Select Blue Advantage Series III, a Preferred Provider Health Insurance Plan offers:

• $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)
• 24-hour, worldwide emergency care
• Routine preventive care – 100 percent up to $300 maximum per year per person
• Well-child care, routine physical, vision and hearing exams
• Immunization benefits
• Human organ and tissue transplant benefits ($300,000 lifetime maximum, subject to $5,000,000 policy lifetime maximum)
• Home health care, hospice and skilled nursing facility benefits (subject to limitations)
• Ground and Air Ambulance Services – up to $1500 each calendar year, subject to deductible and coinsurance
• 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 pricing prescription drug plan
• Prescription Drug Card
• Mail-order prescription drug program
• BlueCard program – providing access to Blue Cross and Blue Shield providers across the Nation

Insurance Plan Details

* Texas Department of Insurance Form: PPO-SELBLUE-ADV-3-OLC-2