Be Prepared for 2021
Log in to your secure member and learn how it works.
Stay informed and use these tools for cost-effective options.
Wherever you are, get the care that works for you.
Know Your Health Plan
HMOHealth Maintenance Organization
HMO PlusPoint of Service
Primary Care Provider (PCP)
You’ll need to select a PCP for your care. This is the one doctor who arranges your care and refers you to specialists.
Some services may require prior authorization (pre-approval.)1 Ask your doctor about this so you’re sure who handles this step.
You’ll need to see a health care provider in your plan’s network. If you don’t, you’ll pay for most of or the full cost of your care.
Preventive Care Services
Some screenings, like your Annual Exam, are included with your health plan at no additional cost.
Primary Care Provider (PCP)
You may need to select a PCP. This is your main doctor who sets up your care and refers you to specialists.
You don’t need referrals to see specialists, but you may need prior authorization (pre-approval).1 Check with your doctor on this step before getting care.
You can go to the health care provider of your choice. Remember, you’ll pay less on health care costs when getting care in your plan’s network.
Preventive Care Services
Your health plan lets you get screenings and services, like your Annual Exam, for no additional out-of-pocket costs.
Make Your Care Personal
Get Annual Preventive Care
Keep your health information up-to-date each year with screens for:
- Heart disease
- Body Mass Index (BMI)
Some screenings, like your Annual Exam, may be offered at no cost to you if you stay in-network.
Other preventive services that may have no out-of-pocket costs are:
- Immunizations and vaccines
- Weight loss programs
- Ways to stop smoking
- Maternity and well-child visits
Remember it's important to talk with your doctor about your lifestyle and any life changes.
Caring for Your Well-Being
Seeking Emotional Care
Understand Your Pharmacy Benefit
See Covered Drugs
Ways to Save
Other Pharmacy Tips
For some drugs, you may need to meet certain criteria before coverage can be approved.
Review your prescription plan materials.
Enjoy Member Discounts
More Resources and Contacts
1 Prior Authorization not required in certain circumstances, such as emergency or urgent situations.
2 The 24/7 Bilingual Nurseline may not be available with all plans. Check your benefits booklet for details.
3 Internet/Wi-Fi connection is needed for computer access. Data charges may apply. Check your cellular data or internet service provider’s plan for details. Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only), along with the ability to prescribe. Non-emergency medical service in Arkansas is limited to interactive audio/video (video only) for initial consultation, along with the ability to prescribe. Behavioral Health service is limited to interactive audio/video (video only), along with the ability to prescribe in all states. Service availability depends on location at the time of consultation.
Virtual Visits, Powered by MDLIVE may not be available on all plans. Virtual Visits are subject to the terms and conditions of your benefit plan, including benefits, limitations, and exclusions. MDLIVE operates subject to state regulations and may not be available in certain states. MDLIVE is not an insurance product nor a prescription fulfillment warehouse. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services.
MDLIVE operates and administers the virtual visit program and is solely responsible for its operations and that of its contracted providers. MDLIVE and the MDLIVE logo are registered trademarks of MDLIVE, Inc. and may not be used without written permission.
Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.
4 Visiting a Retail Clinic may not be covered with all plans. Check your benefits booklet for details.
5 Blue365 is only available to Blue Cross and Blue Shield of Texas (BCBSTX) members with active health plan coverage. Members who do not have an active health plan with BCBSTX will not be able to register on the Blue365 website.
The relationship between Blue365, its vendors and BCBSTX is that of independent contractors. Blue365 is a discount program available to BCBSTX members who have medical coverage with BCBSTX. This is NOT insurance. Some of the services offered through Blue365 may be covered under your health plan. Please refer to your benefit booklet or call the customer service number on the back of your ID card for specific benefit information under your health plan. Use of Blue365 does not affect your premium nor do costs of Blue365 services or products count toward your plan deductible, calendar year or lifetime maximums. Discounts are only available through participating vendors.
BCBSTX does not guarantee or make any claims or recommendations regarding the services or products offered by Blue365 and its vendors. You may want to consult with your physician prior to use of these services and products. Services and products are subject to availability by location. BCBSTX reserves the right to discontinue or change this discount program at any time without notice.