| Insurance Plan Highlights |
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PPO Select Value® CareSM, a Preferred Provider Health Insurance Plan, offers you and your family:
- 5,000,000 lifetime maximum benefit per person
- Inpatient hospital benefits and professional care
- Outpatient professional care (including office visits, X-rays, lab and diagnostic services) covered 50/50
- 24-hour worldwide emergency care
- Well-child routine physical, vision and hearing – 50/50 coinsurance up to $300 preventive care maximum per person per calendar year
- Immunization benefits (through age 7) at 100 percent of allowable amount, no deductible
- Human Organ and tissue transplant benefits – 50/50 ($300,000 lifetime maximum)
- Office visits and emergency room visits – 50/50
- Home health care, hospice and skilled nursing facility benefits (subject to limitations)
- Preventive Care – Up to maximum of $300 per person per calendar year, 50/50 coinsurance
- Physical Medicine Services – 50/50 coinsurance – up to $1,000 per person per calendar year
- Ground and Air Ambulance Services – up to $1,500 per person per calendar year (in-network and out-of-network combined)
- Any day of the month effective date except the 29th, 30th or 31st
- Age-banded, child-only coverage
- Access to one of the largest provider networks in the state, BlueChoice®
- Security of one of the most widely recognized insurance cards – Blue Cross and Blue Shield of Texas
- Three-tier prescription drug program
- Mail-order prescription drug program
- BlueCard Program
- Prescription Drug Card
Insurance Plan Details
* Texas Department of Insurance Form: PPO-IND-VALUE-OLC-2
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