What is SelecTEMP PPO?

SelecTEMP^® PPO is a Preferred Provider Health Insurance Plan that offers you and your family protection against unexpected accidents or illnesses. SelecTEMP PPO offers various benefit periods and deductibles to tailor your coverage, premium rates and out-of-pocket expenses.

SelecTEMP PPO is the temporary plan from Blue Cross and Blue Shield of Texas.

Who is eligible for SelecTEMP PPO?

• Texas residents at least 60 days of age and under 65 years of age; and
• Anyone not currently pregnant; and
• Applicants not anticipating adding newborns or child(ren) to the contract except if required by court order; and
• Unmarried dependent children at least 60 days of age and under 25 years of age; and
• U.S. citizen or a non-U.S. citizen living in the United States for at least two years. A copy of your Alien Registration Receipt Card (Green Card) must be submitted with your application.
  
  

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How does SelecTEMP PPO work?

• You can choose one to six months of benefit coverage and a $500 to $1,500 in-network deductible (out-of-network deductibles are higher).
• You pay the deductible and copayment amount.
• Once the deductible and copayment is met, SelecTEMP PPO pays 80 percent of the allowable amount for eligible expenses from in-network doctors and hospitals and 60 percent of the allowable amount for eligible expenses from an out-of-network doctors and hospitals.
• The maximum lifetime benefit is $2 million.

See outline of coverage for plan details.

When does SelecTemp PPO coverage begin?

The benefit period begins on the latter of (A) the requested future effective date or (B) the day after the postmark date affixed by the U.S. Post Office*.

*If the envelope containing the application is not postmarked by the U.S. Post Office, or if the postmark is not legible, the effective date will be the later of: a) the requested effective date; or b) the date received by Blue Cross and Blue Shield of Texas.

The following conditions MUST be met before SelecTEMP PPO coverage can begin:

• You are a resident of Texas
• You answered “NO” to all the health questions on the SelecTEMP PPO application
• Your completed application and premium are received by Blue Cross and Blue Shield of Texas within 10 days of the signature date

Need additional coverage?

If you need coverage for an additional period of time, you may apply for a second non-renewable SelecTEMP PPO contract. Any condition which may have existed or occurred under the prior contract will be a pre-existing condition under the subsequent contract and will not be covered.

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Extension of Benefits

If you are totally disabled on the expiration date of this contract, covered benefits will continue to be payable for any continuous illness or injury that began while this contract was in force and will continue during the continuous total disability of the participant until the earliest of:

• Date the participant is no longer totally disabled
• Payment of maximum benefits
• End of 90 days

If you are interested in applying for permanent individual coverage see our other products. You may also contact your local agent or Blue Cross and Blue Shield of Texas at (800) 531-4456.

Instructions to Complete the Application

• Complete the online application or download a printable application
• If you are not a U.S. citizen but have been a permanent resident for the past two years, you can apply for coverage. You MUST submit a copy of your Alien Registration Receipt Card or “Green Card” along with the completed application and your premium.

Payment Options:

• Blue Cross and Blue Shield of Texas can accept the first premium payment by automated bank draft, credit card or check.
• Upon underwriting and approval, subsequent monthly premiums can be paid by automated bank draft. Blue Cross and Blue Shield of Texas cannot accept a credit card for subsequent monthly premium payments.
• Once established, customer cannot cancel bank draft until selected benefit period is expired.
• SelecTEMP PPO premiums are non-refundable.
  
  

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Eligible Inpatient Hospital Expenses:

• Pre-authorized hospital admission, room and board charges for semi-private room
• Intensive care and coronary care units
• All other usual hospital services