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Did you know that prices for the same quality medical services can differ by thousands of dollars within the same region and health plan network? Blue Cross and Blue Shield of Texas (BCBSTX) provides Member Rewards, a program administered by Sapphire Digital.
Participants who are enrolled in the TRS-ActiveCare Primary or TRS-ActiveCare Primary+ plan can take advantage of the Member Rewards program. However, if you have a Primary Care Provider (PCP) in the Kelsey Seybold group, you are not eligible for this program.
With Member Rewards, you can compare costs for procedures and services like MRIs, CT Scans, Ultrasounds, Knee Surgery.
Compare
Search online via Provider Finder® or call a Personal Health Guide (PHG) at 1-866-355-5999, 24 hours a day, seven days a week, to find a reward-eligible location for your procedure or service.
Schedule
Call your PCP for a referral to the location you chose. Next, call and schedule the appointment or have a PHG schedule the appointment for you.
Earn
A deposit will be made into a Health Care Account (HCA) once you’ve completed the treatment, the claim is paid and the location is verified as reward eligible.*
*BCBSTX has set up an HCA for all TRS-ActiveCare participants eligible for Member Rewards. This HCA is separate from any Flexible Spending Account or Health Savings Account offered by your district.
Do you have questions about your HCA? Please review the list of FAQs below. If you don't see an answer to your question, please contact a Personal Health Guide at 1-866-355-5999.
An HCA is a health care spending account linked to Member Rewards. Funds are deposited into an HCA after you complete a Member Rewards-eligible procedure and Blue Cross and Blue Shield of Texas (BCBSTX) pays your claim and verifies its eligibility.
You can use HCA funds for:
After your medical claim is submitted, BCBSTX determines what it will pay the provider. This process is referred to as claims adjudication.
As part of this process, the Member Rewards’ funds you earn are put into an HCA that will apply toward your future coinsurance or copays.
Most services process automatically when your medical claim is processed. However, if you need reimbursement that does not occur automatically, you’ll need to complete the TRS-ActiveCare Member Rewards Expense form.
Claims will be processed within 30 days. Once the claim is processed, the funds will be issued within 45 days.
Please call a Personal Health Guide at 1-866-355-5999, 24 hours a day, seven days a week, if you have questions or need assistance.
After you pay for your prescription drug at the pharmacy, you will need to complete the TRS-ActiveCare Member Rewards Expense form and include a copy of the receipt for reimbursement.
To check your Member Rewards balance, you can call a Personal Health Guide at 1-866-355-5999, 24 hours a day, seven days a week. You can also log in to Blue Access for MembersSM and click the My Coverage tab. Next, click on Health Care Account information to see your current balance and your spending summary.
Sapphire Digital is an independent company that has contracted with Blue Cross and Blue Shield of Texas (BCBSTX) to administer the Member Rewards program for members with coverage through BCBSTX. Eligibility for rewards is subject to terms and conditions of the Member Rewards program. Amounts you receive through Member Rewards may be taxable. BCBSTX does not provide tax advice, so please contact your HR or tax advisor for more information. Members that have primary coverage with Medicaid or Medicare are not eligible to receive incentive rewards under the Member Rewards program.
BCBSTX makes no endorsement, representations or warranties regarding third-party vendors.