Blue Cross Medicare Advantage (PPO)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 (PPO) plan offers health coverage to members who reside in:

Bastrop, Bexar, Burnet, Caldwell, Chambers, Collin, Dallas, Denton, Fayette, Fort Bend, Hardin, Harris, Hays, Jefferson, Lee, Liberty, Montgomery, Tarrant, Travis or Williamson counties.

Effective January 1, 2020, Blue Cross Medicare Advantage (PPO)SM networks are expanding in the following areas:

Atascosa, Bandera, Comal, Cooke, Fannin, Guadalupe, Hill, Johnson, Kendall, Llano, Medina, Navarro, Rockwall, Wilson and Wise counties.

Blue Cross and Blue Shield of Texas (BCBSTX) would like to extend the opportunity to you for participation as a provider in the Blue Cross Medicare Advantage (PPO) plan.

Retiree Group Medicare Plans

Our retiree group Medicare plans are Blue Cross Group Medicare Advantage (PPO)SM, Blue Cross Group Medicare Advantage Open Access (PPO)SM and Blue Cross Group MedicareRx (PDP)SM. BlueStagesSM is a Medicare supplement insurance plan that helps cover some costs beyond what is covered by Original Medicare.

Out-of-network Note: If you see Medicare members or accept Medicare assignment and are willing to bill BCBSTX, you may treat Blue Cross Group Medicare Advantage Open Access (PPO) PDF Document members. Out-of-network providers will be paid the Medicare-allowed amount less any member cost-sharing. In-network providers will be paid at their contracted rate.

BlueStages members also can see providers nationwide who accept Medicare assignment.

Network Participation

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 and new medical groups desiring to apply for network participation or existing medical groups who wish to add additional providers to their current contract, will need to complete the Provider Onboarding Form
  • Providers can select the question mark icon where available if they need assistance with those fields.

Have questions?

Please contact your Network Management office.