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Prices for high-quality medical services can differ by thousands of dollars in the same area or network. That's why you have Member Rewards, a program that lowers your out-of-pocket costs and gives you cash rewards when you choose a lower-cost, quality option for certain medical services.
When you compare costs and shop for quality providers or facilities with Member Rewards, you’ll save money on coinsurance and get cash rewards 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.
Log in to Provider Finder and click on the Member Rewards tile to search for a reward-eligible provider or location for a service or procedure.
Once you make a selection, schedule an appointment and get the procedure or service.
You save on coinsurance by choosing a lower-cost, quality option. Then 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.
For example, Provider A charges $620 for an MRI of the lower spine and Provider B charges $1,389. If you’ve already met your deductible, you’ll pay 20% of the cost of your in-network MRI, and the plan will pay the rest.
Reward-eligible Procedure |
Cost |
You Pay 20% |
Provider A |
$620 |
$124 |
Provider B |
$1,389 |
$278 |
You save $154 by using Provider A! On top of savings, you also earn a cash reward!
A Personal Health Guide can help you find a reward-eligible provider or answer questions about Member Rewards. Call a PHG at 1-866-355-5999.
Below are a few frequently asked questions about Member Rewards. A Personal Health Guide is also available to help you at 1-866-355-5999.
Don't see an answer to your question?
The reward is based on the amount of savings each facility represents. It’s compared to other facilities in the zip code and the area where 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.
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.
Once you’ve had your procedure at a reward-eligible location, you don’t need to do anything. Member Rewards will match your paid claim to your search and send a check with your reward amount to the address on your account. Typically, members get their payments within 60 days from the date of service.
Yes, but you must shop for this service before each procedure. You can earn up to $599 per person, per year. You can either shop through Provider Finder online or contact a Personal Health Guide at 1-866-355-5999.
You can call a Personal Health Guide at 1-866-355-5999 to verify if a claim was paid for a reward-eligible procedure.
Yes. Member Rewards releases uncashed reward checks to the State of Texas after 12 months.
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.