Texas Plans
On and Off Exchange
BCBSTX has simplified their plan options for 2020, designed to:
- Control escalating medical costs
- Lower cost barriers to care for members
- Focus on providing a variety of benefit features to a broad base
- Ensure compliance with new 2020 regulations
- Sustain product offering amid changing legislation
All plans/networks are available statewide.
HMO Plans
Just like 2019, and continuing an industry-wide trend (no major carriers offer PPO plans in Texas), BCBSTX will only be offering HMO plans in 2020. However, Blue Advantage Plus plans will offer some out of network benefits, unlike traditional HMOs.
- HMOs help keep upfront costs low
- Tax credits and cost-sharing assistance may be available to help lower premiums and out-of-pocket costs
- Managed care on a personalized level with care coordinated by one doctor
- Physician care extenders – allows physician assistants and advanced registered nurse practitioners to be PCPs
Perks
Helpful Resources 24/7
- 24/7 Virtual Visits
- 24/7 Nurseline (English and Spanish)
- Cost Estimator Tool on Blue Access for Members
- “Where You Go Matters” member education campaign on using ERs
- “On The Go” – BCBSTX App
- Easy-to-use BCBSTX App – find a doctor, see payment options, access electronic ID card and more, just text BCBSTXAPP to 33633 Blue365®
- Blue365 member discount program – members save on health club and gym memberships, weight loss programs, dental products and much more
Health Plans
Blue Advantage HMO:
1 Bronze, 1 Silver, 2 Gold
- Helps keep costs lower and more predictable
- Personalized with a primary care provider (PCP), who
coordinates all health care
Blue Advantage Plus:
1 Bronze, 2 Silver, 1 Gold
- Greater flexibility
- Leverages the HMO network
- Some out-of-network benefits available
Dental Plans:
Current BCBSTX members changing medical plans MUST re-enroll to keep their dental plan in 2020.
Pharmacy:
BCBSTX continues to use a 6 tier formulary
BCBSTX continues to use a 6 tier formulary
• Six prescription benefit tiers for most plans – generic, brand and specialty drugs now have preferred and non-preferred benefit levels
• All plans include a drug list and Preferred Pharmacy Network (CVS Pharmacy is considered a non-network pharmacy)
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