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Where to Go for Care
You have choices for where to get your medical or mental health care. If you are not having an emergency, knowing where to go for health care will save you a lot of time.
Your Care Options
Prior Authorization
Some services for health care and certain drugs need approval from your BCBSTX health plan. This approval is called "prior authorization." Your doctor will need this before they can treat you. If BCBSTX does not approve the services or drugs, the costs will not be covered (paid) by BCBSTX. Your doctor should know if a service needs approval. Find out more about prior authorization.
Out-of Network Coverage
In most cases, you must get your care from an in-network plan provider. If no one in the network can give you the care you need, your PCP will get approval from BCBSTX to send you to a provider that is not in the network.
There are some exceptions when care you receive from an out-of-network provider will be covered. You do not need us to approve:
- Emergency or urgent care
- Going to a family planning care provider
- Doctor care for a mother and her newborn for at least 48 hours after a vaginal delivery and 96 hours after a cesarean section
MEMBER RESOURCES
Helpful Tools and Resources
Find Care
Need to search for providers in your area? Or figure out where to go for care?
Find a ProviderTransportation Services
Learn how you can get a no-cost ride to your medical appointments.
Schedule a RideContact Us
If you have questions about your plan, call the Customer Advocate Department.
Get More HelpDentaQuest, MCNA Dental and UnitedHealthcare Dental are independent companies that provide dental benefits for BCBSTX plans.
Davis Vision is an independent company that has contracted with BCBSTX to provide vision benefits administration for members with coverage through BCBSTX.
BCBSTX makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.