Blue Cross Blue Shield of Texas - Plan Descriptions
BlueCross BlueShield of Texas is the largest health insurance company in the state with over 4 million members in all 254 Texas counties. They offer health plans that can be customized for individuals, children, and families that include Health Savings Accounts, short-term plans, Medicare Supplements, and prescription drug coverage. The different plans are described below.
Select Blue Advantage Plan
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Our Rating: 
Select Blue Advantage provides the most extensive benefits of any individual health insurance plan offered by BlueCross BlueShield of Texas. It features a $25 office visit copay that includes same day lab and x-ray work.
Other Select Blue Advantage plan highlights include:
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- Access to the BlueChoice network, one of the largest PPO networks in Texas
- $25 office visit copayment that includes same day lab and x-rays
- $100 emergency room copayment
- Preventive care benefits for adults and children
- 85% coinsurance
- 3 tier prescription drug copay formulary ($10 / $30 / $45)
- Optional dental coverage
- $5,000,000 lifetime maximum
PPO Select Choice Series III Plan
| PPO Select Choice Documents |
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Our Rating:
PPO Select Choice Series III is a slightly watered-down version of the Select Blue Advantage plan that provides a high level of benefits at a more cost effective premium by changing a few of the enhanced benefits in the Select Blue Advantage plan.
These benefit changes include:
- Adding a $200 prescription drug deductible
- $25 office visit initial office visit only covers consultation (excludes same day lab and x-ray benefit)
- No emergency room copay (subject to deductible and coinsurance)
- 80% coinsurance (instead of 85%)
PPO Select Choice offers choice and flexibility for individual and family health care coverage. It is not a pre-packaged, one-size-fits-all health insurance plan, but rather health coverage that gives you a selection of benefits to fit your health care coverage needs now and the flexibility to fit your needs in the future. PPO Select Choice plan highlights include:
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Like the Select Blue Advantage plan, PPO Select Choice also includes:
- Access to the BlueChoice network, one of the largest PPO networks in Texas
- $25 office visit copayment
- Preventive care benefits for adults and children
- 3 tier prescription drug copay formulary ($10 / $30 / $45) (after $200 Rx deductible)
- Optional dental coverage
- $5,000,000 lifetime maximum
PPO Select Saver
| PPO Select Saver |
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Our Rating: 
If you don't want all the bells and whistles, but are looking for a lower cost alternative for your health care needs, the PPO Select Saver plan may be right for you. This plan keeps your premium low by not including an office visit co-pay. It has a prescription drug card, with a higher co-pay amount for the non-formulary drugs. All of this adds up to insurance premium savings for you.
PPO Select Saver plan highlights include:
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- Access to the BlueChoice network, one of the largest PPO networks in Texas
- Preventive care benefit for adults and children (Pays 75% after deductible)
- 3 tier prescription drug copay formulary ($10 / $30 / $55) (after $200 Rx deductible)
- 75% coinsurance
- Optional dental coverage
- $5,000,000 lifetime maximum
PPO Select Value Care
| Select Value Care |
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Our Rating: 
PPO Select Value Care plan is a cost-sharing plan that provides a wide range of benefits at a reduced co-insurance level. The plan provides 50% benefit coverage on which BCBSTX will share in 50% of your health care costs with no deductible to meet. The coinsurance is shared 50%/50% until you reach your out-of-pocket maximum amount of $10,000 in-network. PPO Select Value Care is a is a great plan for individuals and families seeking a low-cost plan, but needing coverage for health services most likely to involve catostrophic expenses.
PPO Select Value Care plan features include:
- Access to the BlueChoice network, one of the largest PPO networks in Texas
- No deductible to meet
- Preventive care benefit for adults and children (Pays 50%)
- 3 tier prescription drug copay formulary ($10 / $30 / $45) (after $200 Rx deductible)
- Choice of $10,000, $20,000, or $30,000 out-of pocket maximum for individuals
- Choice of $20,000, $40,000, or $60,000 out-of pocket maximum for families
- 50% coinsurance
- The option for a child-only individual health insurance plan with affordable rates based on age
- Optional dental coverage
- $5,000,000 lifetime maximum
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PPO Select Value® CareSM may be right for you if you are an individual or family who:
- Seeks comprehensive coverage at an affordable price
- Wants no deductible to meet
- Wants no copays
- Occasionally visits a doctor
BlueEdge HSA
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Our Rating:
Health Savings Account (HSA)-qualified plans are a smart way for you to better manage your health care dollars. With a high deductible plan, you save on the cost of insurance by sharing more of the smaller expenses such as physician office visits. BlueEdge HSA offers substantially lower premiums, along with the opportunity to put tax-deductible money in a special account which can be used to pay your deductible and other medical expenses. For 2010, the maximum HSA contribution amount is $3,050 for individuals and $6,150 for families.
An HSA, high deductible health insurance plan may be right for you if you:
- Want affordable premiums and need a wide range of benefits
- Don't expect to have a lot of medical expenses
- Have money saved just in case you have to pay unexpected out-of-pocket health care expenses
- Are looking for more control over your health care choices
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BlueEdge HSA plans utilize Blue Cross BlueShield of Texas' PPO network. After you have met your deductible, the plan pays either 75%, 90%, or 100% of all covered expenses depending on which BlueEdge plan you choose. With the BlueEdge HSA plans with 75% and 90% coinsurance, BCBSTX covers 100% of eligible expenses once you have reached an out of pocket limit of $3,000 for individuals or $6,000 for families. The BlueEdge HSA plans with 100% coinsurance cover all eligible expenses once the deductible is met.
This plan qualifies as HSA-eligible. Combining a Health Savings Account with any BlueEdge HSA plan allows you to make tax-deductible contributions, pay medical expenses with pre-tax dollars, and earn tax-deferred interest. This account works much like an IRA, except you may use your tax-free savings for qualified medical expenses your health plan does not cover, such as your deductible, contact lenses, dental costs, or most types of alternative medicine (see the qualified medical expenses). If you do not use these funds, they simply accumulate with interest, for distribution upon your retirement. BCBS of Texas has partnered with Mellon Bank and can initiate the process of opening an HSA with them, but they charge a start-up fee and monthly administration fees. We recommend asking your current bank if they offer health savings accounts without monthly administration fees. If your bank charges maintenance or administration charges, we can refer you to several banks that offer no-fee health savings accounts.
Foundation Hospital Care
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Our Rating: 
Foundation Hospital Care provides basic coverage at the lowest price. It provides coverage where inpatient care is necessary that includes hospitalization, surgery, testing and emergency medical services, but does not cover outpatient doctor office visits and prescriptions.
After you meet your calendar year deductible, the Network Foundation Hospital Care plan pays 80% and you pay 20% of covered expenses until you reach the $5,000 out-of-pocket maximum for individuals and $15,000 for families. Emergency Room visits are subject to a $200 co-payment amount and calendar year deductible, then pays 80% and you pay 20%.
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The Foundation Hospital Care plan is a good choice for those seeking the lowest cost, but needing coverage for health services most likely to involve catastrophic expenses. The plan also offers affordable, child-only coverage with premiums based on the age of your child. For parents on an employer plan that do not cover children, this an affordable coverage alternative to paying expensive dependent premiums. If you have one than more child, one application per child is required.
SelectTemp PPO (short-term medical)
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Our Rating: 
SelectTEMP PPO is an affordable short-term individual health plan that provides basic protection against unexpected accident or illness. Individuals who are temporarily without health insurance because COBRA is too expensive, are in-between jobs, or waiting for employer coverage to begin find SelectTEMP PPO to be an affordable alternative.
SelecTemp PPO plan features include:
- Access to the BlueChoice network, one of the largest PPO networks in Texas
- Copayment of $100 for emergency room facility visit - waived if admitted to Hospital immediately following the visit. (This copayment amount applies to the facility visit only. The facility and physician services and supplies are subject to the deductible and coinsurance amount.)
- 80% coinsurance after your deductible with a maximum of $1,000 for individuals and $3,000 for families
- 3 tier prescription drug copay formulary ($10 / $40 / $55) after $200 Rx deductible
SelectTEMP PPO offers various benefit periods and deductibles to allows you the control to tailor coverage, premium rates and out-of-pocket expenses according to your own needs.
You are able to choose:
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- The date you want coverage to begin
- The coverage period - 1 to 6 months
- Individual deductibles for individuals ranging from $500 to $2,500
- Family deductibles ranging from $1,500 to $7,500
SelecTEMP PPO is your short-term health insurance solution if you are:
- Experiencing a gap in employer coverage or can't afford COBRA
- Waiting for employer coverage to begin
- A recent graduate and still seeking employment
- Age 64 and about to retire, but not yet eligible for Medicare
Who is eligible for SelecTEMP PPO?
- Texas residents at least 60 days of age and under 65 years of age
- Non-expectant parents
- Unmarried dependent children at least 60 days of age and under 25 years of age
- U.S. citizens or non-U.S. citizens living in the United States for at least two years (a copy of your Alien Registration Receipt Card must be submitted with your application)
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