The Blue Advantage HMO product offers a wide range of benefits without financial surprises. Members will have a predictable copayment, no deductible, and no claims or other paperwork to file. Plans offered include varying copay options, including a differing office visit copay when services are received from a PCP or specialist.
Blue Advantage HMO:
- provides benefits only when services are received from providers in the Blue Advantage HMO network and when prescribed, directed, or authorized by the member's Primary Care Physician (PCP) or the HMO.
- requires the member to choose a PCP from the Blue Advantage HMO network of contracting doctors. This doctor coordinates the member's care and helps the member make informed decisions, including 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.
The HMO 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.
Blue Advantage HMO is available to your clients in all 254 Texas counties and the network includes more than 400 hospitals and 55,000 providers statewide.
By choosing Blue Advantage HMO, clients choose more than just a health plan. They're choosing health coverage provided by Blue Cross and 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, visit the Contact Us page for the phone number of the regional sales office near you.