Blue Cross Medicare Advantage (PPO)SM

If you are located in Bastrop, Burnet, Caldwell, Collin, Dallas, Denton, Ellis, Fayette, Fort Bend, Grayson, Harris, Hays, Johnson, Lee, Montgomery, Rockwall, Tarrant, Travis, or Williamson counties, Blue Cross and Blue Shield of Texas (BCBSTX) would like to extend the opportunity to you for participation as a provider in the Blue Cross Medicare Advantage plan.

Blue Cross and Blue Shield of Texas (BCBSTX) was approved to offer, effective Jan. 1, 2013, a Medicare Advantage preferred provider plan that offers improved health benefits for Medicare beneficiaries. Blue Cross Medicare Advantage affords more comprehensive benefits at a lower cost for Medicare beneficiaries, whenever they access care through a participating provider.

BCBSTX believes that our long standing history in providing affordable health care coverage to the people of Texas, our strong brand recognition, and our historical relationship with Medicare makes BCBSTX an excellent choice for seniors seeking new health coverage opportunities.

BCBSTX needs your network participation for this program to be successful. In order to participate in Blue Cross Medicare Advantage, physicians and professional providers:

  • Must be a participating Blue Choice PPOSM physician or professional provider
  • Must have privileges at one of the Blue Cross Medicare Advantage participating hospitals (unless inpatient admissions are uncommon or not required for the physician's or professional provider's specialty)
  • Must have a valid National Provider Identifier (NPI) number
  • Must sign a Blue Cross Medicare Advantage amendment to his/her Blue Choice PPO agreement
  • Cannot have opted-out of Medicare or have any sanctions or reprimands by any licensing authority or review organizations

Note: Additional credentialing will not be required for those physicians or professional providers already credentialed in the Blue Choice PPO network and whose recredentialing is current.

If you have any questions regarding this plan and are interested in participating, please feel free to contact your Provider Relations office:

Austin — 800-336-5696 or 512-349-4847
Dallas — 800-749-0966 or 972-766-8900
Houston — 800-637-0171, press 3 or 713-663-1149

Or go to How to Join BCBSTX Provider Networks and follow the steps.


Blue Choice Physician and Professional Provider - Provider Manual

Blue Cross Medicare Advantage Supplement (Physician and Professional Providers)

Blue Cross Medicare Advantage Supplement (Facility and Ancillary Providers)

Blue Cross Medicare Advantage Orientation 

Blue Cross Medicare Advantage Key Contacts List 

Sample Blue Cross Medicare Advantage Member ID Card 

Blue Cross Medicare Advantage Preauthorization Requirements List 

Blue Cross Medicare Advantage Quick Reference Guide 

Blue Cross Medicare Advantage Preauthorization Request Form 

Blue Cross Medicare Advantage Medicare Part B Medication Prior Authorization Request Form 

Blue Cross Medicare Advantage Predetermination Request Form 

Medicare Marketing Guidelines Excerpt for Providers