Blue cross blue shield of texas prescription coverage

Expansion to reach 4 million eligible Texans

, /PRNewswire/ -- Blue Cross and Blue Shield of Texas (BCBSTX) will now offer health care coverage options for Medicare-eligible individuals in 38 new counties as well as add multiple lower-cost plans in 2023.

This expansion allows BCBSTX to offer Medicare Advantage Prescription Drug (MAPD) plans to nearly 4 million eligible residents in 148 counties – now covering 58 percent of Texas' 254 counties. The 2023 expansion follows 2022's record buildout.

New counties include: Anderson, Aransas, Bowie, Calhoun, Camp, Cass, Cherokee, Delta, DeWitt, Franklin, Grayson, Gregg, Harrison, Hudspeth, Hunt, Jackson, Kaufman, Kleberg, Lamar, Maverick, Morris, Nacogdoches, Panola, Potter, Randall, Red River, Rusk, Shelby, Smith, Starr, Titus, Tom Green, Upshur, Uvalde, Victoria, Wood, Young and Zapata.

"We're excited to announce Blue Cross and Blue Shield of Texas is expanding access and building on our commitment to quality, cost-effective and equitable health care in the communities we serve, particularly in rural and underserved areas," said James 'Jim' Springfield, BCBSTX president. "Year over year, the growth of Medicare Advantage brings more choices and coverage so we can meet diverse health needs across Texas."

The expansion is not just geographic. For 2023, BCBSTX is offering new products and services to best serve the specific needs and lifestyles of the growing Medicare population in Texas.

Many BCBSTX Medicare Advantage (MA) plans provide additional benefits beyond traditional Medicare, including dental, vision and prescription drug coverage at a variety of price points, including options with $0 monthly premiums.

New options for 2023 include an Open Access PPO plan, as well as a Medicare Advantage-only PPO plan with a Part B premium reduction benefit designed with U.S. military veterans in mind. For cost-conscious consumers, BCBSTX will offer two HMO plans with a Part B premium reduction benefit, as well as a PPO plan with Part B premium reduction benefit. In addition, there will now be an HMO plan with a $5,000 dental allowance, a PPO plan with $5,000 dental allowance, and a PPO plan with $1,000 pre-loaded Flexible Spend card to use toward covered dental, vision and hearing benefits.

A Dual Eligible Special Needs HMO plan will include a Flexible Spend card. The Flexible Spend card will add additional allowance, in the form of a prefunded Mastercard, that members can use to help supplement out-of-pocket costs on their nonmedical-covered dental, vision and hearing benefits.

To support the MAPD county expansion, BCBSTX is adding more than 31,000 providers to its network to help members have access to specialized care when and where they want and need it.

The Medicare Advantage and Prescription Drug Plan Annual Election Period starts Oct. 15 and ends Dec. 7, 2022. BCBSTX is hosting multiple in-person and virtual opportunities in the Houston and Dallas regions with enrollment specialists available in English and Spanish to answer questions and simplify the enrollment process. Texans who don't live in those areas can get more information about online seminars by visiting bcbstx.com/medicare.

About Blue Cross and Blue Shield of Texas

Blue Cross and Blue Shield of Texas (BCBSTX) – the only statewide, customer-owned health insurer in Texas – is the largest provider of health benefits in the state, working with nearly 80,000 physicians and health care practitioners, and 500 hospitals to serve more than 6 million members in all 254 counties. BCBSTX is a Division of Health Care Service Corporation (HCSC) (which operates Blue Cross and Blue Shield plans in Texas, Illinois, Montana, Oklahoma and New Mexico), the country's largest customer-owned health insurer. Health Care Service Corporation is a Mutual Legal Reserve Company and an Independent Licensee of the Blue Cross and Blue Shield Association.

BCBSTX.com | Twitter.com/BCBSTX | Facebook.com/BlueCrossBlueShieldOfTexas | YouTube.com/BCBSTX

Medicare Advantage plans provided by Blue Cross and Blue Shield of Texas, which refers to HCSC Insurance Services Company (HISC) (HMO, PPO and HMO Special Needs Plans), and also to GHS Insurance Company (GHSIC) (HMO and PPO plans). HMO and PPO employer/union group plans provided by Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC). HCSC, HISC and GHSIC are Independent Licensees of the Blue Cross and Blue Shield Association. HCSC, HISC, and GHSIC are Medicare Advantage organizations with a Medicare contract. GHSIC is a Medicare Advantage organization with a Medicare contract and a contract with the Texas Medicaid program. Enrollment in these plans depends on contract renewal.

SOURCE Blue Cross and Blue Shield of Texas

Blue cross blue shield of texas prescription coverage

Does BCBS Texas cover prescriptions?

Pharmacy benefits for the Texas STAR program are determined by Medicaid/CHIP Vendor Drug Program (VDP) and are administered by Blue Cross and Blue Shield of Texas (BCBSTX). This includes coverage for selected prescription and over-the-counter (OTC) drugs, and selected medical supplies.

Which pharmacy does BCBS Texas use?

Blue Cross and Blue Shield of Texas (BCBSTX) utilizes Prime Therapeutics LLC as our pharmacy benefit manager to administer certain core services in our pharmacy program that will help contain rising drug costs and maintain and improve the quality of care delivered to members.

What mail order pharmacy does Blue Cross and Blue Shield of Texas use?

Express Scripts® Pharmacy is a pharmacy that is contracted to provide mail pharmacy services to members of Texas. The relationship between Express Scripts® Pharmacy and Blue Cross and Blue Shield of Texas is that of independent contractors.

Are all prescription drugs covered by insurance?

Many health insurance plans will cover a portion of the cost for most prescription medications, but there are some that may not be covered.