Page 4 - 2020 Summer Enrollment

You can see the status of your referrals and prior authorizations by logging in to your Blue Access for Members account.
Go to www.healthselectoftexas.com and click “Log In” in the upper right-hand corner. If you do not have an account, click “Register Now” and use your medical ID card to create an account.
COST-SAVING TIPS
Stay in the Network
You’ll pay less if you see an in-network provider. Go to the “Find a Doctor/Hospital” page on www.healthselectoftexas.com. You can call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039 to find a provider or check network status. You can also use your smart phonetofindin-networkcareusingyourBlueAccessforMembersSM account.Downloadthe BCBSTX App by texting BCBSTXAPP to 33633 to get a download link.1 Click “Register Now” and use your medical ID card to create an account.
Select a Primary Care Provider
Your primary care provider (PCP) serves as your first point of contact when you need non- emergency medical care. Before you see a specialist, talk to your PCP and, if needed, get a referral and/or prior authorization for certain services. If you don’t have a PCP selected, you can call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039 for help, or you can log in to your Blue Access for Members account and go to the “Doctors and Hospitals” tab . Search for providers by specialty or name. From the search results page, select the “Primary Care Provider” filter at the top of the page.
If you enroll in the HealthSelect of Texas plan, you must have a PCP on file with BCBSTX to receive in-network benefits. If you have not chosen a PCP after 60 days of being an active HealthSelect of Texas participant, out-of-network benefits will apply for any services you get—even from in-network providers.
Referrals
Referrals are required under the HealthSelect of Texas plan. A referral is an order from your PCP that must be obtained and authorized through BCBSTX for you to see a specialist. For most services, you need to get a referral before you can get medical care from anyone except yourPCP.Ifyoudon’tgetareferralbeforeyoureceiveservices,yourserviceswillbeconsidered out-of-network, and you will pay more, even if the provider is in your plan’s network.
Some services do not require a referral. Learn more at www.healthselectoftexas.com.
Prior Authorizations
You are required to get prior authorization from BCBSTX for certain services, including inpatient hospital stays, surgery and durable medical equipment. In general, in-network providers are responsible for getting prior authorization before they provide services. To see the full list of services that require prior authorization, visit your plan’s Master Benefit Plan Document on the HealthSelect website.
Find more details about referrals and prior authorizations at
www.healthselectoftexas.com. Go to the “Medical Benefits” tab, then “Referrals and Prior Authorizations.”
4 www.healthselectoftexas.com
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