Blue Cross Medicare Advantage (PPO)SM
The Blue Cross Medicare Advantage Plan offers 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.
- 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.
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 seniors seeking new health coverage opportunities.
Blue Cross Medicare Advantage maintains and monitors 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
- 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 physician, professional provider, facility or ancillary providers must submit claims to Blue Cross Medicare Advantage (PPO) within 90 days of the date of service, using the standard claim form or electronically. Services billed beyond 90 days from date of service are not eligible for reimbursement. Blue Cross Medicare Advantage (PPO) participating physician, professional provider, facility or ancillary providers may not seek payment from the member for claims submitted after the 90-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.