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Learn More About Your HMO Emergency Room Benefits

Jul. 02, 2018

As your health benefits company, we want to be good managers of your health care dollars. One way we do that is to make sure you've been billed correctly for the services and tests you received. We also provide information that may help you make the best choices possible when using your health benefits.

Starting Aug. 6, 2018, if you are covered by an individual, family, or employer-based Health Maintenance Organization (HMO), we're:

  • Taking added steps to make sure you’re billed correctly.
  • Checking that the services you received were for covered emergency care and were medically necessary.
  • Reminding you that there is no benefit for out-of-network emergency room (ER) use unless the issue is serious or life-threatening. This means if you go to an out-of-network ER because it is just a convenient place to get care for something that a person with average medical knowledge would know is not an emergency– like a sports physical – then you may have to pay the entire ER bill.

While this isn't a change to benefits for HMO members, we want to make sure you have the information you need to make choices about your care. Staying in network and choosing the best place for the care you need could lower your costs.

Learn more about your care choices:

  • Visit SmartER CareSM  to learn more about where you can go when you need care.
  • Log in to Blue Access for MembersSM (BAMSM)  and click on the Find a Doctor or Hospital link to find a doctor or urgent care center near you.
  • Get the BCBSTX app. Text1 BCBSTXAPP to 33633 or search for BCBSTX in the iTunes App Store or Google Play. Once logged in, click on Find Care In Network.

If you have any questions, please call the number on your member ID card.



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