Blue Cross Blue Shield Ppo Copay

Blue Cross Blue Shield Ppo Copays
Blue Cross Blue Shield Ppo Deductible Texas
Blue Cross Blue Ppo Plan
Blue Cross Blue Shield Ppo Specialist Copay
Blue Cross Blue Shield Ppo Copay
Blue Cross Blue Shield Texas Ppo Copay

Our PPO managed health care plans provide for the payment of benefits at a higher level of coverage when the member utilizes our network of preferred providers. These network providers, including physicians, specialty care providers, hospitals, and other health care facilities and practitioners, have contracted with BCBSTX to provide health care services at negotiated rates.

If the member elects to receive care from network providers:

They will receive the higher level of benefits (In-Network Benefits)
They are not required to file claim forms — Network providers bill BCBSTX for services provided
They are not balance billed — Network providers will not bill for costs that are in excess of the BCBSTX allowable amount for covered services.
Network providers are responsible for any necessary preauthorization

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If you choose a therapist who is not in-network with Blue Cross Blue Shield and you have a Blue Cross Blue Shield PPO Plan, your therapy session will likely cost between $50 - $100 per session, or 20% - 50% of the full amount that your therapist charges per session.

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If the member elects to receive care from providers outside of the network, they may choose:

Blue Cross Blue Shield Ppo Copays

ParPlan Providers Providers participating in a direct-payment arrangement with BCBSTX	Out-of-Network Providers Non-contracting providers
If the member elects to receive care from a ParPlan Provider, benefits for covered services are available at the lower level of benefits (Out-of-Network); however… ParPlan Providers will file the member’s claim forms ParPlan Providers will not bill the member for costs exceeding the BCBSTX allowable amount for covered services ParPlan Providers will preauthorize necessary services	If the member elects to receive care from a non-contracting provider, benefits for covered services are available at the lower level of benefits (Out-of-Network); and… Members will be required to file their own claim forms Members will be responsible for amounts in excess of the BCBSTX allowable amount for non-contracting providers — which may be considerable Members must preauthorize necessary services

ParPlan Providers

Providers participating in a direct-payment arrangement with BCBSTX

Out-of-Network Providers

Non-contracting providers

If the member elects to receive care from a ParPlan Provider, benefits for covered services are available at the lower level of benefits (Out-of-Network); however…

ParPlan Providers will file the member’s claim forms
ParPlan Providers will not bill the member for costs exceeding the BCBSTX allowable amount for covered services
ParPlan Providers will preauthorize necessary services

If the member elects to receive care from a non-contracting provider, benefits for covered services are available at the lower level of benefits (Out-of-Network); and…

Members will be required to file their own claim forms
Members will be responsible for amounts in excess of the BCBSTX allowable amount for non-contracting providers — which may be considerable
Members must preauthorize necessary services

The PPO plan is available to clients through the Blue Choice^SM Network, one of the largest networks in Texas. Blue Choice^SM provides:

Access to the national BlueCard^® network when members are outside of Texas
Over 600 participating hospitals and facilities in Texas
More than 800,000 doctors and 6,000 hospitals contracting with Blue Cross and Blue Shield plans nationwide

For health care services required outside of Texas, members have access to the BlueCard national network of providers.

Blue Cross Blue Shield Ppo Deductible Texas

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

The three-tier pharmacy copay plan design includes three tiers of medications that are comprised of:

Blue Cross Blue Ppo Plan

Generic Drugs
Preferred Brand-name Drugs
Non-preferred Brand-name Drugs

The four-tier pharmacy copay plan design includes four tiers of medications that are comprised of:

Blue Cross Blue Shield Ppo Specialist Copay

Generic
Preferred Brand-name Drugs
Non-preferred Brand-name / Preferred Specialty
Non-preferred Specialty Drugs

Blue Cross Blue Shield Ppo Copay

Prescription drugs are available through retail pharmacies throughout Texas and mail order pharmacy services.

Blue Cross Blue Shield Texas Ppo Copay

For more detailed information on available benefit designs, a description of the services and supplies that are covered, a listing of those services and supplies that are limited or excluded, terms and general administration or for any questions you may have regarding our products and services, contact us for the phone number of the regional sales office near you.