blue cross blue shield texas cost estimator

Blue cross blue shield texas cost estimator

The cost estimate is provided to help you plan and prepare for an upcoming hospital service or procedure. It is not a guarantee of what you will owe.

After entering your information into the cost estimate tool, you will receive an estimate for the costs you will be financially responsible for after receiving hospital services. The estimate you receive is not a guarantee of the final dollar amount you will be financially responsible for after receiving services.

Your actual hospital out-of-pocket costs (what you owe after insurance or other coverage) may be higher or lower than the estimate provided as many factors impact the total amount due. These factors could include:

Your insurance and other coverage limits (deductibles, coinsurance, copayment, etc.)
Your specific health condition
Changes from initial request for service/procedure
Time spent in surgery and recovery
Your length of stay
Specific equipment, supplies, drugs, and/or implants used for your care
Unexpected additional tests, procedures or issues identified by the physician/surgeon during your care, or changes to procedures you receive.

The estimate is for the hospital bill only and does not include any physicians, other health care providers or other professional fees or charges including but not limited to:

Blue Cross and Blue Shield of Texas

Apply Now

BCBSTX 2022 Plan Guide

Learn More

Blue Cross Blue Shield of Texas

Apply Now

Download BCBSTX Medicare Supplement Application

Apply Online

BCBSTX 2021 Plans

Blue Cross and Blue Shield of Texas is the largest health insurance company in the state with over 5 million members in all 254 Texas counties. BCBSTX offers health plans that can be customized for individuals, children, and families that include consumer-directed plans, Health Savings Accounts, and Medicare Supplements. BCBSTX no longer offers PPOs on the individual market; however, Advantage Plus plans offer the added option of using providers other than Blue Advantage network providers, while still having some of the costs covered.

Gold Plans
Silver Plans
Bronze Plans
Multi-State Plans
HSA Plans

BCBSTX Gold Plans

All Blue Advantage Gold HMO Plans offer the same set of essential health benefits, quality and amount of care as the Blue Advantage Silver and Gold HMO Plans. The Blue Advantage Gold HMO Plans are the most expensive plans, but also have the most comprehensive benefits. Gold Plans have a higher monthly premium and often lower out-of-pocket costs than Silver and Bronze plans. Blue Advantage Gold HMO Plans may be right for you if you are an individual or family who:

Are willing to have a primary care physician (PCP) coordinate your care
Prefers fixed doctor visit copayments
Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
Requires regular prescription medication

There are deductibles for this plan, and this is an HMO plan. You must select a Blue Advantage HMO Primary Care Physician (PCP) when enrolling in this plan.

GoldBlue Advantage Plus GoldBlue Advantage Plus Gold HMO203306Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. $750$0CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max30%0%Out-of-Pocket MaximumAn out-of-pocket maximum is the most you’ll have to pay during a policy period (usually a year) for health care services (includes deductible)2$7,900$7,900Primary Care Office Visit$15$20Specialist Office Visit$15$50Mental Illness Treatment and Substance Abuse Rehabilitation Office Visit $15 $20Emergency Room$950 per occurrence deductible, then 30%$750Urgent Care$50 (Deductible does not apply)$50Inpatient Hospital Services$850 per occurrence deductible, then 50%$850 per occurrence deductible, then 40%Outpatient Surgery4$600 per occurrence deductible, then 50%$600 per occurrence deductible, then 40%Outpatient X-Rays and Diagnostic Imaging450%40%Outpatient Imaging (CT/PET Scans/MRIs)450%40%NetworkBlue Advantage HMOBlue Advantage Plus HMOHSA Eligible5NoYesOutpatient Prescription Drugs – Preferred Pharmacy 6 7$0/$10$50/$70/$150Outpatient Prescription Drugs – Non-Preferred Pharmacy 6,7$10/$20/$30$10/$20/$30Prescription Drug Utilization Benefit Management Programs8Specialty Pharmacy Program: To be eligible for maximum benefits, specialty medications must be obtained through the preferred Specialty Pharmacy provider. Member Pay the Difference: When choosing a brand name drug over an available generic equivalent, you pay your usual share plus the difference in cost. Prior Authorization/Step Therapy Requirements: Before receiving coverage for some medications, your doctor will need to receive authorization from BCBSTX and you may first need to meet certain criteria or try more cost-effective drugs. Mail-Order Program: You may receive a 90-day supply for prescription drugs through the mail-order program or at select retail pharmacies depending on your prescription drug benefit.

Depending on your plan, benefits are either reduced or not available when non-participating providers are used. This is a summary of benefit highlights only. All benefits shown indicate member responsibility.
The standard deductible and out-of-pocket maximum for this plan are shown. You must pay all the costs up to the deductible amount before this plan begins to pay for covered services you use. Note that copays apply whether or not you have met the deductible.
All percentages shown are of the allowable amount for covered services.
Members may have lower out-of-pocket costs for some services provided by non-emergency freestanding outpatient facilities than the out-of-pocket costs for services provided in a hospital setting. See your Summary of Benefits and Coverage for additional details.
As a reminder, a Health Savings Account (HSA) has tax and legal ramifications. Blue Cross and Blue Shield of Texas does not provide legal or tax advice and nothing herein should be construed as legal or tax advice. These materials, and any tax-related statements in them, are not intended or written to be used, and cannot be used or relied on for the purpose of avoiding tax penalties. Tax-related statements, if any, may have been written in connection with the promotion or marketing of the transaction(s) or matter(s) addressed by these materials. You should seek advice based on your particular circumstances from an independent tax adviser regarding tax consequences of specific health insurance plans or products.
Prescription benefit coverage starts after annual medical deductible has been met, not counting copays.
Six prescription drug payment level tiers: Preferred Generics / Non-Preferred Generics / Preferred Brand / Non-Preferred Brand / Preferred Specialty / Non-Preferred Specialty.
Mail order is not available for Preferred and Non-Preferred Specialty tier drugs. These tiers are limited to a 30-day supply. Coverage limitations may apply to certain medications.

Blue Cross Silver Plans

BCBSTX Silver plans offer a higher level of coverage than Bronze plans, and those who purchase on-exchange may also be eligible for cost-sharing reductions based on income, lowering deductibles and co-pays. Silver plans are ideal for people who have regular medications or utilize specialist or doctors visits more often than their included yearly check-up. Silver plans are a good “middle of the road” option for people who might need to utilize their healthcare options more but may not be able to afford higher premium payments.

Blue Advantage Silver HMOBlue Advantage Silver HMOBlue Advantage Silver HMOBlue Advantage Plus SilverPlan Number202306107102 – Three $0 PCP VisitsDeductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. 2$1,000$2,000$1,900$3,250CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max30%-50%30%-50%35%-40%20%Out-of-Pocket MaximumAn out-of-pocket maximum is the most you’ll have to pay during a policy period (usually a year) for health care services (includes deductible)2$7,900$7,900$7,900$6,850Primary Care Office Visit$1025%$25 First two visits, then 50%First three visits $0, then 20%Specialist Office Visit50%100% after deductible50%20%Mental Illness Treatment and Substance Abuse Rehab Office Visit50%50%$30$0Emergency Room$950 per occurence copay, then 50%$950 per occurence copay, then 50%$850 + 50% coinsurance$600 per occurence copay, then 20%Urgent Care$15$50$50$20Inpatient Hospital Services$850 per occurence copay, then 50%$850 per occurrence copay, then 50%$850 per occurrence copay, then 50%$400 per occurence copay, then 40%Outpatient Surgery5$300 per occurence copay, then 30%$600 per occurrence copay, then 40%$600 per occurrence copay, then 40%$300 per occurence copay, then 40%Outpatient X-Rays and Diagnostic Imaging550%40%40%$2,750Outpatient Imaging (CT/PET Scans/MRIs)530%40%-50%20%40%NetworkBlue Advantage HMOBlue Advantage HMOHSA Eligible6NoYesNoNoOutpatient Prescription Drugs – Preferred Pharmacy7 8$5/$10/$15$5/$10/$15$15/$15/$50/$100/40%$0/$10/$50/$100/30%Outpatient Prescription Drugs – Non-Preferred Pharmacy7 8$15/$25/$45$15/$25/$45$15/$15/$50/$100/40%$5/$15/$60/$110/30%

Blue Cross Bronze Plans

BlueCross BlueShield of Texas Bronze plans are ideal for individuals looking for low-cost plans. Bronze plans have higher out of pocket costs, but two plans (the 106 and 104) also have HSA options for those looking for tax savings. These plans are ideal for those who do not have regular medications or visit the doctor outside of their yearly check-up (included as preventative care on all plans.)

Prescription Drug Utilization Benefit Management Programs8Specialty Pharmacy Program: To be eligible for maximum benefits, specialty medications must be obtained through the preferred Specialty Pharmacy provider. Member Pay the Difference: When choosing a brand name drug over an available generic equivalent, you pay your usual share plus the difference in cost. Prior Authorization/Step Therapy Requirements: Before receiving coverage for some medications, your doctor will need to receive authorization from BCBSTX and you may first need to meet certain criteria or try more cost-effective drugs. Mail-Order Program: You may receive a 90-day supply for prescription drugs through the mail-order program or at select retail pharmacies depending on your prescription drug benefit.

Depending on your plan, benefits are either reduced or not available when non-participating providers are used. This is a summary of benefit highlights only. All benefits shown indicate member responsibility.
The standard deductible and out-of-pocket maximum for this plan are shown. You must pay all the costs up to the deductible amount before this plan begins to pay for covered services you use. Note that copays apply whether or not you have met the deductible.
All percentages shown are of the allowable amount for covered services.
Members may have lower out-of-pocket costs for some services provided by non-emergency freestanding outpatient facilities than the out-of-pocket costs for services provided in a hospital setting. See your Summary of Benefits and Coverage for additional details.
As a reminder, a Health Savings Account (HSA) has tax and legal ramifications. Blue Cross and Blue Shield of Texas does not provide legal or tax advice and nothing herein should be construed as legal or tax advice. These materials, and any tax-related statements in them, are not intended or written to be used, and cannot be used or relied on for the purpose of avoiding tax penalties. Tax-related statements, if any, may have been written in connection with the promotion or marketing of the transaction(s) or matter(s) addressed by these materials. You should seek advice based on your particular circumstances from an independent tax adviser regarding tax consequences of specific health insurance plans or products.
Prescription benefit coverage starts after annual medical deductible has been met, not counting copays.
Six prescription drug payment level tiers: Preferred Generics / Non-Preferred Generics / Preferred Brand / Non-Preferred Brand / Preferred Specialty / Non-Preferred Specialty.
Mail order is not available for Preferred and Non-Preferred Specialty tier drugs. These tiers are limited to a 30-day supply. Coverage limitations may apply to certain medications.

Multi-State Plans

The Multi-State Plan (MSP) Program, established under the Affordable Care Act, directs the Federal Office of Personnel Management to contract with private health insurers in each State to offer high-quality, affordable health insurance options called Multi-State Plans. There are no major differences between multi-state plans and other plans, and it does NOT mean these plans provide out of state benefits, just that benefits meet minimum requirements from state to state. Always check the doctor’s networks for each individual plans, and remember that emergency care is covered within the continental US. BCBSTX appears to have discontinued Multi-State plans for 2018.

HSA Plans

Health Savings Accounts can reduce your out of pocket costs as well as your tax burden. BCBSTX offers one of 3 HSA plans in Texas for 2018. Learn more at our HSA Guide.

Blue Cross And Blue Shield Of Texas · Blue Advantage Plus Bronze℠ 201Bronze HMO| Plan ID: 33602TX0770108Deductible$2,850 IndividualOut-of-pocket maximum$6,550Individual TotalCopayments / CoinsuranceEmergency room care: $950 Copay with deductible/40% Coinsurance after deductibleGeneric drugs: 20% Coinsurance after deductiblePrimary doctor: 40% Coinsurance after deductibleSpecialist doctor: 40% Coinsurance after deductibleDOCUMENTSSummary of BenefitsPlan brochureCosts for medical careDeductible$2,850 Individual TotalOut-of-pocket maximum$6,550 Individual TotalPrimary care doctor visitIn Network Tier 1: 40% Coinsurance after deductibleIn Network Tier 2: Not ApplicableOut of Network: 50% Coinsurance after deductibleSpecialist visitIn Network Tier 1: 40% Coinsurance after deductibleIn Network Tier 2: Not ApplicableOut of Network: 50% Coinsurance after deductibleX-rays and diagnostic imagingLimits and exclusions apply: X-rays and diagnostic imagingIn Network Tier 1: 30% Coinsurance after deductibleIn Network Tier 2: Not ApplicableOut of Network: 50% Coinsurance after deductibleLaboratory outpatient and professional servicesLimits and exclusions apply: Laboratory outpatient and professional servicesIn Network Tier 1: 30% Coinsurance after deductibleIn Network Tier 2: Not ApplicableOut of Network: 50% Coinsurance after deductibleOutpatient facilityLimits and exclusions apply: Outpatient facilityIn Network Tier 1: $600 Copay with deductible/30% Coinsurance after deductibleIn Network Tier 2: Not ApplicableOut of Network: $1500 Copay with deductible/50% Coinsurance after deductibleOutpatient professional servicesIn Network Tier 1: $200 Copay with deductible/40% Coinsurance after deductibleIn Network Tier 2: Not ApplicableOut of Network: 50% Coinsurance after deductibleHearing aidsLimits and exclusions apply: Hearing aidsIn Network Tier 1: 40% Coinsurance after deductibleIn Network Tier 2: Not ApplicableOut of Network: 50% Coinsurance after deductibleRoutine eye exam for adultsIn Network: Benefit Not CoveredRoutine eye exam for childrenLimits and exclusions apply: Routine eye exam for childrenIn Network Tier 1: No ChargeIn Network Tier 2: Not ApplicableOut of Network: Benefit Not CoveredEyeglasses for childrenLimits and exclusions apply: Eyeglasses for childrenIn Network Tier 1: No Charge After DeductibleIn Network Tier 2: Not ApplicableOut of Network: Benefit Not CoveredEligible for Health Savings Account (HSA)Yes Prescription drug coverageGeneric drugsLimits and exclusions apply: Generic drugsIn Network Tier 1: 20% Coinsurance after deductibleIn Network Tier 2: 25% Coinsurance after deductibleOut of Network: 50% Coinsurance after deductiblePreferred brand drugsLimits and exclusions apply: Preferred brand drugsIn Network Tier 1: 30% Coinsurance after deductibleIn Network Tier 2: 35% Coinsurance after deductibleOut of Network: 50% Coinsurance after deductibleNon-preferred brand drugsLimits and exclusions apply: Non-preferred brand drugsIn Network Tier 1: 35% Coinsurance after deductibleIn Network Tier 2: 40% Coinsurance after deductibleOut of Network: 50% Coinsurance after deductibleSpecialty drugsLimits and exclusions apply: Specialty drugsIn Network Tier 1: 45% Coinsurance after deductibleIn Network Tier 2: 45% Coinsurance after deductibleOut of Network: 45% Coinsurance after deductibleEmergency room careLimits and exclusions apply: Emergency room careIn Network Tier 1: $950 Copay with deductible/40% Coinsurance after deductibleIn Network Tier 2: Not ApplicableOut of Network: $950 Copay with deductible/40% Coinsurance after deductibleInpatient doctor and surgical servicesIn Network Tier 1: 40% Coinsurance after deductibleIn Network Tier 2: Not ApplicableOut of Network: 50% Coinsurance after deductibleInpatient hospital services (like a hospital stay)Limits and exclusions apply: Inpatient hospital services (like a hospital stay)In Network Tier 1: $850 Copay per Stay with deductible/40% Coinsurance after deductibleIn Network Tier 2: Not ApplicableOut of Network: $1500 Copay per Stay with deductible/50% Coinsurance after deductible

BCBSTX 2018 Plans

2018 Plans Brochure

Gold Plans
Silver Plans
Bronze Plans
Multi-State Plans
HSA Plans

BCBSTX Gold Plans

Are willing to have a primary care physician (PCP) coordinate your care
Prefers fixed doctor visit copayments
Are expecting to have surgery or major services in the near future and want the lowest out of pocket costs
Requires regular prescription medication

There are deductibles for this plan, and this is an HMO plan. You must select a Blue Advantage HMO Primary Care Physician (PCP) when enrolling in this plan.

BronzeBlue Advantage Bronze HMOBlue Advantage Plus Bronze204 – Two $40 PCP Visits201Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. $5,600$2,850CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max50%40%Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services (includes deductible)2$7,350$6,550Primary Care Office VisitFirst 2 PCP visits $40, then 50%40%Specialist Office Visit50%40%Mental Illness Treatment and Substance Abuse Rehabilitation Office Visit 50% 40%Emergency Room$950 per occurrence deductible, then 50%$950 per occurrence deductible, then 40%Urgent Care$60 copay40%Inpatient Hospital Services$850 per occurrence deductible, then 50%$850 per occurrence deductible, then 40%Outpatient Surgery4$600 per occurrence deductible, then 50%$600 per occurrence deductible, then 40%Outpatient X-Rays and Diagnostic Imaging450%40%Outpatient Imaging (CT/PET Scans/MRIs)450%40%NetworkBlue Advantage HMOBlue Advantage Plus HMOHSA Eligible5NoYesOutpatient Prescription Drugs – Preferred Pharmacy 6 7$10/$20/30%/35%/45%/50%20%/25%/30%/35%/45%/50%Outpatient Prescription Drugs – Non-Preferred Pharmacy 6,7$20/$30/35%/40%/45%/50%25%/30%/35%/40%/45%/50%Prescription Drug Utilization Benefit Management Programs8Specialty Pharmacy Program: To be eligible for maximum benefits, specialty medications must be obtained through the preferred Specialty Pharmacy provider. Member Pay the Difference: When choosing a brand name drug over an available generic equivalent, you pay your usual share plus the difference in cost. Prior Authorization/Step Therapy Requirements: Before receiving coverage for some medications, your doctor will need to receive authorization from BCBSTX and you may first need to meet certain criteria or try more cost-effective drugs. Mail-Order Program: You may receive a 90-day supply for prescription drugs through the mail-order program or at select retail pharmacies depending on your prescription drug benefit.

Depending on your plan, benefits are either reduced or not available when non-participating providers are used. This is a summary of benefit highlights only. All benefits shown indicate member responsibility.
The standard deductible and out-of-pocket maximum for this plan are shown. You must pay all the costs up to the deductible amount before this plan begins to pay for covered services you use. Note that copays apply whether or not you have met the deductible.
All percentages shown are of the allowable amount for covered services.
Members may have lower out-of-pocket costs for some services provided by non-emergency freestanding outpatient facilities than the out-of-pocket costs for services provided in a hospital setting. See your Summary of Benefits and Coverage for additional details.
As a reminder, a Health Savings Account (HSA) has tax and legal ramifications. Blue Cross and Blue Shield of Texas does not provide legal or tax advice and nothing herein should be construed as legal or tax advice. These materials, and any tax-related statements in them, are not intended or written to be used, and cannot be used or relied on for the purpose of avoiding tax penalties. Tax-related statements, if any, may have been written in connection with the promotion or marketing of the transaction(s) or matter(s) addressed by these materials. You should seek advice based on your particular circumstances from an independent tax adviser regarding tax consequences of specific health insurance plans or products.
Prescription benefit coverage starts after annual medical deductible has been met, not counting copays.
Six prescription drug payment level tiers: Preferred Generics / Non-Preferred Generics / Preferred Brand / Non-Preferred Brand / Preferred Specialty / Non-Preferred Specialty.
Mail order is not available for Preferred and Non-Preferred Specialty tier drugs. These tiers are limited to a 30-day supply. Coverage limitations may apply to certain medications.

Blue Cross Silver Plans

Blue Advantage Silver HMOBlue Advantage Silver HMOBlue Advantage Silver HMOBlue Advantage Plus SilverPlan Number102103107102 – Three $0 PCP VisitsDeductiblea specified amount of money that the insured must pay before an insurance company will pay a claim.2$3,000$3,750$3,500$3,250CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max30%None (Member pays 0% after deductible)20%20%Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services (includes deductible)2$7,150$3,750$7,150$6,850Primary Care Office Visit$40100% after deductible$30First three visits $0, then 20%Specialist Office Visit$60100% after deductible$6520%4Mental Illness Treatment and Substance Abuse Rehab Office Visit$4040%4$30$0Emergency Room$600 per occurence copay, then 30%440%4$400 copay after deductible$600 per occurence copay, then 20%Urgent Care$40100% after deductible$75$20Inpatient Hospital Services$500 per occurence copay, then 30%4100% after deductible20%4$400 per occurence copay, then 20%Outpatient Surgery5$300 per occurence copay, then 50%4100% after deductible20%4$300 per occurence copay, then 40%Outpatient X-Rays and Diagnostic Imaging550%4100% after deductible20%440%Outpatient Imaging (CT/PET Scans/MRIs)530%4100% after deductible20%440%NetworkBlue Advantage HMOSMBlue Advantage HMOHSA Eligible6NoYesNoNoOutpatient Prescription Drugs – Preferred Pharmacy7 8$0/$10/$50/$100/30%No member share3$15/$15/$50/$100/40%$0/$10/$50/$100/30%Outpatient Prescription Drugs – Non-Preferred Pharmacy7 8$5/$15/$60/$110/30%No member share3$15/$15/$50/$100/40%$5/$15/$60/$110/30%

Blue Cross Bronze Plans

BronzeBlue Advantage Bronze HMOBlue Advantage Plus Bronze 204 – Two $40 PCP Visits201Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. $5,600$2,850CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max50%40%3Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services (includes deductible)2$7,350$6,550Primary Care Office VisitFirst 2 PCP visits $40, then 50%40%3Specialist Office Visit50%340%3Mental Illness Treatment and Substance Abuse Rehabilitation Office Visit 50%3 40%3Emergency Room$950 per occurrence deductible, then 50%$950 per occurrence deductible, then 40%Urgent Care$60 copay40%3Inpatient Hospital Services$850 per occurrence deductible, then 50%$850 per occurrence deductible, then 40%Outpatient Surgery4$600 per occurrence deductible, then 50%$600 per occurrence deductible, then 40%Outpatient X-Rays and Diagnostic Imaging450%340%3Outpatient Imaging (CT/PET Scans/MRIs)450%340%3NetworkBlue Advantage HMOSMBlue Advantage HMOSMHSA Eligible5NoYesOutpatient Prescription Drugs – Preferred Pharmacy 6 7$10/$20/30%/35%/45%/50%20%/25%/30%/35%/45%/50%Outpatient Prescription Drugs – Non-Preferred Pharmacy 6 7$20/$30/35%/40%/45%/50%25%/30%/35%/40%/45%/50%Prescription Drug Utilization Benefit Management Programs8Specialty Pharmacy Program: To be eligible for maximum benefits, specialty medications must be obtained through the preferred Specialty Pharmacy provider. Member Pay the Difference: When choosing a brand name drug over an available generic equivalent, you pay your usual share plus the difference in cost. Prior Authorization/Step Therapy Requirements: Before receiving coverage for some medications, your doctor will need to receive authorization from BCBSTX and you may first need to meet certain criteria or try more cost-effective drugs. Mail-Order Program: You may receive a 90-day supply for prescription drugs through the mail-order program or at select retail pharmacies depending on your prescription drug benefit.

Depending on your plan, benefits are either reduced or not available when non-participating providers are used. This is a summary of benefit highlights only. All benefits shown indicate member responsibility.
The standard deductible and out-of-pocket maximum for this plan are shown. You must pay all the costs up to the deductible amount before this plan begins to pay for covered services you use. Note that copays apply whether or not you have met the deductible.
All percentages shown are of the allowable amount for covered services.
Members may have lower out-of-pocket costs for some services provided by non-emergency freestanding outpatient facilities than the out-of-pocket costs for services provided in a hospital setting. See your Summary of Benefits and Coverage for additional details.
As a reminder, a Health Savings Account (HSA) has tax and legal ramifications. Blue Cross and Blue Shield of Texas does not provide legal or tax advice and nothing herein should be construed as legal or tax advice. These materials, and any tax-related statements in them, are not intended or written to be used, and cannot be used or relied on for the purpose of avoiding tax penalties. Tax-related statements, if any, may have been written in connection with the promotion or marketing of the transaction(s) or matter(s) addressed by these materials. You should seek advice based on your particular circumstances from an independent tax adviser regarding tax consequences of specific health insurance plans or products.
Prescription benefit coverage starts after annual medical deductible has been met, not counting copays.
Six prescription drug payment level tiers: Preferred Generics / Non-Preferred Generics / Preferred Brand / Non-Preferred Brand / Preferred Specialty / Non-Preferred Specialty.
Mail order is not available for Preferred and Non-Preferred Specialty tier drugs. These tiers are limited to a 30-day supply. Coverage limitations may apply to certain medications.

Multi-State Plans

HSA Plans

Health Savings Accounts can reduce your out of pocket costs as well as your tax burden. BCBSTX offers one of 3 HSA plans in Texas for 2018. Learn more at our HSA Guide.

Plan Brochures

Links to Summaries of Benefits & Coverage (SBC), Benefit Highlights and Plan Comparison Charts for all Blue Cross and Blue Shield of Texas (BCBSTX) qualified health plans in the under 65 retail market. PLAN Comparison Charts

COMPARISON CHARTLink to ChartsBCBSTX Gold Plan Comparison ChartEnglish ● SpanishBCBSTX Silver Plan Comparison ChartEnglish ● SpanishBCBSTX Bronze Plan Comparison ChartEnglish ● Spanish

GOLD Plans

PLAN NAME Plan VarianceMarketplace or Non Marketplace*Link to SBC DocumentLink to Benefit HighlightsBlue Advantage Plus Gold HMO 203StandardNon MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Gold HMO 203StandardMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Gold HMO 203Native American ZeroMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Gold HMO 203Native American LimitedMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Gold HMO 206 – Three $30 PCP VisitsStandardNon MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Gold HMO 206 – Three $30 PCP VisitsStandardMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Gold HMO 206Native American ZeroMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Gold HMO 206 – Three $30 PCP VisitsNative American LimitedMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Gold HMO 207StandardNon MarketplaceSummary of BenefitsBenefit Highlights

SILVER Plans

PLAN NAME Plan VarianceMarketplace or Non Marketplace*Link to SBC DocumentLink to Benefit HighlightsBlue Advantage Plus Silver HMO 202StandardNon MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Silver HMO 202StandardMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Silver HMO 202Native American ZeroMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Silver HMO 202Native American LimitedMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Silver HMO 20273% Actuarial Value (AV)MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Silver HMO 20287% Actuarial Value (AV)MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Silver HMO 20294% Actuarial Value (AV)MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Silver HMO 205 – Two $25 PCP VisitsStandardNon MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Silver HMO 205 – Two $25 PCP VisitsStandardMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Silver HMO 205Native American ZeroMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Silver HMO 205 – Two $25 PCP VisitsNative American LimitedMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Silver HMO 205 – Two $25 PCP Visits73% Actuarial Value (AV)MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Silver HMO 205 – Two $15 PCP Visits87% Actuarial Value (AV)MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Silver HMO 205 – Two $5 PCP Visits94% Actuarial Value (AV)MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Silver HMO 102 – Three $0 PCP Visits Standard Non Marketplace Summary of Benefits Benefit Highlights

BRONZE Plans

PLAN NAME Plan VarianceMarketplace or Non Marketplace*Link to SBC DocumentLink to Benefit HighlightsBlue Advantage Plus Bronze HMO 201StandardNon MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Bronze HMO 201StandardMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Bronze HMO 201Native American ZeroMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Plus Bronze HMO 201Native American LimitedMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Bronze HMO 204 – Two $40 PCP VisitsStandardNon MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Bronze HMO 204 – Two $40 PCP VisitsStandardMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Bronze HMO 204Native American ZeroMarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Bronze HMO 204 – Two $40 PCP VisitsNative American LimitedMarketplaceSummary of BenefitsBenefit Highlights

CATASTROPHIC Plans

PLAN NAME Plan VarianceMarketplace or Non Marketplace*Link to SBC DocumentLink to Benefit HighlightsBlue Advantage Security HMO 200StandardNon MarketplaceSummary of BenefitsBenefit HighlightsBlue Advantage Security HMO 200StandardMarketplaceSummary of BenefitsBenefit Highlights

Phone: (312) 726-6565 Email: [email protected]

Popular Hospital Network Guide

HospitalIncluded in Advantage HMO Network?Doctors Hospital At Renaissance (Edinburg)YESUniversity Health System (San Antonio)NOMedical City Hospital (Dallas)YESMemorial Hermann Hospital (Sugar Land)YESMother Frances Hospital (Tyler)NOScott & White Hospital (Round Rock)NONorth Austin Medical Center (Austin)YESSeton Medical Center (Austin)YESHill Country Memorial Hospital (Fredericksburg)YESTexas Health Harris Methodist (Fort Worth)YESUT Southwestern Medical Center (Dallas)NOMemorial Hermann Texas Medical Center (Houston)YESSt. Lukes Episcopal Hospital (Houston)YESBaylor University Medical Center (Dallas)YESThe Methodist Hospital (Houston)YES

Find What Plans Your Doctor Accepts

Find Every Plan In Your Area Calculate Your Subsidy Live Chat Our Agents Apply On Or Off the Exchange Apply in Under 5 Minutes

Does Blue Cross Blue Shield cover in Texas?

Blue Cross and Blue Shield of Texas is a statewide, customer-owned health insurer. We believe Texas consumers and employers deserve the best of both worlds: access to affordable, quality health care and top-notch service from a company that focuses solely on customers, not shareholders.

Is Blue Cross Blue Shield of Texas PPO?

BCBSTX offers a variety of PPO plans with varying deductible, coinsurance and copay amount options. All plans include an outpatient prescription drug benefit with either a three-tier or four-tier pharmacy copay design.

Does Blue Cross Blue Shield of Texas require referrals?

Reminder about the Claims Billing Referral Requirement Currently, specialists and other providers must obtain a referral from a BCBSTX member's PCP or referring provider prior to treating that member.

Is Blue Cross Blue Shield of Texas nationwide?

It has affiliated plans in all 50 states, the District of Columbia, and Puerto Rico, as well as licensees offering plans in several foreign countries; it also participates in the nationwide health insurance program for employees of the United States federal government.

Blue cross blue shield texas cost estimator

BCBSTX 2022 Plan Guide

Apply Now

BCBSTX 2021 Plans

BCBSTX 2018 Plans

Find What Plans Your Doctor Accepts

Does Blue Cross Blue Shield cover in Texas?

Is Blue Cross Blue Shield of Texas PPO?

Does Blue Cross Blue Shield of Texas require referrals?

Is Blue Cross Blue Shield of Texas nationwide?

Related Posts

Flying m ranch archer city texas

How much does it cost to add central ac

Average cost to add 1000 square foot addition

How much does a honda rancher 420 cost

Empire blue cross blue shield an anthem company

Blue diamond lightly salted almonds 40 oz

How much is a yard of gravel cost

2014 audi q5 windshield replacement cost

Oil change and transmission fluid change cost

How much does a pitbull boxer mix cost

Toplist

Latest post

TAGs