Blue Cross Blue Shield Experts

BCBS of TX

Blue Cross and Blue Shield of Texas is the largest insurer in the state of Texas, offering traditional plans that can include co-payments for doctor visits and prescriptions, and economical major medical plans which have a deductible that must be met before coverage begins.

Plans at a Glance:                      Select a plan name below to view its brochure

Plans
Lifetime
Maximum
$5 Million per Member
$5 Million per Member
$5 Million per Member
$5 Million per Member
Dr. Co-Pay
$30 - $45,
varies by deductible
$25
Subject to Deductible
and Co-insurance
Subject to Deductible
and Co-insurance

Rx
  $2,500 per Calendar Year maximum for each Participant.
Co-payment is $20 for Generic Drug, $35 for Preferred Brand Name Drug, $50 for Non-Preferred Brand Name Drug.
  $2,500 per Calendar Year maximum for each Participant.
$300 deductible.
Co-payment is $15 for Generic Drug, $25 for Preferred Brand Name Drug, $40 for Non-Preferred Brand Name Drug.
  $2,500 per Calendar Year maximum for each Participant.
$500 deductible.
Co-payment is $10 for Generic Drug, $50 for Preferred Brand Name Drug, $65 for Non-Preferred Brand Name Drug.
  $2,500 per Calendar Year maximum for each Participant.
Deductible varies based on plan deductible.
Co-payment is $10 for Generic Drug, $50 for Preferred Brand Name Drug, $65 for Non-Preferred Brand Name Drug.

Wellness
Services
  100% of Allowable Amount subject to Physician office visit Co-payment.
$300 per Calendar Year maximum.

Childhood Immunization:
100% of Allowable Amount, through age 7.
  Benefits provided for routine physical examinations, well-child care, hemoccult test, pap smears, immunizations for Participants 8 years of age and over, routine lab, x-ray, vision and hearing examinations up to a $300 combined Calendar Year max for Network and Out-of-Network Benefits.
Subject to $25 co-pay.
  Immunizations through age 7 paid at 100%,
Annual mammogram screening for females over age 35, Test for detection of prostate cancer (at age 40 with a family history or routinely after age 50).
  Immunizations through age 7 paid at 100%,
Annual mammogram screening for females over age 35, Test for detection of prostate cancer (at age 40 with a family history or routinely after age 50).

Deductibles
  $250, $500, $1,000, $1,500, $2,500, $5,000 per individual.

The family deductible is three times the individual deductible.

  $250, $500, $1,000, $1,500, $2,500, $5,000 per individual.

The family deductible is three times the individual deductible.

 

$1,500, $2,500, $3,500, $5,000 per individual.

The family deductible is three times the individual deductible.

  $500, $1,000, $1,500, $2,500, $5,000 per individual.

The family deductible is three times the individual deductible.

Network
Co-insurance
85% after deductible
80% after deductible
75% after deductible
75% after deductible
Non-Network
Co-insurance
Deductible doubles,
then 75% after deductible.
Deductible doubles,
then 75% after deductible.
50% after deductible.
Deductible doubles,
then 60% after deductible.

Out-of-Pocket Maximum
(in addition to the deductible)
 

$250 or $500 ded. = ind:$2,000, fam:$4,000

$1000 or $1500 ded. = ind:$3,000, fam:$6,000

$2,500 or $5,000 ded. = ind:$5,000, fam:$10,000

  $3,000 individual, $6,000 family
(in network).

$5,000 individual, $10,000 family
(out of network).
 

$3,000 individual

$9,000 family

 

$3,000 individual

$9,000 family

All other
Services
85% after deductible
80% after deductible
75% after deductible
75% after deductible

Coverage Synopsis:

Blue Cross Blue Shield generally offers the best value for full coverage.  They cover doctor visits, prescription drugs, vision, accident benefit, and of course, hospitalization.  The coverage and rates are excellent, and they have what is probably the widest PPO network in the state of Colorado.  Complete details can be seen by opening the"Outline of Coverage" brochure for the plan you are interested in:

You can also refer to the chart above for a coverage overview.

Blue Cross Blue Shield of Colorado

Rates:

Rates vary based upon zip code, age, and effective date.  You can get an instant quote, or check out the rate chart.

Blue Cross Blue Shield of Colorado

PPO Network:

Blue Cross of Texas gives you access to one of the largest networks in Texas, with thousands of health care providers throughout the state.  The large list of doctors and hospitals can be viewed at their online directory.

Blue Cross Blue Shield of Colorado

Underwriting:

Blue Cross has one of the easiest, most efficient underwriting teams in the industry.  The process is very fast if no medical records are needed.  While it is always a good idea to apply at least three weeks prior to the time you need your new coverage to take effect, some applications that are done online are approved by BCBS within 24 hours.  If medical records are needed, you may have to reapply, and include medical records.

The company does have the right to accept or decline any individual or family application.  Certain conditions may be waivered with a temporary rider (usually for one to two years), or an indefinite rider.  If you are currently being treated for depression, anxiety, or high cholesterol, please let us know before you apply so we can make sure there are no delays in getting you covered.

Blue Cross Blue Shield of Colorado

Effective dates:

The coverage can go into effect in as quickly as 24 hours, though the applicant risks being declined if claims are submitted before the underwriting process is completed.  You may request an effective date any time the date after you sign the application and 60 days later.  Please note that you will be billed starting on your requested effective date, even if you have not yet been notified that you have been approved.  This is very good for someone who does not have any present coverage and would like for their benefits to begin right away.  For those who are already covered, it is suggested that you maintain your current coverage in force until you have received notice from either Health Insurance for America or directly from Blue Cross that your coverage has been approved and is in force.

Your earliest possible effective date will be the day after Blue Cross has received all the necessary documents and information needed to process your application.

Blue Cross Blue Shield of Colorado

About Blue Cross Blue Shield:

Since 1939, Blue Cross and Blue Shield of Texas has worked to help keep Texans healthy.  The company's stated mission since its founding has been to provide financially sound health care coverage to as many Texans as possible.

  • Blue Cross serves more than 3 million members in all 254 Texas counties.
  • Blue Cross maintains its state headquarters in Richardson, with regional headquarters in Houston, Austin and Lubbock.
  • Blue Cross processes members' claims in Texas -- an average of more than $22 million worth every day, five days a week -- in their claims and customer service facilities in Abilene, Houston, Marshall, Richardson, San Angelo, Waco and Wichita Falls.
  • Over the past few years, Blue Cross has cut administrative costs by 20 percent, saved more than $100 million and increased claims processing productivity by 24 percent.
  • Their health care provider network is the largest in the state, with more than 27,000 physicians and 400 hospitals across Texas.
  • They have 15 medical doctors on staff combining more than 400 years of experience in medicine, an Office of Physician Advocacy dedicated to addressing network physician concerns and fostering robust communication with the physician community.
  • Blue Cross provides physicians with its exclusive BlueLink online referral and precertification system, which allows physicians to obtain real-time access to network specialist referrals and approval of inpatient and outpatient procedures, 24 hours a day, seven days a week.

A division of Health Care Service Corporation (HCSC), Blue Cross and Blue Shield of Texas is among the financially strongest health insurers in the nation providing its members with a high level of confidence and security.  For detailed financial reports, please visit the HCSC web site.

Blue Cross Blue Shield of Colorado

Call Toll Free: (800) 707- 9849
or
Email: Health Savings Account

Toll Free Fax: 866-284-0082

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