Blue Cross Medicare Advantage (HMO)SM and Blue Cross Medicare Advantage Dual Care (HMO SNP)SM
Blue Cross Medicare Advantage plans offer all the same coverage as Original Medicare — plus benefits not covered by Medicare or most Medicare Supplement insurance plans, including built-in prescription drug coverage and extra health and wellness options. Blue Cross and Blue Shield of Texas (BCBSTX) offers both individual and group Medicare Advantage plans.
- The Blue Cross Medicare Advantage HMO plans offer health coverage to members who reside in Atascosa, Bandera, Bastrop, Bexar, Burnet, Caldwell, Cameron, Chambers, Comal, El Paso, Fort Bend, Hardin, Harris, Hays, Hidalgo, Jefferson, Kendall, Lee, Liberty, Medina, Montgomery, Orange, Webb, Willacy, Wilson or Williamson counties. BCBSTX would like to extend the opportunity to you for participation as a provider in the Blue Cross Medicare Advantage (HMO) plan.
- Effective January 1, 2020, Blue Cross Medicare Advantage (HMO)SM networks are expanding in the following areas:
Collin, Dallas, Denton, Tarrant and Travis counties
- The Blue Cross Medicare Advantage HMO SNP plans offer health coverage to members who reside in Bastrop, Burnet, Caldwell, Hays, Lee and Williamson counties.
- Effective January 1, 2020, Blue Cross Medicare Advantage (HMO SNP)SM networks are expanding in the following areas:
Atascosa, Bandera, Bastrop, Bexar, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell, Collin, Colorado, Comal, Coryell, Dallas, Denton, Falls, Fayette, Gonzales, Grimes, Guadalupe, Hays, Hill, Kendall, Lampasas, Lavaca, Lee, Leon, Limestone, Llano, Madison, Medina, Milam, Mills, Navarro, Robertson, Rockwall, San Saba, Somervell, Tarrant, Travis, Williamson and Wilson counties.
- Our retiree group Medicare plans include Blue Cross Group Medicare Advantage (HMO)SM. This plan provides group Medicare members access to providers within a defined network, with no out-of-network benefit.
BCBSTX believes that our long-standing history in providing affordable health care coverage to the people of Texas, our strong brand recognition, and our historical relationship with Medicare makes BCBSTX an excellent choice for Medicare-eligible individuals. We maintain and monitor a network of participating providers including physicians, hospitals, skilled nursing facilities, ancillary providers, and other health care providers through which members obtain covered services.
- New individual providers, new medical groups desiring to apply for network participation and existing medical groups who wish to add additional providers to their current contract, will need to complete the Provider Onboarding Form
- Please refer to the Provider Onboarding Form User Guide for tips on completing the Provider Onboarding form.
If you have any questions regarding this plan, please feel free to contact your Network Management office.
Participating physicians and professional providers must submit claims to Blue Cross Medicare Advantage HMO and DSNP within 180 days of the date of service, using the standard claim form or electronically. Services billed beyond 180 days from date of service are not eligible for reimbursement. Blue Cross Medicare Advantage HMO and DSNP participating physicians and professional providers may not seek payment from the member for claims submitted after the 180-day filing deadline.
To join our Blue Cross Medicare Advantage network, follow the Provider Onboarding Process:
All providers who contract with BCBSTX to provide Medicare Advantage services are expected to abide by the Centers for Medicare & Medicaid Services (CMS) rules for marketing when it involves BCBSTX or Blue Cross Medicare Advantage products or benefits.
- Blue EssentialsSM, Blue Advantage HMOSM, Blue PremierSM and MyBlue HealthSM Provider Manual
- Blue Cross Medicare Advantage HMO and DSNP Supplement
- Blue Cross Medicare Advantage HMO and DSNP Orientation
- Blue Cross Medicare Advantage HMO and DSNP Member ID Card Sample
- Medicare Advantage Waiver of Liability
- Blue Cross Medicare Advantage Dual Care (HMO SNP) Model of Care training