Cross Blue Shield of Illinois, Blue Cross Blue Shield of New Mexico, and Blue Cross Blue Shield of Oklahoma.

The nonprofit Baylor Plan, formed by Dr. Justin Ford Kimball in 1929 as the nation’s first hospital pre-payment plan, is whence Blue Cross Blue Shield of Texas (BCBSTX) gets its name.

Blue Cross Blue Shield of Texas has become a branch of Health Care Service Corporation (HCSC), a mutual legal reserve business founded in 1936 and registered in Texas.

Blue Cross Blue Shield of Illinois, Oklahoma, and Blue Cross Blue Shield of New Mexico are all subsidiaries of HCSC, headquartered in Chicago.

Across Texas, local offices serve specific markets, negotiate provider agreements, and recruit and manage network providers.

Local sales, service, and network management staff are supported by centralizing core services for training, consistency, and economies of scale.

Comprehensive Support Units, which are likewise spread around the state, offer a full range of administrative services on an account-by-account basis, including a single point of responsibility for customers and one-stop shopping for all member service needs.

Gold Plans for Blue Cross Blue Shield of Texas in 2022

With over 5 million members in 254 counties, Blue Cross Blue Shield of Texas is the state’s largest health insurance business.

The Blue Cross Blue Shield, Texas will also offer consumer-directed plans, Health Savings Accounts, and Medicare Supplements tailored for individuals, children, and families.

On the individual market, Blue Cross Blue Shield of Texas no longer offers PPOs; however, Advantage Plus plans have the option of using providers outside of the Blue Advantage network while still having some costs covered.

As with the Blue Advantage Silver and Gold HMO Plans, the Blue Advantage Gold HMO Plans to provide the same set of essential health benefits, quality, and volume of care.

The Blue Advantage Gold HMO Plans are expensive, but they also have incredible benefits. Gold plans feature a more significant monthly premium and, in many cases, lower out-of-pocket expenses than Silver and Bronze plans.

Blue Advantage Gold HMO Plans may be a good fit for you if you or your family:

  • Prefers set copayments for doctor visits.
  • Are you planning on having surgery or other costly procedures shortly and want to keep your out-of-pocket payments to a minimum?
  • Prescription medication is required regularly.

Since this is an HMO plan, there are deductibles. When you enroll in this plan, you must choose a Blue Advantage HMO Primary Care Physician (PCP).

Prescription Drug Utilization Benefit Management Programs

Specialty Pharmacy Program:

Individuals should obtain specialty drugs through the preferred Specialty Pharmacy provider to be eligible for maximum benefits.

Member Make a Difference: You pay your regular portion plus the cost difference if you choose a brand-name drug over a generic counterpart.

You must pay all expenses up to the deductible amount before this plan begins to pay for covered services you use.

It’s vital to remember that copays apply whether or not your deductible has been met.

For some services offered by non-emergency outpatient facilities, members may have lower out-of-pocket fees than services delivered in a hospital setting.

The Health Savings Account, also known as HSA, has tax and regulatory implications as a reminder.

Blue Cross Blue Shield of Texas does not provide legal or tax advice, and anything in this document should be considered as such. These materials, including any tax-related assertions in them, are not intended or prepared to be used to avoid tax penalties, and they cannot be used or relied on to do so.

Requirements for Pre-authorization

Certain services in UT SELECT require BCBSTX’s prior approval (pre-authorization).

Pre-authorization proves the medical need for particular care and services covered by UT SELECT in advance (In and around 48 hours of an emergency hospital admission).

U.T. offers UT SELECT, a self-funded PPO plan operated by Blue Cross Blue Shield of Texas, as its only medical insurance plan.

You will receive the highest benefits, spend far less out-of-pocket, and rarely have to file any claims if you utilize a network doctor.

You will still be covered if you visit an out-of-network doctor, but your out-of-pocket expenditures for health care services will be significantly greater.

Summary

So, that was all about Blue Cross Blue Shield of Texas, which is the largest health insurance company with over 5 million members in 254 Texas counties.

Blue Cross Blue Shield of Texas offers health plans customized for individuals, children, and families, including consumer-directed plans, Health Savings Accounts, and Medicare Supplements.

Blue Cross Blue Shield of Texas no longer offers PPOs on the individual market.

The Blue Cross Blue Shield Advantage Plus plans offer the added option of using providers other than Blue Advantage network providers while still covering some costs.

See Also

Grants for Single Mothers in Texas

Blue Cross Blue Shield Telehealth Grants

Blue Cross Blue Shield IVF Coverage

How Much Does IVF Cost?

DHHS Grant Program

Does Medicare Cover Shingles Shots?

Lap Band Surgery Cost Without Insurance

Does Medicaid Cover Dermatology?

References 

https://publicsitestx.hcsc.net/

https://publicsitestx.hcsc.net/insurance-basics/

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