Page 4 - 2021 Summer Enrollment

Select a Primary Care Provider
Your primary care provider (PCP) serves as your first point of contact when you need non-emergency medical care. To choose a PCP, you can call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039 (TTY:711) for help, or you can log in to your Blue Access for Members account and go to the “Doctors and Hospitals” tab to select a PCP online.
Referrals
Referrals are required under the HealthSelect of Texas plan. Before you see a specialist, be sure you have chosen a PCP and informed BCBSTX. 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 your PCP.Ifyoudon’tgetareferralbeforeyougetservices, your services will be considered 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. Click the “Referrals and Prior Authorizations” tab under the “Find a Doctor/ Hospital” tab.
SAVE ON COSTS
Stay in the Network
You’ll pay less if you see in-network health care providers. Go to the “Find a Doctor/Hospital” page at www.healthselectoftexas.com or call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039 (TTY:711) to find a provider or check network status. You can also use the BCBSTX App to access Provider Finder® through Blue Access for MembersSM. Download the BCBSTX App by texting BCBSTXAPP to 33633.1
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, see your plan’s Master Benefit Plan Document on the HealthSelect website.
1 Message and data rates may apply. Read terms, conditions and privacy policy at bcbstx.com/mobile/text-messaging.
If you enroll in the HealthSelect of Texas plan, you will have to contact BCBSTX to name an in-network PCP. If you haven’t named a PCP after your first 60 days on the plan, out-of-network costs apply to most services — even if they’re from an in-network provider — until an in-network PCP is named. Please see the charts on pages 16-20 for out-of- network charges. Remember: you can change your PCP at any time.
Save on Costs www.healthselectoftexas.com 4