Blue Cross Blue Shield of Texas - BlueChoice® Plus Point-of-Service (POS)

BlueChoice® Plus Point-of-Service (POS)

The BlueChoice® Plus managed care program is a Point-of-Service (POS) plan that lets you choose how you receive covered health care services every time you need them.

Care Coordinated by Your PCP
When you become a member of the POS Plan, you'll choose a primary care physician (PCP) for you and each covered family member from a network of contracting doctors. Then, to receive the highest level of benefits, contact your PCP first. Your PCP will coordinate all of your covered medical care, including referrals for specialist care and preauthorizations for hospital admissions when necessary.

When you see your PCP, or visit a doctor or hospital your PCP has referred you to, you pay a copayment -a flat dollar amount- at the time of your visit.

Care Not Coordinated by Your PCP
In the POS Plan, you also may choose to obtain care from a provider other than your PCP. If you use a BlueChoice network doctor:

You'll pay less out of pocket
You usually won't have to file any claims
You'll get a higher level of benefits

The BlueChoice Network
When you choose the POS Plan, you have access to the BlueChoice network, one of the largest networks of contracting doctors and hospitals in Texas. You also have access to the BlueCard® network, one of the largest networks in the country, with more than 600,000 doctors and 6,000 hospitals nationwide.

If You Go Out-of-Network
Even if you do not go to a POS network provider, Blue Cross and Blue Shield Plans contract with a number of physicians, facilities and other providers outside the network to help you save money and time when you visit. Inside Texas, this program is known as ParPlan. Nationwide, the program is known as the Traditional Indemnity Network.

If you go outside the PPO network, your out-of-pocket costs will be higher than if you use a POS network provider. But if you use a ParPlan/Traditional Indemnity Network provider, although your out-of-pocket costs will be higher, you won't have to file your own claims, and your provider won't bill you for any charges that exceed allowable amounts.

ParPlan/Traditional Indemnity Network providers agree to:

File members' claims
Accept Blue Cross and Blue Shield allowable amounts for covered services
Cooperate with Blue Cross and Blue Shield utilization review activities

When you visit a ParPlan/Traditional Indemnity Network provider, you:

Pay your deductible and coinsurance, when applicable
May have to preauthorize your own care when required
Avoid paperwork because claims are generally filed for you

Find a ParPlan provider in Texas.
Find a Traditional Indemnity Network provider nationwide.

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