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Did you know that prices for the same quality medical services can differ by thousands of dollars within the same region and health plan network?
That's why you have Member Rewards, a program that rewards you for choosing a cost-effective, trusted provider for services like MRIs, CT scans, colonoscopies and mammograms.
When you compare costs and shop for quality providers or facilities with Member Rewards, you’ll save money on coinsurance and get rewarded for many procedures such as screenings, scans, surgeries and more. This growing list of reward-eligible services includes:
*One reward per calendar year is given for seeing a PCP.
**Members can receive one reward for seeing a quality specialist and two rewards for going to a quality specialist at a cost-effective, reward-eligible facility per calendar year.
This isn’t a comprehensive list of reward-eligible services. If you have questions, log in to your Blue Access for MembersSM account or call a Personal Health Guide at 1-866-355-5999.
Providers who are highly rated for quality, cost-efficient care and appropriate treatment plans have a Top Performing Physician badge in Provider Finder. Below you can see how much you’re rewarded per specialty service. This growing list of reward-eligible specialties includes1:
PCP | Surgical | Medical |
Family Medicine: $25 | Cardiothoracic Surgery: $150 | Cardiology: $50 |
Internal Medicine: $25 | Ophthalmology: $50 | Gastroenterology: $50 |
Pediatrics: $25 | Orthopedic Surgery: $150 | OB/GYN: $25 |
| Urology: $50 |
|
1. Reward-eligible specialties are subject to change.
If you have TRS-ActiveCare Primary, TRS-ActiveCare Primary x Arlington ISD, TRS-ActiveCare Primary x Region 4, TRS-ActiveCare Primary+ or TRS-ActiveCare 2, you get a cash reward by check, which we’ll mail to your home after we pay your claim and verify the provider as reward eligible.
If you have TRS-ActiveCare HD, you get a cash reward by check, mailed to your home after we pay the claim, verify the provider as reward-eligible and your deductible is met before the procedure or service. You don’t need to meet your deductible to get a reward for preventive care, but you must meet it to earn a reward for non‑preventive care.
In-network facilities can charge different amounts for the same procedures. For example, Provider A may charge $29 for an X-Ray of the Chest and Provider B may charge $102 for an X-Ray of the Chest.
Going to a cost-effective facility, like Provider A, saves your health plan money and helps lower the cost of health care in your area. So, through Member Rewards, your health plan passes some of the savings to you.
The reward is based on the amount of savings each facility offers. It’s compared to other facilities in the zip code and area you’re searching. Higher savings = higher rewards.
For example, you can earn up to $500 in rewards for a CT Scan of the Abdomen and up to $150 in rewards for a mammogram. Rewards vary by procedure, location and facility. Once you begin your search for a procedure in Provider Finder, you’ll see the amounts listed. You can earn up to $599 total per year.
You can shop for a procedure anytime. In some cases, you get an order from a doctor to have a same-day procedure like an MRI. As long as you shop and identify the location as reward eligible before getting the procedure, you can earn a reward.
A physician who is highly rated for quality, cost-efficient care and appropriate treatment plans. They’re identified in Provider Finder with a green badge that says Top Performing Physician.
Don't see an answer to your question?
A Personal Health Guide can also help you find a reward-eligible provider or answer questions about Member Rewards. Call a PHG at 1-866-355-5999 or chat in the BCBSTX App.
*If your PCP is in the Kelsey Seybold group, you're not eligible for this program.
Top performing providers are identified using an evidence-based data and analytics program that measures physician performance based on their efficiency, appropriateness and quality compared to their peers.
You can use the “Top Performing Physician” badge to help when you choose your provider. Please consider all relevant information and consult with your Primary Care Provider when selecting a specialist.
BCBSTX makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.