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 offers both individual and group Medicare Advantage plans.

Blue Cross Medicare Advantage (PPO) Service Areas

Anderson, Andrews, Aransas, Archer, Armstrong, Austin, Bailey, Baylor, Bee, Bell, Bexar, Blanco, Borden, Bosque, Bowie, Brazoria, Brazos, Brewster, Briscoe, Brooks, Burleson, Calhoun, Cameron, Camp, Carson, Cass, Castro, Cherokee, Clay, Cochran, Coke, Coleman, Collin, Concho, Coryell, Crane, Crosby, Culberson, Dallam, Dallas, Dawson, Deaf Smith, Delta, Denton, DeWitt, Dickens, Dimmit, Donley, Duval, Ector, Edwards, El Paso, Ellis, Erath, Falls, Fisher, Floyd, Foard, Fort Bend, Franklin, Freestone, Frio, Gaines, Galveston, Garza, Gillespie, Glasscock, Goliad, Grayson, Gregg, Grimes, Hale, Hall, Hamilton, Hansford, Hardeman, Harris, Harrison, Hartley, Haskell, Henderson, Hidalgo, Hockley, Hopkins, Houston, Howard, Hudspeth, Hunt, Hutchinson, Irion, Jack, Jackson, Jeff Davis, Jefferson, Jim Hogg, Jim Wells, Karnes, Kaufman, Kenedy, Kent, Kimble, King, Kinney, Kleberg, Knox, La Salle, Lamar, Lamb, Lavaca, Leon, Liberty, Limestone, Live Oak, Loving, Lubbock, Lynn, Madison, Marion, Martin, Mason, Maverick, McCulloch, McLennan, Menard, Midland, Mills, Mitchell, Montague, Montgomery, Moore, Morris, Motley, Nacogdoches, Nueces, Oldham, Orange, Palo Pinto, Panola, Parker, Pecos, Polk, Potter, Presidio, Rains, Randall, Reagan, Red River, Reeves, Refugio, Roberts, Robertson, Runnels, Rusk, San Augustine, San Jacinto, San Patricio, San Saba, Schleicher, Shackelford, Shelby, Sherman, Smith, Somervell, Starr, Stephens, Sterling, Stonewall, Sutton, Swisher, Tarrant, Terry, Throckmorton, Titus, Tom Green, Travis, Trinity, Tyler, Upshur, Upton, Uvalde, Van Zandt, Victoria, Walker, Waller, Washington, Webb, Wheeler, Willacy, Williamson, Winkler, Wise, Wood, Yoakum, Young, Zapata and Zavala counties.

Additional Blue Cross Medicare Advantage (PPO) Service Areas effective 1/1/2025:

Childress county

Network Participation

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

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.

Retiree Group Medicare Plans

Our retiree group Medicare plans are Blue Cross Group Medicare Advantage (PPO), 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.

UT CARETM Medicare PPO Open Access Retiree Plan

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) 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.

Have questions?

Please contact your Network Management office.

 

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX.

eviCore is a trademark of eviCore healthcare, LLC, formerly known as CareCore, an independent company that provides utilization review for select health care services on behalf of BCBSTX.

BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.