UT CARETM Medicare PPO (UT CARE)
We are proud to insure The University of Texas System (UTS) retiree plan UT CareTM Medicare PPO (UT CARE) as of Jan, 1, 2023. Approximately 30,000 retirees age 65+ and their Medicare-eligible dependents of UTS become members utilizing UT CARE in all 254 counties in Texas and nationwide leveraging open access to care.
UT CARE is an open access Medicare Advantage PPO plan that may be referenced as Blue Cross Group Medicare Advantage Open Access PPOSM or UT Care Medicare PPO.
The open access allows patients to receive treatment from both:
- Providers contracted in the Blue Cross Group Medicare Advantage Open Access (PPO) plan or
- Providers who are not contracted with BCBSTX; however, they accept Medicare
Open Access Reminders
- Plan members may see any provider in the U.S. who accepts Medicare assignment.
- Providers submit claims to BCBSTX, regardless of the provider’s contract or network status with BCBSTX.
- The provider doesn’t need to participate in BCBSTX Medicare Advantage networks or in any other BCBSTX networks.
- PCP selection or referrals are not required.
- Prior authorization may be required for certain services from BCBSTX Medicare Advantage-contracted providers. Learn more
- Non-participating providers aren’t required to follow utilization management guidelines. However, they may request a review to confirm medical necessity.
- Approximately 6,000 participants living outside of Texas have access to BlueCard which enables our members to obtain health care services while traveling or living in another Blue Cross and/or Blue Shield Plan’s service area.
How to Identify UT Care Members
- The Plan name Blue Cross Group Medicare Advantage Open Access along with the Network Plan# 80840 will be on ID Card.
- Providers with eligibility, benefit or claims questions use Availity or call 1-877-842-7562.
Behavioral Health Care Management Program
BCBSTX manages mental health benefits and services for UT Care MEDICARE PPO. Learn more
Outpatient Clinical Laboratory Information
All Plan providers should refer members to in-network lab providers for outpatient lab services. To locate participating labs in the Plan network, visit Statewide In-Network Clinical Labs for UT Care Members include:
- Clinical Pathology Laboratory (CPL) — For locations or questions, contact CPL at 1-800-595-1275 or visit CPL's website.
- LabCorp — For locations or questions contact LabCorp at 1-888-LAB-CORP or visit LabCorp's website.
- Quest Diagnostics, Inc — For locations or questions contact Quest at 1-888-277-8772 or visit Quest's website.
Refer to Provider Finder® for additional participating clinical laboratories and other providers.
Healthy Living encouraging your patients to take charge and maximize their health. Learn more
COVID-19 Information Learn more
Verification of eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility, any claims received during the interim period and the terms of the member’s certificate of coverage applicable on the date services were rendered.
Availity is a trademark of Availity, L.L.C., a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX.
PPO plans provided by Blue Cross and Blue Shield of Texas, which refers to HCSC Insurance Services Company (HISC) and GHS Insurance Company (GHSIC). PPO employer/union group plans provided by Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC). HCSC, HISC, and GHSIC are Independent Licensees of the Blue Cross and Blue Shield Association. HCSC, HISC, and GHSIC are Medicare Advantage organizations with a Medicare contract. Enrollment in these plans depends on contract renewal.