Frequently Asked Questions

Problems Logging In?

If you’re having trouble getting online access to your account using Blue Access for Members^SM (BAM^SM), these Frequently Asked Questions may help you troubleshoot.

What should I do if I get a login error that says my password is not recognized?

First, check your password by pressing the eyeball icon after typing it in, this will ensure that you’ve entered it correctly.

If you still get an error message, this is a quick and easy way to reset your password:

1. Choose Forgot Password.
2. Enter your username. (See below if you get a username error.)
3. Choose whether you want a one-time verification code sent by email or text message. (The code will be sent to the email or mobile phone number tied to your account.)
4. Choose Send Code.
5. Enter the 6-digit verification code you receive and follow the directions to reset your password.
6. When choosing a new password, keep in mind these rules…

Password must have:

• 8-40 characters
• An uppercase letter and a lowercase letter
• A number
• A special character, like ~ ! @ # $ % ^ & * ( ) [ { }

Password can't have:

• More than two sequential or repeating characters, like 123, ABC, CBA, 111 or AAA
• Abbreviations for months or days, like Jan, Feb, Mon, or Tue
• Restricted terms, like Appl, Asdf, Basic, Cadam, Demo, Focus, Game, Net, New, Pas, Ros, Sign, Sys, Tso, Valid, Vtam, Log
• Your first or last name, or username
• The same exact characters as any of your last 24 passwords

Once your password has been reset, try again to log in to BAM^SM.

I keep asking for the code to reset my password, but I don’t see it in my email or text messages. What can be causing this?

• Wait a few minutes when you request a code.
• If getting it by email, check your spam folder.
• If you are still not getting the verification code, it may be that the email address or mobile number tied to your account was not entered correctly when you signed up for your account.
• You may be using a different email than you used when you set up your account.
• If you have changed your mobile number recently, it may not have been updated in your account records.

You can call the customer service number listed on the back of your Blue Cross and Blue Shield of Texas (BCBSTX) member ID card to make sure the right email and mobile number is linked to your account or to change your contact preferences. Or you can use our online form to update your preferences using your member ID number.

What should I do if I get an error message when I enter my username?

If you are unsure that your username is correct or don’t remember it, you can get your username using these easy steps:

1. Choose Forgot Username.
2. You’ll be prompted to enter the email linked to your account so we can send you the right username. The email address must be linked to your account. If not, you will get an error message and won’t be able to continue.
3. The email will come from BCBSTX_noreply@bcbstx.com and provide the username listed for your account. If you don’t see an email after a few minutes, check your spam folder.
4. Use the exact username provided in the email to log in to your account.

What if I forget my username?

You can use the same steps above to have your username sent to you.

Why am I being asked to get a one-time passcode?

Because your account includes private health and financial information, we pledge to keep your account information safe. This passcode is a security feature we’ve added to protect your account from hackers, malicious actors and cyber threats. It is an extra step, and that can be annoying. But you will have the option to check a box when entering the one-time verification code that will allow you to skip the verification steps on that device for 30 days.

I already registered with the Shopping Cart. Why aren't my username and password working when I try to log in to BAM^SM?

Our “Shop Plans and Prices” site is a tool used to pick a plan and enroll. For security reasons, it isn't part of our member accounts system. That means you’ll need to sign up for BAM^SM, as well – even if you use the same username and password.

The link I saved and use to access my BAM^SM account is not working. What should I do?

We've updated Blue Access for Members to give you a better experience, so the website address you saved may have changed. Access the new BAM^SM website and use Sign Up or Log In within the Member Login window on the top right of the webpage. You can save the new BAM^SM link, but don’t forget to delete the old one.

How do I create an account as a legal guardian?

Go to BAM^SM and click Sign Up or Log In and follow these simple steps:

1. Enter information about the policyholder (the person you are guardian of): first and last name, date of birth and the BCBSTX member ID number listed on their member ID card or on their welcome letter.
2. Check the legal guardian checkbox.
3. Enter your information as legal guardian.
4. Choose Continue.
5. Enter an email address, username and password.
6. Choose Create Account.
7. When you get an email from BCBSTX_noreply@bcbstx.com, click the link to verify your account and complete your legal guardian account setup.

Still Need Help Logging In?

For technical questions about the BAM^SM website:

Internet Help Desk
1-888-706-0583

TTY, dial 711

24 hours a day, 7 days a week

How do I submit a health insurance claim?

Most often, your health care provider will submit a claim on your behalf. If your health care provider does not send the claim for you, you can file a claim yourself.  

Print out or download a “Medical Claim Form” from Form Finder or from the Forms & Documents link under My Account tab on Blue Access for Members^SM (BAM^SM). Then fill out the form completely.

To submit your completed form, you can:

• Submit your claim online in the BAM^SM Message Center. Attach the completed claim form, the original bill issued by the provider and select “Claims Submission Attachments” in the subject dropdown, or;
• Mail the form and the original bill issued by your provider to the address printed at the top of the claim form.

Learn more: 

What Is a Health Insurance Claim?

How do I get reimbursed for a health care claim that I’ve already paid for?

If you’ve already paid for a health care service that you believe should be covered, you can submit a claim to be paid back.

Print out or download a “Medical Claim Form” from Form Finder or from the Forms & Documents link under My Account tab on BAM^SM. Then fill out the form completely.

To submit your completed form, you can:

• Submit your claim online in the BAM^SM Message Center. Attach the completed claim form, the original bill issued by the provider and your receipts. Then select “Claims Submission Attachments” in the subject dropdown and send, or;
• Mail the form, the original bill issued by the provider and your receipts to the address printed at the top of the claim form.

How do I check the status of my claim?

To check the status of your claim you can visit the “Claims” section in BAM^SM. You can also sign up to get alerts about your claims. 

There are three types of claims statuses that you may see:

• Paid - The health care services you received were covered and the claim has been paid.
• Not Paid - The health care services you received were not covered by your health care benefits plan. You may still be responsible for all or part of your bill.
• Processed - The health care services you received were covered by your health care benefits but no payment was required.

Please note that BAM^SM and Customer Service agents will not have updates on your claim until it is processed.

Why was my claim denied?

You have the right to know why a claim was denied. Learning why your claim has been denied is also the first step to appealing or re-filing your claim. 

You can always check your Explanation of Benefits (EOB) for why your claim was denied and to make sure your claim information is correct. If a claim is denied, a reason for the denial will be listed at the end of your EOB. 

Learn more: 

5 Reasons a Claim May Be Denied

How do I appeal a denied claim?

You always have the right to know why a claim was denied and to appeal a denied claim. Every EOB has instructions on what to do if a claim has been denied. It is also explained in your benefit book. You may get your EOB in the mail. If you have a BAM^SM online account, your EOB and benefit book can also be found there.

While some appeals can be faster, a standard appeal takes about 30 days for review. Some appeals may take up to 60 days.

If your life or health could be at risk by waiting, you can ask for an urgent appeal. If you qualify, the review will be handled within 72 hours. You and your doctor will get a phone call from us explaining the decision and next steps.

Learn More:

My Claim Has Been Denied, Now What?

Claim Not Approved? Here’s What to Do

What is an Explanation of Benefits (EOB)? 

When you go to your doctor and pay your copay – you’ll get an Explanation of Benefits (EOB) after your claim is final. An EOB shows costs from your health care provider and how the claim was processed. Charges change according to what your plan covers and what services you receive. 

Learn more: 

Need an Explanation of Your Explanation of Benefits?

I got a bill from my provider, but I haven’t gotten my EOB yet. How do I get my EOB?

If you get paper EOBs, an EOB will be mailed to you after a claim has been finalized. If you have a BAM^SM online account, your EOB and benefit book can also be found there. If you are signed up for paperless statements, you can opt in to get an email or text when your EOB is ready to view in your BAM^SM account.

I thought my routine visit was covered. Why was I sent a bill?

It can be confusing when you go to the doctor for a covered routine or diagnostic visit and still get a bill. There can be a few reasons this happens:

• You may have gone out of network.

You may have gone to a doctor that’s out of network, or you may have had lab work done that was sent out of network. When you go out of network, this may incur a charge.

• You may have asked for additional services that were not routine. 

When you go to a routine visit, only certain services are covered at 100%. If you ask for or choose to have other services performed, or talk about other issues that are not covered as routine, you may be charged.

Learn more:

Staying In-Network Can Help Cut Costs

Preventive Care or Medical Care? Learn the Difference

My claim was approved, but my provider still sent me a bill. Why did this happen?

It can be confusing if you believe that a claim was approved, and you still get a bill. First, double check your EOB to make sure all the services you received were covered. Sometimes when you visit a provider, only certain services are covered at 100%. Your health plan may have only covered part of your total bill.

If you have checked your EOB and believe you were billed for a service that was covered, call your provider. If you are still having issues you can call the customer service number on the back of your ID card.

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible. 

Learn more:

Staying In-Network Can Help Cut Costs

Preventive Care or Medical Care? Learn the Difference

Why was my pharmacy/prescription drug claim denied? What can I do?

There may be several reasons why your prescription drug claim has been denied: 

• Your prescription drug may not be on, or may have been removed from, the covered drug list.
• For some drugs, you may need to meet certain criteria before your prescription drug coverage may be approved.
• If you need a specialty drug to treat a complex or rare condition may need to follow the specialty pharmacy program requirements. 
• Some drugs may also have limits on how much medicine can be filled per prescription or in a given time span.

If your medication is not on your drug list, you or your prescribing doctor can request a coverage exception. To request this exception, your prescribing doctor will need to send us documentation, or you can fill out and submit the Prescription Drug Coverage Exception form.

We will usually let you or your doctor know the coverage decision within 72 hours of receiving your request.

You or your doctor may be able to ask for an expedited review if:

• You take medication for a health condition and failure to get that medication may either pose a risk to your life or health or could keep you from regaining maximum function
• Your current drug therapy uses a non-covered drug

We will usually let you or your doctor know the coverage decision on an expedited review within 24 hours of receiving your request.

If the coverage request is denied, we will let you know why it was denied and may advise you of a covered alternative drug. You can also appeal the benefit determination.

Learn More:

What Happens if a Drug I Need is Not Covered?

What is Coordination of Benefits (COB)? 

If you’re covered by two health plans, your doctor may file a claim with both. Insurance companies decide which plan covers what costs. This is called Coordination of Benefits (COB). 

You may get a COB Questionnaire from your insurer to set up the coordination of benefits so claims get paid correctly. If you do, please be sure to fill it out, even if you do not have any other coverage. You may also want to document any other coverage you have when your plan renews each year.

Learn more: 

What Is Coordination of Benefits?

I received a letter from Equian saying they have partnered with Blue Cross and Blue Shield of Texas (BCBSTX) to investigate my medical claim. Should I respond to the letter?

BCBSTX and Equian have partnered to review the medical claim listed on your letter to determine if another person or insurance company should be responsible for the claim. The claim we are investigating may be for treatment you received from an injury experienced at work or from an auto accident.

The information could help to get back money that should be paid by someone else, like another insurance carrier. This is one of several tools used by BCBSTX to help control rising costs of health care. Call the number on the letter to answer the claim question.

What are my options to pay my premium?  

Here are convenient ways you can pay your bill. 

When will I get my member ID cards, and how many will I get? 

You should get your member ID cards in the mail soon after your application is approved. Individual and family PPO members will receive no more than 2 member ID cards. Please note that all member ID cards will have only the subscriber name’s but can be used by all the dependents enrolled under the policy. HMO Individual and family plans will get a card for each member enrolled. 

 You can print a temporary ID card and request additional cards through your Blue Access for Members ^SM (BAM^SM) account. You will need your member identification number and group number to log in to BAM^SM. These numbers can be found on the new member welcome letter you will receive within days of enrolling. 

Learn more:

• Member ID cards explained
• New member guide to using your health insurance

I received my member ID cards in the mail but with only my name on them and not my spouse's. Can I get another ID card with their name on it? 

Your member ID cards will only have the primary subscriber's name on them, but they can be used by all the dependents (in this case your spouse) enrolled under your policy. 

 
How do I get a replacement  ID card?  

Don’t worry if your ID card is lost or misplaced.  We know this happens, so we’re ready to help.  Find out more about your card and how to replace it. 

How do I Use My Digital Member ID Card?  

Your trusty smartphone now safely stores your health information. Your mobile phone/device can:    

• Find insurance benefits 
  
• Use favorite payment methods 
  
• View your digital ID member card   

Learn more:

Digital member ID cards explained

How can I learn more about my benefits?  

Log in to Blue Access for Members^SM (BAM^SM) 24/7 to access your benefits information or call Customer Service at the number listed on your Blue Cross and Blue Shield of Texas (BCBSTX) member ID card. 

Learn more:

Using BAM^SM

Are my medical records kept private?   

Yes. We are committed to protecting your medical records. We have strict rules to keep all your member information confidential. This includes our staff and anyone who needs to see your records. If your medical records or claims details need to be reviewed, precautions are taken to keep your information safe. In many cases your identity, such as name and address, will not be included in the information provided during the review. 

Learn more:

• Your password to privacy, the standard authorization form
• HIPAA: What more do you need to know?

Where do I find my plan’s mobile app?  

Download the BCBSTX mobile app in the iTunes App Store  for your iPhone; or use Google Play.   for Android users. Or, text BCBSTXAPP to 33633. To learn more, watch this Health Care One-to-One video. 

Learn more: 

 Go Digital With the BCBSTX Mobile App (Video)

When will I get benefit coverage information and the contract on the plan I selected?  

Within days of your application being accepted, you will receive a welcome letter from BCBSTX that includes your member identification number and group number. This information can be used by providers and pharmacies to verify your coverage until you get your member ID card. Your ID card will be sent separately soon after.  

Your policy information is available through your BAM account once your plan is in effect. 

Learn more:

New member guide to using your health insurance
 

How do I change my personal information? 

Moving? Expecting a new arrival? When your life changes, let us help.  Find out more about making a seamless transition. 

How do I change my communication messages?

Blue Access Members can tweak how you receive communications from Blue Cross and Blue Shield. To make changes, go to your communication preferences page.

Learn more:

 How Do I Update my Communication Preferences? (Video)
 

When I try to register for BAM^SM, I get a message telling me it's not available. When will it be available for me to register?  

You may have received this error message during your registration for several reasons. Many times, the information you entered may not have matched the data in our system. Please remember to have your group and member ID numbers handy when you register. These numbers can be found on your welcome letter and your member ID card. Register now. 
 

What communications are available in Spanish?  

Members can receive Explanation of Benefits (EOB) statements in Spanish. Check here for available Spanish communications. You can also call the customer service number listed on your member ID card. Customer Service will record your preference.  

We also have the following tools available to meet the Spanish language preference of our members:  

• Spanish language website — Browse health plans, get information on member services and tips for using your health insurance. 
  
• Provider Finder® in Spanish — Locate medical professionals who speak Spanish in your area. 
  
• BCBSTX App — Access your secured health plan information easily on your mobile device. The App will open in Spanish if the device language is set to Spanish. 
  
• Facebook Latino  — Follow us on Facebook en español for content and posts in Spanish. 

Learn more:

Spanish Resources (Video)

How do I choose the best health care coverage for my needs?  

All our health plans will cover your essential health benefits and services. That said, you’ll want to find the one best suited to you and your family’s needs. Learn more about your choices and how to make your best decision.  

Learn more:  

• How do I buy an individual health insurance plan?
  
• Comparison Shopping
• Choosing Coverage
• How to sign up for health insurance
• 9 myths about using an agent to buy a health plan

What should I ask when choosing a plan?  

Getting the best answers starts with asking the right questions. You’ll want to know what you need to know before making your decisions.  Find out more about how to go about seeking the best plan for you. 

How does open enrollment work?  

Taking advantage of open enrollment requires planning in advance.  We can help you make your list, check it twice and be ready when the time comes to act.  Learn more about how this works.  

 Learn more: 

• Everything you need to prepare for buying health insurance
• Make a list to prepare for open enrollment
• Top 5 things to know about open enrollment (Video)

I missed the open enrollment deadline. Can I still buy health coverage? 

In most cases, you can only sign up for a health insurance plan during the open enrollment period. If you missed open enrollment, you may be able to enroll during the special enrollment period. To be eligible, you must have had a qualifying "life event" within the past 60 days or experienced other complications that did not allow you to complete your enrollment. 

Learn more about special enrollment. 

I have additional questions about my Health Care Benefits 

Learn more:

View the Cost of Care Series (Videos)

I bought my health plan on the Health Insurance Exchange. How can I make changes to that account or profile?

This Contact Guide has the phone numbers and instructions you’ll need. Find the change you’d like to make, then learn where to get started.

What is an HMO? How is it different from other health care plans?  

A Health Maintenance Organization (HMO) is a type of health plan that gives you access to certain doctors and hospitals that have contracted with the HMO, often called a provider network or just network. 

Learn more:

• How HMO health insurance works
• Tips for using your HMO
    

What types of doctors can be a Primary Care Provider (PCP)? 

The following doctors can be selected as a PCP: 

• Family medicine doctor 
  
• OB/GYN 
  
• Pediatrician 
  
• Internal medicine doctor 
  

How do I select a PCP?  

Use our Provider Finder online directory to find a PCP in the HMO network who best fits your needs. Be sure the doctor you select is accepting new patients. 

It's easy to use the Provider Finder by registering for Blue Access for Members^SM (BAM^SM): 

• Visit BAM^SM. 
  
• Use the information on your Blue Cross and Blue Shield of Texas (BCBSTX) member ID card to complete the registration process. 
  
• Once you are registered, log in to BAM^SM. The Provider Finder tool is located under the Find Care tab. 
  
• Know the name of your plan and choose it from the dropdown box "Select network type". 
  
• Continue to search until you find a doctor who meets your needs and is accepting new patients. 

Learn more: 

• Blue Buzz: Have you found a primary care provider? (Video)
• Your doctors need to talk to each other about your care
  

What happens if I don't select a PCP?  

You must have a primary care provider assigned. If you don't select your own, we will assign one to you. 

Do I need a referral to see a specialist?  

Yes. However, if the specialist is not in your plan's network, in most cases, you may have to pay for services that are considered out-of-network. 

Learn more:

• How the HMO referral process works
• HMO: The referral process (Video)

Can I continue to see my current doctor when I join the HMO plan?  

Yes, if your current doctor is a part of the HMO’s network. If your doctor is not in the network, you will need to select a new PCP. To make sure a provider is in the HMO network, search  Provider Finder.  
 

How do I find out if a doctor is in my network?  

Search for an in-network doctor under your plan on Provider Finder. Also: 

Log in to BAM^SM and choose your primary doctor. 

Learn more:

Compare costs and finds doctors and hospitals with provider finder

Do I have coverage if I am traveling?  

In an emergency, go directly to the nearest hospital. For non-emergencies, some HMO plans allow you to get health care services from a BCBS affiliated doctor or hospital when you are traveling outside of Texas. 

If you aren't sure, contact customer service at the number listed on your member ID card before you go. And always remember to carry your current BCBSTX member ID card. It contains helpful information for accessing health care at home or away. 

If you or a covered family member will be temporarily living outside Texas for 90 days or more, you may be eligible for guest memberships in a BCBSTX affiliated HMO. In some circumstances, moving can also qualify you to be able to enroll in a new plan in your new location.

Learn more:

• Coverage while traveling
  
• Information about blue card insurance when you travel

What if I'm already in treatment when I enroll and my provider isn't in the network?  

We'll work with you to provide coverage for the most appropriate care for your medical situation, especially if you are pregnant or receiving treatment for a serious illness. You may still be able to see your current provider for a brief time. Call us at the customer service number listed on your BCBSTX member ID card for more information. 

Does my plan cover prescriptions? 

Your BCBSTX HMO benefits also cover prescription drugs. Not all drugs are covered. You can visit our website to view the list of prescriptions your plan covers. This list is called a preferred drug list. To look for your medicines, you will need to know:  

• The medicine's exact name 
  
• The dose you take 
  
• How many pills your doctor often prescribes for you 
  

While costs can vary depending on your benefit plan, you usually pay less for generic drugs and more for brand name drugs. Your plan may cover some of the costs of drugs not on your preferred drug list. You can learn more by looking in your benefit book or calling the customer service number listed on your member ID card.  

Can I save money using preferred pharmacies?

If your plan offers a preferred pharmacy, save money by filling prescriptions at these places. Subscribers pay less for a 90-day supply of covered medicines in the store or by home delivery.  

• Go to MyPrime  to find a preferred drugstore. 
  
• To filter your Pharmacy Search results, type in your city, state, or zip codes to find in-network pharmacies. 
  
• You may also search without logging in. 
  

Learn more:

• Is your pharmacy in-network?
• Tips to save at the pharmacy

Where do I go when I need care?  

Be prepared. Learn your options before you find yourself in need of medical care, You may not know when you’ll need care but you’ll know where to go when the need arises. Find out more about the different resources available. 

Learn more:

• Price tag of care
  
• Where to go when an emergency isn't an emergency

How should I go about finding a doctor?  

Don’t wait until you are sick to find a personal doctor. You’ll want the practice best suited to you and your family’s needs.  Get started with some expert advice. 

• Comparison shopping
• Compare health care costs with Provider Finder
• Finding a doctor that is a good fit  

What is Blue Cross Blue Shield of Texas doing to make their web services available for the disabled?

We build and test our webpages and apps so they work with assistive tools used by the disabled.   We follow the standards set by the global Web Content Accessibility Guidelines 2.1 (WCAG 2.1).  We also meet US law, Section 508 Accessibility Standards.   

What help do you give if I cannot read or understand your website? 

To get language or communication help (hearing or sight) free of charge, please call us at 1-855-710-6984. 

Please got to Our Accessibility Statement Page for more information on our accessibility efforts.