Premium Paid-To-Date Now Included in BCBSTX Eligibility Response for Policies On and Off the Health Insurance Marketplace

September 20, 2016

Blue Cross and Blue Shield of Texas (BCBSTX) providers can now view the premium paid-to-date status for Individual members on and off the Health Insurance Marketplace when checking eligibility and benefits through their preferred online web vendor or clearinghouse.

The paid-to-date is the last coverage date for the member based on their premium payments. BCBSTX previously returned the paid-to-date for Advanced Premium Tax Credit (APTC) subsidized members once they reached the second month of their grace period. However, the paid-to-date is now returned on all active Healthcare Marketplace policies, regardless of grace period involvement.

For additional information regarding checking eligibility and benefits online, please visit the Claims and Eligibility section or email a Provider Education Consultant.

Checking 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.