When it comes to getting health insurance in the Lone Star State, BCBSTX (BlueCross and BlueShield of Texas) is amongst the best company in the marketplace.
Their many perks and benefits, large provider network of doctors and hospitals, makes them one of the top choices. But is important to understand and learn more about the company to see if it is a good fit for you and your family.
In this article, you will learn about the benefits, the different types of plans, costs, availability and much more. Is BCBS the right one for you? Let’s find out!
What is BCBSTX?
BCBSTX is more commonly known as BlueCross and BlueShield of Texas, which sells individual and family plans through the health insurance marketplace. They are part of Health Care Service Corporation (HCSC) which is a mutual legal reserve company that owns BCBS plans in several states.
It is one of the biggest companies in the nation with over 1.7 million providers combining doctors and hospitals. All the companies under the BCBS umbrella insure over 115 million Americans! It is without a doubt one of the best choices Texans can make when it comes to health insurance. So, what are the benefits and why should you choose them?
The BCBSTX benefits
Aside from the usual health benefits that a standard ACA plan provides like doctor visits, emergency rooms, hospitalization, prescription drugs, maternity care, rehab, and more, BCBS has its own unique benefits. What are they?
With a BCBSTX plan you will have access to:
24/7 nurse line in both English and Spanish
Large network of providers throughout the Lone Star State
24/7 virtual visits
Cost estimator tool on their website for their members
Mobile app that lets you find doctors, make payments, and get your ID card
Blue365 member discounts program that helps you save money on dental products, gym memberships, weight loss programs, and much more.
On top of this, they provide the highest quality plans throughout the state and have several plans that include $0 primary care visits for their members. However, everyone’s coverage will be different and that depends on what kind of plan you choose. Which is why you need a great insurance agent!
Types of BCBSTX plans
In the state of Texas, BlueCross and BlueShield is the only company that offers the 4 types of plans available in the marketplace, which are HMO, EPO, PPO, and POS. They are also the only ones to offer the catastrophic tier as well as all other tiers like bronze, silver, gold, and platinum.
Each of these plans will vary in price, coverage, and availability. It is important to learn more about each type of plan to see which one suits you or your family the best. Let’s dive in and explore each one.
HMO
The HMO (Health Maintenance Organization) is the cheapest plan out of the four. The main characteristics of HMO plans are that you need to select a PCP and they will need to provide you with referrals to see specialist doctors. Also, you can only receive care in network and cannot go outside your plan’s network. It is the most personalized plan with a doctor overlooking your health.
EPO
EPO plans (Exclusive Provider Organization) are the most “balanced” in the marketplace. They do not require you to get a referral from your primary doctor to see a specialist. Making it a highly sought out option for Texans. Like an HMO however, you cannot get care outside of your plan’s network. It strikes a balance between monthly premiums and medical costs.
PPO
A PPO plan (Preferred Provider Organization) has the most flexibility by allowing members to choose their doctors in and out of network. You also don’t require referrals. You will save money by using providers that are in-network but having that out-of-network option is nice. They will usually be the most expensive option of the four.
POS
POS plans (Point of Service) combine the characteristics of an HMO and the PPO. Like an HMO, members with a POS plan must choose primary doctor to give them referrals for specialists. However, you can also receive care outside of your plans network (although with a referral), and higher costs. It is the least chosen of the four but still an option for those who may want that combination.
Shop for BCBS plans in Texas with Cuspide
Save money on finding plans, find doctors, make payments, and much more with our services here at Cuspide. All at no cost to you! Call us at (305) 970-8583.
BlueCross BlueShield Texas provider map
For 2024, BlueCross & BlueShield’s HMO network has around 451 hospitals and 38,000 providers in the state. ACA/Obamacare coverage is based per county. So, it is possible that in your county they may not be available (however it is unlikely). BCBS is available in almost all the counties inside the Lone Star State. Below is a map of the coverage area.
What hospitals accept BlueCross and BlueShield in Texas?
While there are too many hospitals to talk about in the lone Star State, we will focus on the most well-known and best. In Texas, BCBS works with the following hospitals:
Houston Methodist Hospital
UT Southwestern Medical Center
Baylor St. Luke’s Medical Center
Baylor University Medical Center
Memorial Hermann Hospital
Scott & White Hospital
Texas Health Harris Methodist
Hill Country Memorial Hospital
Seton Medical Center
Medical City Hospital
Keep in mind, these are just the most popular, the actual list would be much longer. Once you have a BCBS plan, you can find what doctors and hospitals are in your network by going to your member portal. With BlueCross & BlueShield being one of the biggest health insurance companies in the nation, you should have no problem finding covered doctors/hospitals.
How much does BCBSTX cost?
The cost of your plan will be based on many factors like what type of plan you choose, household income, age, and location. In Texas, a BlueCross & BlueShield plan will cost you around $523 a month for a silver plan without a subsidy.
Below are the cheapest plans in the Texas marketplace by tiers:
| Tier | Plan | Cost |
|---|---|---|
| Bronze | MyBlue Health Bronze | $265 |
| Silver | MyBlue Health Silver 405 | $431 |
| Gold | MyBlue Health Gold 403 | $358 |
As you can see, for all 3 tiers, BlueCross & BlueShield of Texas has the cheapest plans in the marketplace. That is why it is regarded by many as one of the best health insurance companies not just in TX, but in the nation.
Pros and Cons of BlueCross BlueShield Texas
Every company has its good and bad, and BCBS is no different. Learn both sides so you can make a better decision when it comes time to select a plan.
Pros
– Offers all 4 types of plans (HMO, EPO, PPO, POS)
– Has all tiers (bronze, silver, gold, platinum)
– Cheapest plans in Texas across all 3 tiers
– Largest network of providers in the state
Cons
- Overall, plans can be costly
Where does BlueCross BlueShield of Texas rank?
According to our Cuspide article, on the best health insurance companies in TX, BCBS ranks as the best overall in the Lone Star State. Their plans have the furthest reach, best care, and overall best prices. We gave them a 4.8 out of 5-star rating. Below are some reviews of BCBS of Texas across the internet.
Investopedia
NCQA
ValuePenguin
Cuspide
Frequently asked questions
If you do not see your question in this article, or have specific questions regarding BCBS, contact us at (305) 970-8583 to speak to one of your agents!
Does BCBS of Texas have dental and vision plans?
Yes, some BlueCross & BlueShield plans in Texas will have dental and vision included in their coverage. It all depends on which type of plan you end up choosing. Also, it will have extra costs for those services. If it ends up being too much, you can always grab the health coverage and just find something outside the marketplace for dental/vision. Ask your agent if the plan includes dental and vision coverage before selecting it.
Are BCBSTX and BSW working together?
As of 2024, BSW (Baylor Scott and White) is working with BCBSTX to get a contract that says that BSW members will cover patients with a BlueCross & BlueShield plan. In their article, they say that they plan to reach an agreement no further than July 1st, 2024. Think of this as a partnership that extends your network of coverage. We will keep you updated on how this turns out here.
How do I contact BlueCross BlueShield of Texas?
There are many ways to reach out to BCBS and get their help. Members can head over to their website here and receive help there. If you want to speak to them directly, call them at 1-888-697-0683 for any questions or concerns. Lastly, you can reach out to us here at Cuspide at (305) 970-8583 as we work directly with BCBS and can help with anything you may need. Get fast and quality help from us!
The bottom line
Now that you know more about BCBS in Texas, you are ready to make a better decision on what type of insurance company you want to go with. While there are others in the marketplace, just know that they are one of the top choices.
Based on their prices, large network of providers, availability, and more, they should be on your radar. If you get a quote and it happens to be a suitable choice, you can rest assured that you will be covered without any problems. They are not one of the biggest companies for no reason!
As always, we are one of the top brokers in the Lone star state, so if you are looking for BCBSTX plans, contact Cuspide for anything health insurance!
