2020 SUMMER ENROLLMENT › ... › se2020-presentation.pdf · 2020-06-19 · 2020 SUMMER ENROLLMENT EXPLORING YOUR MEDICAL BENEFITS The 2021 health plan year begins on September 1,
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2020 SUMMER ENROLLMENT EXPLORING YOUR MEDICAL BENEFITS The 2021 health plan year begins on September 1, 2020, and runs through August 31, 2021
2020 SUMMER ENROLLMENT EXPLORING YOUR MEDICAL BENEFITS
The 2021 health plan year begins on September 1, 2020, and runs through August 31, 2021
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Welcome to Summer Enrollment. This is your chance to choose a new medical plan for Plan Year 2021, if you want to. The 2021 health plan year begins September 1, 2020, and runs through August 31, 2021. We are pleased to review the benefits you get if you enroll in a HealthSelectSM plan. Whether you are new to HealthSelect, or have had this coverage previously, this presentation will give you an overview of the plans available, as well as information about plan changes, program highlights and ways to stay connected throughout the year.
• Help you shop for cost-effective providers and earn HealthSelectShoppERSSM rewards
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One of the most useful resources available to HealthSelect participants is our Blue Cross and Blue Shield of Texas (BCBSTX) Personal Health Assistants. BCBSTX Personal Health Assistants can help you and your covered family members with: any questions you have on your benefits and coverage, prior authorizations and referrals, helping you find in-network providers, understanding your health care costs and options for care, scheduling appointments for doctor’s visits, accessing participant web and mobile tools, connecting you with a nurse to help you learn more about a diagnosis or medical condition and identify resources available to you in your community and new for plan year 2021, BCBSTX Personal Health Assistants can help you shop for quality, cost effective providers where you can earn HealthSelectShoppERSSM rewards. Details on this new program will be covered later in the presentation. Remember, there is one toll-free number to call: (800) 252-8039. A BCBSTX Personal Health Assistant is available Monday through Friday 7 a.m. to 7 p.m. and Saturday 7 a.m. to 3 p.m. CT.
Coverage Options and Benefits
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Let’s take a look at your coverage options, plan changes and some important information for making the most of your benefits.
Plan Updates
Diagnostic Mammogram Benefits • In-network diagnostic mammograms will be
covered with no out-of-pocket cost, the same as preventive screening mammograms. ‒ For Consumer Directed HealthSelect participants, diagnostic
mammograms are subject to deductible and coinsurance.
Mental Health Benefit Services • Blue Cross and Blue Shield of Texas (BCBSTX)
will manage mental health benefits for all HealthSelectSM participants, replacing Magellan Healthcare®.
• Benefits (deductibles, copays and coinsurance) and eligible services for mental health and substance use will not change.
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First, we want to update you on benefit changes starting September 1, 2020. Diagnostic mammograms, when done at an in-network imaging facility, will be covered with no out-of-pocket cost, the same as preventive screening mammograms for participants in the HealthSelect of Texas®, HealthSelect SecondarySM and HealthSelectSM Out-of-State plans. For Consumer Directed HealthSelectSM participants, diagnostic mammograms are subject to the deductible and coinsurance. BCBSTX will manage mental health benefits for all HealthSelect participants, replacing Magellan Healthcare®. Your benefits (any deductibles, copays and coinsurance) and eligible services for mental health and substance use will not change as a result of this transition. Most providers who were in network for Magellan will also be in the HealthSelect network. If you or a covered dependent are currently seeing an in-network mental health provider for outpatient office visits (counseling, therapy, psychiatric care, etc.), and your provider will no longer be in the HealthSelect network after September 1, your HealthSelect plan offers a 90-day grace period. This means that from September 1, 2020 through November 30, 2020, your claims for covered services with the out-of-network provider will continue to be paid at the in-network benefit level. To get the most of your benefits and keep your out-of-pocket costs lower, you are encouraged to find an in-network provider during this 90-day grace period.
Plan Updates
• Earn rewards for making cost-
effective choices when shopping for certain medical services and procedures.
• Available to active participants enrolled in HealthSelect of Texas®, HealthSelectSM Out-of-State and Consumer Directed HealthSelectSM. ‒ Retirees and Medicare-primary participants
are excluded.
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HealthSelectShoppERS is a new program beginning September 1, 2020 that allows eligible HealthSelect participants and their eligible dependents to save money and earn rewards for making cost-effective choices when shopping for certain medical services and procedures. The program is available to active participants enrolled in HealthSelect® of Texas, HealthSelectSM Out-of-State, and Consumer Directed HealthSelectSM. Retirees and Medicare-primary participants are excluded.
Plan Updates
Three easy steps
1. SHOP When your doctor recommends a service or procedure, use Provider Finder® to find out if it is eligible for a reward and where it can be performed.
2. GO Have your procedure at a HealthSelectShoppERS reward-eligible location; complete your selection prior to receiving service.
3. EARN Once your procedure or test is complete and BCBSTX has processed your claim, your reward is deposited into your TexFlex health care FSA or LFSA.
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Earning HealthSelectShoppERS rewards is simple. When your doctor recommends a procedure, first use Provider Finder® to find out if it is eligible for a reward and where it can be performed. You can also call a BCBSTX Personal Health Assistant to help you compare costs. Whether you use Provider Finder or call a BCBSTX Personal Health Assistant, if you select a lower-cost, in-network care option, you can earn rewards. Then, have your procedure at the HealthSelectShoppERS reward-eligible location you chose. You can earn incentives on services like ultrasounds and mammograms, CT scans and MRIs, and procedures like knee, shoulder and hip surgery. Once your procedure or test is complete, your reward is deposited into your TexFlex health care FSA. If you are enrolled in Consumer Directed HealthSelect, that reward is deposited into a Limited-Purpose flexible spending account. If you are eligible for a health care FSA or LFSA and do not have an account already, ERS will set up an account for you. You and your eligible dependents can earn a total of $500 in rewards each plan year. Participants can use those incentives to for future eligible health care services (defined by the IRS). Consumer Directed HealthSelect can use their rewards to pay eligible vision and dental expenses—which is what limited-purpose FSA funds can be used for. More information about HealthSelectShoppERS is available online at healthselectoftexas.com on the Summer Enrollment page.
Plan Updates
New Medical ID Cards • All HealthSelect participants will get new medical ID cards with updated mental health benefits
information.
• Be sure to show your new ID card to your health care providers when you visit after September 1.
Diabetes Supplies at No Cost • Certain diabetic supplies will be covered at no cost to participants under the HealthSelect
prescription drug plan (PDP) when you use an in-network pharmacy and present your prescription drug ID card. ‒ Consumer Directed HealthSelectSM deductibles still apply.
• This HealthSelect PDP benefits change does not change the diabetic supply benefits available under the BCBSTX medical plan.
• For more information, contact HealthSelect PDP customer care toll-free at (855) 828-9834 (TTY:711).
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All HealthSelect participants will get new medical ID cards for Plan Year 2021. Your new ID card will have updated information related to your mental health benefits. You can expect to get your new card in the mail by mid-August. Be sure to show your new ID card to any providers you see after September 1. Certain diabetic supplies will be covered at no cost to participants under the HealthSelect prescription drug plan (PDP) when you use an in-network pharmacy and present your prescription drug ID card. (Consumer Directed HealthSelectSM deductibles still apply.) For more information, contact HealthSelect PDP customer care toll-free at (855) 828-9834 (TTY:711). This HealthSelect PDP benefits change does not change the diabetic supply benefits available under the BCBSTX medical plan.
Out-of-Pocket Maximums
The total in-network out-of-pocket maximum for all HealthSelect plans is the same as it was in Plan Year 2020: • $6,750 for individuals • $13,500 for families
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This year there is no change to the total in-network out-of-pocket maximum. It remains $6,750 for individuals and $13,500 for families for all HealthSelect plans. The out-of-pocket maximum is the most you’ll pay for eligible health care services for the calendar year and includes costs for deductibles, coinsurance and copayments for both medical and prescription drug expenses. We’ll now go into details about your plan options.
HealthSelect of Texas®
• No deductible for in-network care ‒ $500 per person/$1,500 per family deductible for out-of-network
• Copay applies to certain services like primary care and specialists
• Primary care provider (PCP) is required for in-network benefits
• Referral from PCP is required before seeing an in-network specialist
• Services that don’t require PCP referral: ‒ Chiropractors ‒ Convenience care clinics ‒ Mental health counseling ‒ OB/GYN ‒ Ophthalmologists ‒ Optometrists
‒ Occupational, physical and speech therapy
‒ Routine eye exams ‒ Urgent care ‒ Virtual Visits
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For HealthSelect of Texas: As a HealthSelect of Texas participant, you have access to more than 50,000 network doctors, providers and hospitals. There is no deductible for in-network care. For out-of-network care, you must meet a deductible of $500 per person, $1,500 per family before the plan begins to pay for services. That is why it is important to stay in-network and coordinate your care with your designated primary care provider (PCP). While there is no deductible for in-network services, a copay will apply to certain services like primary care and specialist office visits. To receive in-network benefits, you must select a PCP. Your PCP will coordinate all of your care, and manage any referrals needed to see specialists. You will save money by getting a referral from your PCP before seeing an in-network specialist.��If you are new to the HealthSelect of Texas plan, you have 60 days from the effective date of your coverage to select a PCP. After 60 days, if you still have not selected a PCP, out-of-network benefits will apply for any services you receive, regardless of whether the provider you see is in-network or not. Referrals are not required for the following services: chiropractic visits, OB/GYN visits, routine eye exams, convenience care clinics, visits to ophthalmologists and optometrists, urgent care centers, mental health counseling, occupational, physical and speech therapy and Virtual Visits.
HealthSelectSM Out-of-State
• For active employees, non-Medicare-enrolled retirees and their eligible dependents living or working outside of Texas
• Benefits are the same as HealthSelect of Texas
• No deductible for in-network services
• A copay will apply to certain services like primary care and specialist office visits
• No PCP required, no referral needed to see a specialist
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Presentation Notes
HealthSelect Out-of-State benefits are available to active employees, non-Medicare-eligible retirees and their eligible dependents living or working outside of Texas. Benefits are the same as HealthSelect of Texas. There is no deductible for in-network services and a copay will apply to certain services like primary care and specialist office visits. Participants are not required to select a PCP, and referrals to specialists are not required. However, having a PCP is important to managing your overall health. When seeking care, be sure to use a network provider. To find in-network out-of-state providers, visit www.healthselectoftexas.com, click on “Find a Doctor/Hospital,” look for HealthSelect Out-of-State and click “Search.” Note: HealthSelect Secondary is available to retirees with Medicare and their Medicare-eligible covered dependents.
Consumer Directed HealthSelectSM
• Not required to designate a PCP or get PCP referrals to specialists
• Has a high deductible that must be met before the plan begins to pay for any services (except in-network preventive care)
• The State of Texas contributes pre-tax dollars to a health savings account (HSA): For individuals: $45 month/$540 annual and for families: $90 month/$1,080 annual
• Funds in the HSA can be used to pay for qualified covered medical and prescription drug expenses
Annual Deductible In-Network Out-of-Network
Individual $2,100 $4,200
Family $4,200 $8,400
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Consumer Directed HealthSelect is a high deductible health plan (HDHP) that qualifies for a health savings account (HSA). BCBSTX administers the high deductible health plan, while Optum Bank administers the HSA. This plan does not require you to select a PCP or obtain referrals to see specialists. Even though the plan does not require you to select a PCP, we encourage maintaining a relationship with a PCP to assist in managing health care needs. There are both an in-network and out-of-network annual deductibles. You are responsible for paying an annual in-network deductible of $2,100 for an individual or $4,200 for a family for covered health services. There is an out-of-network deductible of $4,200 for an individual or $8,400 for a family, so the deductible is twice as much if you do not use in-network providers in this plan. You must meet the deductible each calendar year before the plan begins to pay for any services, except preventive care. After meeting the deductible, the plan pays 80% and you pay 20% of covered, in-network services and prescriptions. If you go out-of-network, the plan only pays 60% and you are responsible for 40% of the allowed amount for covered services and prescriptions. Preventive health care services, like annual check-ups or vaccinations, are covered at 100% for in-network care, and you don’t have to meet your deductible first. The State of Texas contributes pre-tax dollars to an HSA for Consumer Directed HealthSelect plan participants, and as a participant, you can also contribute pre-tax dollars into your HSA. These funds can be used to pay for qualified covered medical and prescription drug expenses. Consumer Directed HealthSelect has the same provider network as HealthSelect of Texas. By using network providers, you receive a higher level of benefits and will also have access to in-network discounts which can lower out‐of‐pocket costs. When paying for qualified expenses, you can use funds in your HSA.
Choose a Plan
Plan Decision Tool • The Plan Decision Tool is
designed to help you decide which plan best meets your needs.
• The tool can be found on the HealthSelect website. Visit www.healthselectoftexas.com and click on HealthSelect Plans in the left-hand menu. Click on the Plan Decision Tool link and follow the prompts.
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If you’re not sure which plan is right for you and your family, the plan decision tool is designed to help you decide. The tool takes you through a series of questions to suggest the plan that might best fit your needs. The tool can be found on the HealthSelect website. Visit www.healthselectoftexas.com. Click on HealthSelect Plans in the left-hand menu, then click on the Plan Decision Tool link and follow the prompts once the tool opens.
Why Should I Select a PCP?
Your primary care provider: • Will get to know you - your health history,
your medications, your overall lifestyle
• Can treat many non-urgent health issues including ear infections, rashes, allergies, fevers, colds and flu
• Will coordinate your overall care including routine medical and preventive care
• Will manage referrals to specialists for HealthSelect of Texas participants
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If you are newly enrolled, or if you are already enrolled in a plan but haven’t selected a PCP, you may be wondering why it’s worthwhile to do so. Having a PCP is important, even if you rarely go to the doctor or get sick. Your PCP can be the single best resource for knowing and understanding your health. This includes knowledge of your personal health, your family history and risk factors, the medications you are taking and your overall lifestyle. He or she can make sure you’re getting the care you need and are up-to-date on any preventive screenings or immunizations. Your PCP also can treat many non-urgent health issues like colds and flus, rashes, allergies and respiratory infections. Also, the cost of seeing an in-network PCP can be significantly less than going to an urgent care facility or an emergency room. Seeing a PCP for health issues is one of your lowest cost options of care! Lastly, for HealthSelect of Texas participants, your PCP is responsible for managing referrals to specialists. If you need to see a specialist for care, your PCP must provide a referral in order to get in-network benefits for your specialist visit. If you don’t get a referral before you see a specialist, your services will be considered out-of-network and you will pay more, even if the provider is in your plan’s network. As a HealthSelect of Texas participant, you have 60 days from the effective date of your coverage to select a PCP. Once you make your PCP selection, all services must be coordinated through your PCP in order to receive in-network benefits. After 60 days, if you have not selected a PCP, out-of-network benefits will apply for any services you receive.
How to Select a PCP
Use Blue Access for MembersSM:
• Go online to www.healthselectoftexas.com
• Click “Log In” in the top right corner
• If you already have a Blue Access for Members account, log in using your username and password. Otherwise, register for Blue Access for Members following the instructions on the screen
• Once logged in, go to the “Doctors & Hospitals” tab and click “Find a Doctor or Hospital” to launch Provider Finder
Speak with a BCBSTX Personal Health Assistant:
• Call toll-free at (800) 252-8039, Monday–Friday, 7 a.m. - 7 p.m. and Saturday, 7 a.m. - 3 p.m. CT
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Presentation Notes
So, you may be asking, how do I select a PCP? There are two different ways you can select a PCP for yourself and your covered dependents. �You can choose a PCP online, go to www.healthselectoftexas.com and click on “Log In” in the top right corner. This will open the screen where you can access the Blue Access for MembersSM participant portal. If you already have a Blue Access for Members account, log in using your username and password. Otherwise, you can register following the instructions on the screen. Once you’re logged into your account, you will click the tab at the top titled “Doctors and Hospitals”. Then, you can click on “Select Primary Care Physician”. Another option for selecting or changing your PCP is to call a BCBSTX Personal Health Assistant, who can easily help you select and change your PCP. Call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039, Monday–Friday from 7 a.m. to 7 p.m., and Saturday from 7 a.m. to 3 p.m. CT for assistance.
Resources for You
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Now, we want to go over some important resources available to you. We will also discuss where you should go for any questions or additional information.
Custom Website
Website for HealthSelect participants • Find a provider
• Get plan information
• Use the plan decision tool to find the best plan for your needs
• Get the latest news and updates
• Learn about health and wellness resources
• Download forms and documents
www.healthselectoftexas.com
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The HealthSelect website should be your first stop for medical benefits and health and wellness information. It is dedicated to HealthSelect plans and has information specific to your coverage. On the HealthSelect website, you can find in-network doctors, hospitals and other providers by clicking on the “Find a Doctor, Lab or Hospital” button or on the “Find A Doctor/Hospital” tab. Remember, you get the highest level of benefits when you see an in-network provider, so this is an important resource to help your out-of-pocket costs as low as possible. For those of you who are new to the plan, or thinking about switching plans, the plan decision tool is a useful resource. The website includes HealthSelect plan benefits information, recent news and updates, a listing of the health and wellness resources available to you, and important forms and documents.
Educational Materials
• Visit the HealthSelect site for educational materials
• Make the most of your benefits with information about HealthSelectShoppERS, options for care and Virtual Visits
www.healthselectoftexas.com
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The HealthSelect website also has handouts that provide information on a variety of HealthSelect plan information. Most HealthSelect programs have fliers that can be downloaded from the website. If you are a participant looking for downloadable content, visit the Forms and Publications page. If you are an agency benefits coordinator looking for resources and content to share with employees throughout your agency or higher-education institution, there is a dedicated page on the HealthSelect website. This page includes links to additional fliers and resources. If you are a benefits or wellness coordinator and would like more information on how to access this page, please reach out to me after this presentation.
Participant Portal
www.healthselectoftexas.com
Blue Access for Members
• View your claims and download EOBs
• Find an in-network doctor, hospital or other provider
• Choose HealthSelectShoppERS rewards-eligible procedures and providers
• Change or select a primary care provider
• Check the costs of doctors and services covered under your plan
• Download a temporary ID card
• Confirm prior authorizations and referrals are in place
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Blue Access for Members is the online portal where you can log in to find information related to your medical coverage, claims, referrals and prior authorizations, primary care provider, and links to health and wellness programs. You can access the Blue Access for Members participant portal by going to www.healthselectoftexas.com and clicking on “Log In” at the top right-hand corner of the home page. You will need to have your medical ID card handy to register and create your personalized account. With Blue Access for Members and the BCBSTX App, (which we will cover on the next slide), your benefits are at your fingertips, wherever you are. Our online tools help you stay informed and better manage your health, wellness and benefits. Whether you connect at work or at home, using Blue Access for Members you can: check your claims status and download explanation of benefits (EOBs), find a doctor, hospital, or other provider in your HealthSelect plan’s network, shop for HealthSelectShoppERS rewards-eligible procedures, change or select a primary care provider for yourself and/or your covered dependents, check the costs of doctors and services covered under your plan, download a temporary ID card and view any referrals and prior authorizations you and/or your covered dependents have on file.
Mobile Access
BCBSTX App – Text BCBSTXAPP to 33633
See claims and EOBs Dashboard Live chat
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The BCBSTX App allows HealthSelect participants to find the most important participant information quickly and easily. You can use the app to check claims status, track deductibles and out-of-pocket maximums, view prior authorizations and referrals, and out-of-pocket spending. You can view your ID card and add it to Apple Wallet or Google Pay or email your ID card to providers. If you’re looking for a provider near you, the app uses GPS technology to locate doctors, hospitals or urgent care facilities close to you and in your plan’s network. � You can also take advantage of the live chat function to communicate with a BCBSTX Personal Health Assistant and get answers to your questions on claims, coverage, benefits and more. The BCBSTX app also is available in Spanish for both iPhone and Android users. Get the app by texting BCBSTXAPP to 33633 or visit Google Play or the Apple App Store and download to your phone.
Value-added Programs and Incentives
• Virtual Visits: Doctor On Demand® and MDLIVE®
• 24/7 Nurseline: Call a BCBSTX nurse toll-free at (800) 581-0368
• Weight management programs: Naturally Slim® and Real Appeal®
• Well onTarget®: Online portal to access programs and take the Health Assessment
• Blue PointsSM: Get rewarded for healthy activities
• Fitness Program: Nationwide network of fitness centers
www.healthselectoftexas.com
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As part of your HealthSelect plan’s benefits, there are a variety of value-added programs and incentives available to you and your covered dependents. Some highlights include: Virtual Visits: Medical Virtual Visits are a great option to save money and time when you can’t get to your doctor, when you are sick while traveling, or as an alternative to the emergency room or urgent care facility. You can consult a doctor anytime online or by phone. Doctors can provide treatment for variety of conditions like cold and flu, sore throat, and bronchitis. You also have access to mental health Virtual Visits, which are similar to an outpatient visit to a mental health provider’s office, but the visit is conducted online. Providers include licensed mental health professionals such as therapists, social workers, psychologists and psychiatrists. You must make appointments in advance – appointments are typically available within 5-7 days on average, but could take up to two weeks. You can choose from two Virtual Visit providers: Doctor On Demand and MDLIVE. To access Doctor on Demand, visit doctorondemand.com or call (800) 997-6196. To access MDLIVE, visit mdlive.com/healthselect or call (800) 700-5531. 24/7 Nurseline: Call a BCBSTX nurse toll-free at (800) 581-0368. You can call 24 hours a day, seven days a week to get answers to medical questions. Registered nurses can answer many of your general health questions, and advise you to call a doctor or encourage you to seek emergency services if necessary. Weight management programs: Participants enrolled in a HealthSelect plan have access to two weight management programs at no additional cost. Naturally Slim and Real Appeal are available to eligible employees, spouses and dependents 18 and older (excludes Medicare-eligible participants) enrolled in the HealthSelect of Texas or Consumer Directed HealthSelect plan, and with a BMI of 23 or higher. For Naturally Slim, visit naturallyslim.com/healthselect. For Real Appeal, visit healthselect.realappeal.com. You may apply to participate in either program. If you are approved to participate, HealthSelect will cover the cost of one of the programs, but will not cover your participation in both programs at the same time. Acceptance in either program is not guaranteed. Well onTarget: Well onTarget is an online wellness portal that offers personalized resources and incentives to support you on your wellness journey. Well onTarget offers the Health Assessment. It takes about 15 minutes to fill it out and will assist in identifying what you are doing well and where there are opportunities for improvement. You can take self-directed courses on topics such as losing weight, quitting tobacco and managing stress. To access Well onTarget, once you’re logged in to Blue Access for Members, click “Well onTarget” under Quick Links on the left. Blue Points: As part of Well onTarget®, you have access to Blue Points. With the Blue Points program, you can earn points each year when you complete self-management programs, coaching and use fitness trackers. As soon as you earn points, you can redeem them for fitness gear, wearables, camping equipment and more. You can spend up to 17,325 points each year for participating in healthy activities. Fitness Program: The Fitness Program is a flexible membership program that gives you unlimited access to a nationwide network of more than 10,000 fitness centers. And you can visit gyms while you’re on vacation or traveling for work. There are more program perks: You’ll have no long-term contract: Membership is month to month. After a one-time enrollment fee of $25, plus tax, per member, each member then pays $25, plus tax, per month. To join the Fitness Program just call the toll-free number (888) 762-BLUE (2583) Monday—Friday, 8 a.m. - 9 p.m. in any continental U.S. time zone.� For more information on all these programs, including how to access them, go to www.healthselectoftexas.com.
As we mentioned before, one of the most useful resources available to HealthSelect participants are our BCBSTX Personal Health Assistants. They can answer questions about your health coverage or benefits. You can call the number listed on the slide toll-free six days a week (Monday-Saturday). You can also reach out directly to ERS. If you have questions on how to enroll, you can contact ERS toll-free at (866) 399-6908 or enroll online at www.ers.texas.gov.
Disclosures
Under the Affordable Care Act, certain preventive and women’s health services are paid at 100% (at no cost to the participant) dependent upon physician billing and diagnosis. In some cases, the participant will still be responsible for payment on some services. Effective September 1, 2020, diagnostic mammograms are covered at no cost to the participant. Consumer Directed HealthSelect participants must meet their deductible and then pay 20% of the approved charges for diagnostic mammograms. Until the contract ends, Blue Cross and Blue Shield of Texas will continue to contract with Magellan Behavioral Health, Inc. (“Magellan”), an independent company administering BCBSTX managed mental health program. In the event of an emergency, Virtual Visits should not take the place of an emergency room or urgent care center. MDLIVE and Doctor On Demand doctors do not take the place of your primary care doctor. Internet/Wi-Fi connection is needed for computer access. Data charges may apply. Check your cellular data or internet service provider’s plan for details. Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only). Non-emergency medical service in Arkansas is limited to interactive audio/video (video only) for initial consultation. Service availability depends on location at the time of consultation. Medical Virtual Visits are subject to the terms and conditions of your benefit plan, including benefits, limitations, and exclusions. Mental health Virtual Visits are subject to the terms and conditions of your mental health office visit benefit of your plan, including benefits, limitations and exclusions. Claims for medications prescribed as part of mental health Virtual Visits are treated the same as those prescribed during a mental health office visit. The telemedicine services made available through Doctor On Demand are provided by licensed physicians practicing within a group of independently owned professional practices collectively known as “Doctor On Demand Professionals.” These professional practices provide services via the Doctor On Demand telehealth platform. Doctor On Demand, Inc. does not itself provide any physician, mental health or other healthcare provider services.
MDLIVE and Doctor On Demand operate subject to state regulations and may not be available in certain states. MDLIVE and Doctor On Demand are not insurance products nor prescription fulfillment warehouses. MDLIVE and Doctor On Demand do not guarantee that a prescription will be written. MDLIVE and Doctor On Demand do not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE and Doctor On Demand physicians reserve the right to deny care for potential misuse of services. MDLIVE is a separate company that operates and administers the Virtual Visits program for Blue Cross and Blue Shield of Texas. MDLIVE is solely responsible for its operations and for those of its contracted providers. MDLIVE® and the MDLIVE logo are registered trademarks of MDLIVE, Inc., and may not be used without written permission. Doctor on Demand is an independent company that operates and administers the Virtual Visit program for Blue Cross and Blue Shield of Texas. Doctor on Demand is solely responsible for its operations and for those of its contracted providers.
Disclosures
Naturally Slim and Real Appeal are independent companies that contract directly with ERS to provide wellness services for the HealthSelect of Texas and Consumer Directed HealthSelect plans. They are solely responsible for the products and services that they provide.
Blue Points Program Rules are subject to change without prior notice. See the Program Rules on the Well onTarget Member Wellness Portal at wellontarget.com for further information.
The Fitness Program is provided by Tivity HealthTM, an independent contractor that administers the Prime Network of fitness centers. The Prime Network is made up of independently owned and operated fitness centers.
Sapphire Digital is an independent company that administers the HealthSelectShoppERS program for Blue Cross and Blue Shield of Texas (BCBSTX). BCBSTX makes no endorsement, representation or warranty regarding Sapphire Digital’s administration of the HealthSelectShoppERS program. Information received through the HealthSelectShoppERS program is not meant to replace the advice of a health care professional, and decisions regarding the course and place of treatment remain with the member and his or her health care provider. Eligibility for rewards is subject to the terms and conditions of the HealthSelectShoppERS program. Active HealthSelect of Texas® , HealthSelectSM Out-of-State and Consumer Directed HealthSelectSM participants may be eligible for rewards. Consumer Directed HealthSelect participants are eligible for a limited purpose FSA that can only be used for eligible vision and dental expenses.
Blue Cross and Blue Shield of Texas is not the administrator of pharmacy benefits. Please contact your employer for information.
Blue Cross and Blue Shield of Texas is the third-party administrator for HealthSelect of Texas® and Consumer Directed HealthSelectSM.
Blue Cross®, Blue Shield® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans
Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
