The Blue Cross/Blue Shield of Texas (BCBS) Preferred Provider Organization (PPO) Blue Choice medical insurance plan provides access to a large national provider network but also offers the option of seeking services from out-of-network providers.

The PPO plan design helps keep costs in control by paying a more substantial benefit for services that are rendered with in-network doctors , in Texas and out-of-state and facilities. International medical benefits are also available on our medical plan. Out-of-network services are covered at a reduced amount, and subject to Blue Cross Blue Shield of Texas’s allowable cost. When receiving services from an out-of-network provider, you may be required to file the claim by submitting a medical claim form along with your provider’s statement of service to the claims department at BCBS.

Routine eye exams are covered by using a BCBS network provider; however, eyeglasses/contacts are not covered.  BCBS has contracted with Davis Vision to allow for discount vision benefits with participating Davis Vision companies (local participating companies are VisionWorks and Eyemart).  When receiving the discount benefit, request a comparison of the discount with promotions that may be offered at that time.

For specific details on the plan design, please see the PPO Summary of Benefits and/or the Summary of Benefits and Coverage (SBC). The SBC includes standard language required by the Affordable Care Act.

Blue Access for Members enables members to review the status of their claims, view their explanation of medical benefits and confirm who is covered under their plan. Members can receive an e-mail when Blue Cross and Blue Shield of Texas finalizes their medical claims and opt to stop receiving paper copies of Explanation of Benefits. This online tool provides access to extensive health and wellness information, a health risk assessment, a personal health manager and many more tools to manage your health.

Costs

Baylor University and regular full-time faculty/staff share in the cost of medical premiums to cover the employee and their eligible family members.

• Employee Premium Schedule 
  
• Explanation of How Medical Premiums are Determined

Enroll in the Medical Plan

• To enroll in BCBS medical insurance plan you will need to complete the Benefits Enrollment Application/Change Form. This form allows you to enroll or make changes to your medical and dental insurance plans, as well as, provide authorization for payroll to deduct the pre-tax premium for coverage. New hires must complete the application to enroll within 30 days of hire. Enrollment changes must be made during open enrollment (November 1st - 30th) or within 30 days of a qualifying life event.
  

Additional Information

2011 Health Care Reform Information

Baylor Medical Insurance Policy

Blue Cross/Blue Shield (BCBS) of TX Medical Policies/Procedures
Policies listed are not a guarantee of coverage. Contact BCBS customer service (1-800-521-2227) for coverage information.

HIPP Medicaid
If a member of your family is eligible for Medicaid, you may be eligible for a reimbursement of your medical premium.

Your Guide to Enrolling in Medicare
Learn about some important decisions you will need to make about your health care in the months before you reach age 65.