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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 TRS-ActiveCare participants have Member Rewards, a program that rewards them for choosing a cost-effective, trusted provider for services like MRIs, CT scans, colonoscopies, and mammograms.
See how easy it is to compare, schedule and earn.
*If they have a PCP in the Kelsey Seybold group, they're not eligible for this program.
To get started:
Participants can use Provider Finder® to find a rewards-eligible location for a service or procedure, like an ultrasound or MRI. They can also connect with a Personal Health Guide by calling 1-866-355-5999 or chatting through the BCBSTX App.
Participants will need a referral from their PCP for the rewards-eligible location.* Then, they can schedule the procedure or service, or have a PHG schedule the appointment for them.
*TRS-ActiveCare Primary and TRS-ActiveCare Primary+ only. TRS-ActiveCare 2 participants don't need a PCP referral.
The reward will be deposited into the participant's Health Care Account (HCA) once they’ve completed their treatment, their claim is paid, and the location is verified.* They can use their rewards for future medical expenses, like copays. See the full list below under the HCA FAQs.
*BCBSTX has set up an HCA for all TRS-ActiveCare participants eligible for Member Rewards. This HCA is separate from the district’s Flexible Spending Account or your Health Savings Account.
To get started:
Participants can use Provider Finder to find a rewards-eligible location for a service or procedure, like an ultrasound or MRI. They can also connect with a PHG by calling 1-866-355-5999 or chatting through the BCBSTX App.
They'll schedule the procedure or service at the rewards-eligible location they choose or have a PHG schedule the appointment for them. They don't need a referral from their PCP.
Participants can use their reward for dental or vision services. Once they incur dental and vision expenses, they'll fill out and submit the HCA limited purposes reimbursement form.*
*BCBSTX has set up an HCA for all TRS-ActiveCare participants eligible for Member Rewards. This HCA is separate from the district’s Flexible Spending Account or your Health Savings Account.
Do you have questions about the HCA? Please review the list of FAQs below. If you don't see an answer to your question, please contact a Personal Health Guide at 1-866-355-5999.
An HCA is a health care spending account linked to Member Rewards. Funds are deposited into an HCA after participants complete a Member Rewards-eligible procedure and BCBSTX pays the claim and verifies its eligibility.
If they have TRS-ActiveCare Primary, TRS-ActiveCare Primary+ or TRS-ActiveCare 2, they can use HCA funds for:
After the medical claim is submitted, BCBSTX determines what it will pay the provider. This process is referred to as claims adjudication.
As part of this process, the Member Rewards’ funds they earn are put into an HCA that will apply toward future coinsurance or copays.
Most services process automatically when your medical claim is processed. However, if you need reimbursement that does not occur automatically, you’ll need to complete the TRS-ActiveCare Member Rewards Expense form.
Claims will be processed within 30 days. Once the claim is processed, the funds will be issued within 45 days.
Please call a PHG at 1-866-355-5999, 24 hours a day, seven days a week, if you have questions or need assistance.
After they pay for their prescription drug at the pharmacy, they'll need to complete the TRS-ActiveCare Member Rewards HCA Expense form and include a copy of the receipt for reimbursement.
If a participants has TRS-ActiveCare HD, they can use HCA funds for:
Once they incur vision and dental services, they'll fill out the Member Rewards HCA limited purposes reimbursement form and include a copy of the original receipt for reimbursement.*
*Please note that TRS-ActiveCare HD has it's own reimbursement form. Make sure you are using the form that says Claim Form for TRS-ActiveCare Member Rewards Limited Purpose Health Care Account (HCA) Expenses at the top.
To check a Member Rewards balance, call a PHG at 1-866-355-5999 available 24/7. They can also log in to their Blue Access for MembersSM account.
MDX Medical, LLC a Zelis company, is an independent company that has contracted with Blue Cross and Blue Shield of Texas to administer the Member Rewards program for members with coverage through BCBSTX. Reward-eligible options and reward amounts are subject to change.Eligibility for rewards is subject to terms and conditions of the Member Rewards program. Amounts received through Member Rewards maybe taxable. BCBSTX does not provide tax advice. Members that have primary coverage with Medicaid or Medicare are not eligible to receive incentive rewards under the Member Rewards program.