Blue PremierSM and Blue Premier AccessSM
Blue Premier (Groups 151+)
Blue Premier is a health maintenance organization (HMO) that provides benefits only when services are:
- Received from providers in the Blue Premier network when prescribed
- Directed by the member's Primary Care Physician (PCP) or the HMO
- Authorized by the member's Primary Care Physician (PCP) or the HMO
Members are required to choose a PCP from a network of contracting doctors in the Blue Premier network. This doctor will:
- Coordinate the member's care
- Help the member make informed decisions
- Make recommendations for wellness and preventive care services
In addition, female members can receive specialized care from an OB/GYN from the same network as their PCP without a referral.
Blue Premier Access (Groups 51-150)
Blue Premier Access is an open access health maintenance organization (HMO) that provides benefits when services are:
- Received from providers in the Blue Premier network
- Members are not required to choose a PCP or receive referrals for services
Blue Premier and Blue Premier Access offer a wide range of benefits without financial surprises. Members will have:
- A predictable copayment
- No claims or other paperwork to file
Plans offered include varying copayment options including a differing office visit copayment when services are received from a PCP or specialist. The Blue Premier Access product also includes Away From Home Care® (AFHC) Guest Membership coverage for members living out of the service area for at least 90 consecutive days.
The Blue Premier network includes more than 94 hospitals and 7,600 providers. By choosing Blue Premier Access, clients choose more than just a health plan. They're choosing health coverage provided by Blue Cross Blue Shield of Texas, one of the most widely recognized health insurance companies in the state.
For more detailed information on the benefit designs available, covered benefits, services or supplies that are limited or excluded, general administration of the plan, or any other questions you may have regarding our products and services, please contact us for the phone number of the regional sales office near you.