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Blue Access for Members and quoting tools will be unavailable from 3am - 6am on Saturday, October 20.
We apologize for any inconvenience.
Blue Access for Members and quoting tools will be unavailable from 2am - 5am Saturday, October 20.
We apologize for any inconvenience.
You can log into Blue Access for Members 24/7 to access your benefits information or Call the Customer Service number on the back of your BCBSTX ID card.
Yes. We are committed to protecting your medical records, and have strict rules to make sure our staff and anyone who needs to see your records keep all your member information confidential. Your medical records or claims details may have to be reviewed. If so, precautions are taken to keep your information safe. In many cases your identity, such as name and address, will not be included in the information provided during the review.
Your first premium payment activates your coverage, so you can start using your health plan within 1–2 days of making your payment, depending on how you pay.
After you've made your first payment and your coverage is activated, you can have health care expenses during that coverage gap applied to your deductible, or even get paid back for some services. In this case, the coverage gap would be the time between your requested effective date and the date you make your first payment.
Even if you haven't received your ID card, you should have received a new member welcome letter within days of your enrollment being completed. Your member identification and group number listed on your welcome letter can be used by the pharmacy to verify your benefits. You will need to pay your first premium payment before you can use your prescription benefits.
We receive new applications from the Marketplace every day. If you applied through the Marketplace, it will take a few days for processing through the Marketplace before they are sent to us. It then takes us about 5–10 business days to process your enrollment in the BCBSTX system.
If you just applied recently, we encourage you to wait to see if you receive your membership information soon. If you applied weeks ago and have not received anything from us, it is possible your application has been held up for some reason.
If you applied on the Health Insurance Marketplace or with BCBSTX online and you have not received information from us, call our Customer Service Center at 888-697-0683 and we will look up the status of your application. Our call volumes are still very high, so you may have to hold for a long period before getting through. We will help you as quickly as possible.
You should get your member ID cards in the mail soon after your application is approved. Individual plans will get 1 card and family plans will get 2 cards. Please note that all member ID cards will have only the subscriber name on it, but can be used by all of the dependents enrolled under the policy.
You can print a temporary ID card and request additional cards through your Blue Access for Members account. You will need your member identification number and group number to log in to Blue Access for Members. These numbers can be found on the new member welcome letter you will receive within days of enrolling.
Your member ID cards will only have the primary subscriber's name on them, but they can be used by all of the dependents (in this case your spouse) enrolled under your policy.
Within days of your application being accepted, you will receive a welcome letter from BCBSTX that includes your member identification number and group number. This information can be used by providers and pharmacies to verify your coverage until you get your member ID card. Your ID card will be sent separately soon after.
Your policy information is available through your Blue Access for Members account once your plan is in effect.
Since you have new coverage with us, we want to make sure you understand your benefits and that we have the information we need to help you with your health care needs. We are calling to:
We also check to make sure the information we have is correct, such as the names of everyone on your plan, your address and other details.
The call often only takes about 15 to 20 minutes. If you have any concern that the person calling you is not with BCBSTX, ask the caller for a number you can use to call us back.
You may have received this error message during your registration for a number of reasons. Many times, the information you entered may not have matched the data in our system. Please remember to have your group and member ID numbers handy when you register. Both of these numbers can be found on your welcome letter and your member ID card. Register now.
In most cases, you can only sign up for a health insurance plan during the open enrollment period, which for this year, ended on March 31. If you missed open enrollment, you may be able to enroll during the special enrollment period that runs until November 14, 2014. To be eligible, you must have had a qualifying "life event" within the past 60 days or experienced other complications that did not allow you to complete your enrollment . To learn more about special enrollment visit bcbstx.com/coverage/special-enrollment.
If you don't qualify for the special enrollment period, you can still stay insured by buying short-term insurance directly from Blue Cross and Blue Shield of Texas (BCBSTX). We offer affordable short-term plans that can keep you covered until the next open enrollment period begins on November 15. Start shopping now.
Please note: Short-term plans give you basic health care coverage, but they don't meet the Affordable Care Act's minimum essential coverage requirements. As a result, you may still have to pay a fine for having a plan that doesn't meet these requirements.
For more information on all the ways you can pay your bill visit bcbstx.com/payment-options.
We sincerely apologize for our error in drafting your bank account twice for your premium payment. We had two active policies for you in our system, which pulled your records twice when the automated drafts were processed. We have corrected the error in our system, so this should not happen again. We will mail a refund check for the overpayment amount within 5 days of the error. If you don't see it soon, please give us a call. In addition, if you had overdraft fees as a result of the double billing, please contact us so we can refund these charges as well. You can reach us at 800-792-8595.
We cannot process a cancellation request for a Marketplace plan. If you want to cancel your Marketplace plan, you can call the Marketplace at 800-318-2596. If you want to cancel our off-Marketplace plan, we can process that cancellation for you. Call Customer Service at 800-538-8833. You can also log in to your Blue Access for Members account and send us a secure email message.
A policy will also automatically be cancelled for nonpayment if you don't pay the premium. This may be your best option. You would simply pay the premium for the plan you want to keep and not pay the premium for the plan you want to cancel.
If you have questions about how health care reform affects you or would like to learn more about your health plan options, please visit our Health Care Reform and You website to learn about the new law.
Members can log in to their Blue Access for Members account from a desktop or mobile browser for more information about benefits, claim status and more.
A Health Maintenance Organization (HMO) is a type of health plan that gives you access to certain doctors and hospitals who have contracted with the HMO, often called network providers. An HMO is different from other health care plans in a number of ways:
Use our Provider Finder® online directory to find the PCP in the HMO network who best fits your needs. Be sure the doctor you select is accepting new patients.
It's easy to use the Provider Finder by registering for Blue Access for MembersSM (BAM):
You must have a primary care physician assigned. If you don't select your own, we will assign one to you.
You can call the Customer Service number on the back of your ID card to identify your new primary care physician (PCP) selection. You can also change your PCP by logging into your Blue Access for MembersSM account and clicking "Doctors and Hospitals." Before you change, make sure the PCP you are requesting is in your network and accepting new patients.
Your primary care physician (PCP) will provide you with a referral to a specialist if you need to see one. Always contact your PCP first for any care you need. However, women do not have to have a referral to see an OB/Gyn.
It is possible. Your doctor may already be in the HMO network you are considering. But if your doctor is not in the network you will need to select a new primary care physician (PCP).
In an emergency, go directly to the nearest hospital. For other needs, some HMO plans allow you to get health care services from a Blue Cross and Blue Shield affiliated doctor or hospital when you are traveling outside of Texas. If you aren't sure, contact customer service at the number on the back of your member ID card before you go. And always remember to carry your current BCBSTX member ID card. It contains helpful information for accessing health care at home or away.
If you or a covered family member will be temporarily living outside of Texas for 90 days or more, you may be eligible for guest membership in a Blue Cross and Blue Shield-affiliated HMO. In some circumstances, moving can also qualify you to be able to enroll in a new plan in your new location. You can call the customer service number on the back of your ID card to find out if your plan covers you when living outside Texas and to discuss your options.
We'll work with you to provide coverage for the most appropriate care for your medical situation, especially if you are pregnant or receiving treatment for a serious illness. You may still be able to see your current provider for a brief time. Call us at the Customer Service number on the back of your BCBSTX ID card for more information.
When you join an HMO your doctor, known as a primary care physician (PCP), coordinates all your care, including referrals to specialists if needed. If you are already seeing a specialist for your condition, make sure that specialist is in your plan's network. If the specialist is not in your plan's network, in most cases you will pay more. You will still need a referral from your PCP to see a specialist.
Your BCBSTX HMO benefits also cover prescription drugs. Not all drugs are covered. You can visit our website to view the list of prescriptions your plan covers. This list is called a preferred drug list. To look for your medicines, you will need to know:
While costs can vary depending on your benefit plan, you usually pay less for generic drugs and more for brand name drugs. Your plan may cover some of the costs of drugs not on your preferred drug list. You can learn more by looking in your benefit book, or calling the customer service number on the back of your ID card.
* BCBSTX has contracted with a third-party vendor, Alacriti Payments, LLC, to process your ACH/electronic check payment. In order to process this payment, you will be redirected to Alacriti's secure payment site, OrbiPay. If you have any problems with your payment, please contact BCBSTX customer service at 800-538-8833.