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7 Tips to Help Guide You Through the Special Enrollment Period

Selecting a health insurance plan that meets you or your family’s needs can be challenging under normal circumstances but trying to navigate options during a pandemic can compound that anxiety.

Blue Cross and Blue Shield of Texas (BCBSTX) is offering help in selecting a health plan during the federal marketplace’s Special Enrollment Period (SEP) that runs until May 15, 2021. President Joe Biden issued an Executive Order opening a SEP in response to the COVID-19 Public Health Emergency. No proof of a qualifying life event is required to buy a health plan during this new SEP.

BCBSTX has multiple plans that provide access to quality, cost-effective healthcare to the uninsured and families statewide. In Dallas and Harris counties, BCBSTX is offering plans where nearly half of the on-exchange population may qualify for a $0 monthly payment on a Bronze plan after subsidies are applied. Subsidies helped 92% of Texans lower their monthly bill in 2020 for plans purchased on the exchange.

Here are seven tips to help guide you through the process of selecting a health plan:

1. Know the SEP enrollment deadline:  Enrollment ends May 15, 2021.

2. Take time to review your options:  Explore and understand the benefits and costs of each plan so you can find the coverage that works best for you and your family members. Check if your current coverage still meets your needs, if your benefits will change and if the plan fits your budget. Also, understand other out-of-pocket costs, including deductibles, copays and coinsurance. Make sure your medications are covered. Even if you don’t expect to change plans, it’s important to ensure your prescription drugs will remain covered.

3. Is your doctor in your plan’s care provider network:  Even if you don’t make any changes to your health insurance, make sure the provider who cares for you regularly or who you plan to visit, is in your benefit plan’s provider network. This is important, because if you visit an out-of-network doctor or hospital rather ones that are in-network, your costs will most likely be higher.

4. Find a primary care physician:  Primary care physicians (PCP) are key to optimal health. So, after selecting a health plan, make sure to identify a PCP to help navigate your health. BCBSTX is collaborating with the Sanitas Medical Centers in the Houston and Dallas regions in the MyBlue Health HMO network, which allows members to enjoy a $0 copay for primary care in-person and primary care telehealth appointments with their Sanitas primary care physician.

5. Telehealth is here to stay:  With the COVID-19 pandemic still active, check if your plan includes 24/7 telehealth services.

6. Don’t forget about additional benefits:  Check for additional benefits such as dental, vision, accident or critical-illness insurance. There are often affordable options that can protect you and your family. Also, look for programs that reward you for making healthy choices and for being more engaged in improving your health. Some plans even offer discounts on gym memberships and provide financial incentives for completing health assessments, signing up for health coaching programs, lowering your cholesterol, losing weight, meeting walking goals, or stopping smoking.

7. Finally, get help:  Selecting a health insurance plan is not easy. To help, BCBSTX will be holding virtual educational seminars throughout the SEP with Think Blue representatives providing help in English and Spanish so Texans can know what health plans are right for them and their families. Schedule a virtual one-on-one appointment, or register for a virtual educational seminar.

Phone help is offered at 866-427-7497:

  • Monday – Friday: 8 a.m. – 8 p.m. CT
  • Saturday: 8 a.m. – 6 p.m. CT
  • Sunday: 10 a.m. – 2 p.m. CT

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association