Information about Life, Accident & Health, Home/Auto/Personal Property Insurance from ACE Insured.
For Individuals & Families
ACE provides individuals and families with products to insure your well-being as well as your assets. Our personal policies give you added peace of mind in facing life’s unexpected events. We offer a broad array of offerings directly to you or through sponsors in select regions of the world:
Accidental death insurance
Automobile insurance
Coverage for laptop computers, mobile phones and other small electronics
Identity theft protection
Income protection
Life insurance protection and savings products
Prescription drug
Recreational marine
Personal accident and sickness insurance to help pay expenses if income is lost as a result of an accident or illness
Supplemental medical insurance
Medicare supplemental insurance
Traditional life insurance protection and investment and savings products
Travel accident and vacation insurance
Residential products to cover your home and personal belongings including a house, apartment and/or condominium, and personal liability for property owners, landlords and tenants
Life Insurance
ACE Life helps individuals and families in Asia, Latin America, the Middle East and Europe plan for the future with personal life insurance products to meet your needs.
We offer a comprehensive range of traditional life insurance protection and savings and investment products designed to provide financial protection for you and your family.
Key products include:
Protection products including term life, whole life and specialized protection including credit life and accident
Savings and investment products including endowment, universal life and variable annuity
Riders including accidental death, accidental disability, dread disease, cancer and critical illness
ACE’s accident and health products are available through employers, affinity groups, sponsors such as banks, credit card companies, mobile network operators, utilities, travel providers/agents, universities and websites, as well as direct marketing and agents of Combined Insurance, our subsidiary that offers personal accident and sickness coverages.
Home/Auto/Personal Property Insurance
Whether it’s for your home, car, boat, or other valuables and personal possessions, ACE offers policies to protect what’s yours.
Homeowners Insurance
Our policies provide financial protection for the structure of your home as well as your personal possessions. Homeowners insurance also helps protect you from personal liability if someone is injured on your property.
Key coverages include the following:
Fire damage
Water damage
Theft
Debris removal
Storm damage
Personal accident
Living expenses if your home is uninhabitable
Automobile InsuranceNew or used, sporty or classic, our automobile policies offer protection from accidents, theft, and other mishaps.
Key coverages include the following:
Collision/damage to your own vehicle
Vandalism
Trip interruption
Liability
Coverage for military personnel
Theft
Medical expenses for occupants
Tourist policies
Towing expenses
Third party property damage
Boat Insurance and Other Personal Property InsuranceWhile a homeowners policy includes coverage for your valuables, you may also choose to insure your other precious possessions with the added protection and coverage on a worldwide basis for personal property such as:
Pleasure boats and yachts
Fine art, antiques, jewelry, and collectibles
Private aviation
Mobile Technology ProtectionMobile technology – including smart phones, laptops, PDAs, digital cameras, and MP3 players – are part of our daily lives. Replacing them if they are lost, stolen or damaged can be costly. ACE’s mobile technology insurance products cover the cost of replacing or repairing these devices against theft or damage with comprehensive protection and cover at home and abroad.
This general product description is informational only. It is neither an offer to sell nor a solicitation to purchase any particular insurance product. Coverages may not be available in all jurisdictions and may be available only through appropriately licensed brokers. Refer to the Licensing Information document for a chart of the jurisdictions in which each ACE Group subsidiary is licensed.
How Does the Program Work? Read our FAQ and Enjoy Happy Savings!
What is Blue365?
Blue365 is a program sponsored by participating local Blue Companies that helps you stay healthier, for less. Since 2007, Blue365 has offered discounts for members to save on products and services for a well balanced lifestyle. These “Blue365 Deals” can help you maintain a healthy lifestyle, while spending less at some of your favorite vendors nationwide.
Can anyone buy Blue365 deals?
Blue365 is currently available to members of participating Blue Companies, and we’re working to roll out the savings to even more Blue Companies’ members. Blue365 is also available to all members of the Federal Employee Program Service Benefit Plan across the USA. To find out if your BCBS Plan participates, go to www.Blue365Deals.com.
What kind of deals are available through Blue365?
Blue365 offers access to a wide range of savings from top health and wellness brands around the country plus some of your favorite local companies. You’ll see weekly “Featured Deals” and long term “Ongoing Deals” on healthy products, along with discounts on health and fitness clubs, weight-loss programs, healthy travel experiences and so much more.
How do I join Blue365?
It is very simple. Just go to www.Blue365Deals.com, enter your email and member number and register on the website. Now you are all set to enjoy our great health and wellness deals!
Does joining Blue365 cost money?
Blue365 is free to members of participating Blue Companies.
How do I find out about deals?
Blue365 makes it easy for you to find out about weekly Featured Deals by sending the news right to your email.
Here are a few general guidelines for enjoying Blue365 Deals: They’re not valid for cash back. They can’t be combined with other promotions. They must be used in one transaction. They don’t cover tax or gratuity.
For more details, please check the Terms of Use on Blue365’s website.
How do I buy a Blue365 Deal?
In one of two easy ways:
If you see a “Buy Now” button that means you’ll be able to purchase your deal directly on the Blue365 website. We’ll email a voucher right to your inbox, as soon as you purchase it.
If you see a “Redeem Now” button, you’ll be directed to a Blue365 vendor’s website, where you’ll find special savings offered only to Blue365 members. There, you’ll be able to get either a coupon code to use on that website or a printable coupon to redeem at a specified retail location.
Either way, you’ll get some of the best healthy savings around.
Which Blue Cross and/or Blue Shield Companies offer Blue365?
Twenty-three companies are currently participating in Blue365, with more coming aboard soon. Those in the program are:
Blue Cross and Blue Shield of Arizona
Florida Blue
Blue Cross and Blue Shield of Kansas
Blue Cross and Blue Shield of Kansas City
Blue Cross and Blue Shield of Louisiana
Blue Cross and Blue Shield of Massachusetts
Blue Cross Blue Shield of Michigan
Blue Cross and Blue Shield of Montana
Blue Cross and Blue Shield of Nebraska
Blue Cross and Blue Shield of North Carolina
Blue Cross & Blue Shield of Rhode Island
Blue Cross and Blue Shield of South Carolina
Blue Cross and Blue Shield of Vermont
Blue Cross of Northweastern Pennsylvania
Capital BlueCross
CareFirst BlueCross BlueShield
Excellus BlueCross BlueShield
Federal Employee Program
Highmark, Inc.
Highmark Blue Cross Blue Shield of Delaware
Horizon Blue Cross and Blue Shield of New Jersey
Independence Blue Cross
Wellmark Blue Cross and Blue Shield
Don’t worry if you don’t see your BCBS Plan isn’t participating yet. You can go to www.Blue365Deals.com to enter your email address and we will be sure to let you know when your BCBS Plan signs up!
Blue365 offers access to savings on items that Members may purchase directly from independent vendors, Vouchers and Coupons which can be used to obtain products and services from independent vendors, and other options to encourage healthy living, all of which are different from items that are covered under your policies with your independent, local Blue Company, its contracts with Medicare, or any other applicable federal healthcare program.
To find out what is covered under your personal Blue Company insurance policies, call your Blue Company. The products and services described on the Site are neither offered nor guaranteed under your Blue Company’s contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding your health insurance products and services may be subject to your Blue Company’s grievance process. BCBSA may receive payments from vendors providing products and services on or accessible through the Site. Neither BCBSA nor any Blue Company recommends, endorses, warrants, or guarantees any specific vendor, product or service available under or through the Blue365 Program or Site.
The Blues® Commitment in Fighting Childhood Obesity
Childhood obesity is a critical public health issue. As the prevalence of childhood obesity has tripled over the past 30 years, its impact on children's health risks has increased. Cases of type 2 diabetes has risen among children and adolescents who are obese. Although diabetes and glucose intolerance, a precursor of diabetes, are common health effects of adult obesity, only in recent years has type 2 diabetes begun to emerge as a health-related problem among children and adolescents.
Combating this troubling trend and improving the health of our children require concerted efforts by local neighborhoods, schools, families and physicians. The Blue Cross and Blue Shield Association (BCBSA) and the 38 independent, locally operated Blue Cross and Blue Shield companies recognize the urgent need to support these efforts and have established numerous programs to educate and empower children, as well as their families, teachers and physicians, toward healthy lifestyles. To read more about the Blues' support in fighting obesity and educating communities towards healthier lifestyles are the Blue Cross and Blue Shield Association program The Good Health Club and local programs outlined in Commitment to the Next Generation of Healthy Americans report.
For more than 80 years, the 38 independent Blue Cross and Blue Shield companies have made a difference in the lives of the communities they serve.
As community leaders, Blue Cross and Blue Shield companies provide knowledgeable leadership, funding and enthusiastic volunteers to local programs that improve the public’s health and wellness. The Blues invest and work in partnerships with schools, healthcare providers and charitable organizations to produce a wide range of programs that address issues with healthcare accessibility and affordability — such as dental health clinics, child and adult fitness programs, chronic disease management, maternal and infant care and more.
In 2010, the Blues collectively contributed more than $200 million in direct charitable giving to support such community investment programs nationwide. Through this work, and our service to more than 100 million the Blues are committed to better health and better healthcare value for our communities and for all Americans.
Learn more about our efforts by clicking on the reports below.
You can access all seven seasons of Second Opinion, the award-winning health education series which features panels of doctors, patients and related experts tackling real-life complex medical cases. The ground-breaking program lets viewers see first-hand, how doctors navigate their way through tough medical decisions. Sponsored by the Blue Cross and Blue Shield Association, the series aims to improve doctor-patient communication and empower viewers to take charge of their own healthcare.
Second Opinion Season Seven
In the new season, Dr. Peter Salgo leads the discussion on a range of new topics, including: celiac disease, bipolar disorder, multiple sclerosis, racial disparities in cardiac care, mammography, fecal incontinence, the HPV vaccine and cervical cancer, spinal cord injury, breast reconstruction, late effects of cancer treatment, heart replacement, vitamin D deficiency and dizziness. To see a preview of season seven, click on the YouTube video below.
You can also click on any of the links below to access full-length episodes of Second Opinion. For more information about Second Opinion, go to its official website.
Walking works — in a lot of ways. A brisk-paced walk can help you and your family look and feel better, increase energy and pick up your spirits.
Walking can work to improve your health, too. A regular routine of brisk-paced walking daily can help you lose weight, lower cholesterol, strengthen your heart and reduce the likelihood of serious health problems down the road. And with America spending more than ever on preventable health problems like heart disease, osteoporosis, type 2 diabetes, and conditions associated with obesity such as arthritis, every step counts.
While any increase in walking will help promote good health, the President's Council on Physical Fitness and Sports recommends 30 minutes a day, on five or more days a week, or 10,000 steps daily, to produce the best, long-term health benefits for most individuals. That is why Blue Cross and Blue Shield Plans have launched WalkingWorks.
WalkingWorks Basics
Before you start your walking program, the President's Council on Physical Fitness and Sports recommends following a few basic principles that will help keep you safe and comfortable:
If you have a health condition or have not done any regular physical activity for a long time (men over 40, women over 50), talk with your doctor before starting any new exercise program.
Choose comfortable, supportive shoes, such as running, walking, or cross training shoes, or light hiking boots.
If you're going for a longer walk, warm up with stretching exercises and include a cool-down period to reduce stress on your heart and muscles.
Maintain a brisk pace. You should work hard to keep up your pace but still be able to talk while walking.
Practice correct posture — head upright, arms bent at the elbow and swinging as you stride. Drink plenty of water before, during and after walking to cool working muscles and keep your body hydrated.
Starting the WalkingWorks Program
Your WalkingWorks Plan
To avoid injury, consider starting out slowly. Unless you are already walking a lot, it may take a while before you reach the 10,000 steps goal. Follow these steps to establish your individual goal and shape your program:
BASELINE. There are two ways to track your progress, either by tracking time or steps. If you are using a pedometer, count your steps for seven days; if you don't have a pedometer, follow the recommendations of the President's Council on Physical Fitness and Sports - begin with 30 minutes of brisk-paced walking at least five days each week. Keep a log to track the amount of daily walking activity you are currently doing. This will establish your baseline. Include all of your normal walking activities, such as walking up the stairs at home, walking to work, etc. At the end of each day, tally your total steps in the walking log. If you are not using a pedometer, keep track of the minutes you spend walking and apply the same principle with steps.
BENCHMARK. Your benchmark is the highest number of steps or minutes you walked on any given day while establishing your baseline the first week. Use that number as your daily goal for the second and third weeks. Log your daily walks, and at the end of the third week, review your log. If you averaged your goal, add another 500 steps or several more minutes to your daily goal for the fourth and fifth weeks.
BUILD. At the end of each 2-week period, try to add 500 steps or several more minutes to your walking goal. If you had difficulty reaching your goal, walk at the same level until you build enough endurance to increase your target. Continue to log your activity to prevent slipping back or dropping out. If you find yourself falling behind your average daily goal, try not to become discouraged. To maintain your motivation, keep logging your progress and stay with the same number of steps or minutes instead of increasing your target. Keep in mind that 10,000 steps may not be a realistic goal for everyone. If you are very overweight or have other chronic health problems, talk with your doctor to determine a goal that may be more appropriate.
Is 10,000 Steps Too Few for You?
For some people, 10,000 steps are too few to meet ultimate health or weight loss goals. For example, individuals who are already walking 7,000 or 8,000 steps per day may not get enough benefit from increasing to just 10,000. If this applies to you, ultimately aim to add a total of 7,600 steps to your current daily total, adding 500 steps every two weeks as indicated in the plan. You also can add hills, stairs, or arm weights to your routine, to make your walks more challenging.
WalkingWorks Log
Use this log to track your progress every day. Reward yourself as you make progress toward your goals. As you track your steps, take a few minutes each day to sit down and relax. Think about the good feelings that exercise gives you, and reflect on what you've accomplished. This type of internal reward can help you make a long-term commitment to regular exercise. Click here for a printer-ready copy of the WalkingWorks log.
Links to Health Organizations
For additional information on the benefits of walking and other health issues, please check out the following organizations.
Blue Distinction® is a designation awarded by the Blue Cross and Blue Shield companies to medical facilities that have demonstrated expertise in delivering quality healthcare.
The designation is based on rigorous, evidence-based, objective selection criteria established with input from expert physicians and medical organizations. Its goal is to help consumers find quality specialty care on a consistent basis, while enabling and encouraging healthcare professionals to improve the overall quality and delivery of care nationwide.
The criteria we use to select Blue Distinction Centers® are made available to the public. This allows both consumers and providers to understand what's behind this quality designation. Our goals are:
to encourage providers to improve the overall quality and delivery of healthcare, resulting in better overall outcomes for patients
to support consumers as they identify medical facilities that best meet their needs.
Learn more by viewing a short video clip on Blue Distinction.
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Blue Distinction Centers
At the core of the Blue Distinction program are the six Blue Distinction Centers for Specialty Care®, facilities that we recognize for their distinguished clinical care and processes.
Bariatric Surgery
Morbid obesity is widely recognized as a contributor to serious health risks. According to the Agency for Healthcare Research and Quality (AHRQ), between 1998 and 2004, the total number of bariatric weight-loss surgeries increased nine times, from 13,386 to 121,055. Blue Distinction® provides objective information to help patients make informed decisions when choosing a provider.
Blue Distinction Centers for Bariatric Surgery® have demonstrated their commitment to quality care, resulting in better overall outcomes for bariatric patients. Each facility meets stringent clinical criteria, developed in collaboration with expert physicians and medical organizations*, including the American Society for Metabolic and Bariatric Surgery (ASMBS), the Surgical Review Corporation (SRC) and the American College of Surgeons (ACS), and is subject to periodic re-evaluation as criteria continue to evolve.
Blue Distinction Centers for Bariatric Surgery provide a full range of bariatric surgery care services, including inpatient care, post-operative care, outpatient follow-up care and patient education. To date, The Blues' have designated approximately 350 Blue Distinction Centers for Bariatric Surgery across the country.
To view the list of Blue Distinction Centers for Bariatric Surgery, please click on the link to launch a PDF. You will need Adobe Acrobat Reader® to view the document. If you do not have Acrobat, please click here to download it for free.
Cardiac Care
The American Heart Association estimates that 1.2 million Americans will experience a first or recurrent heart attack each year. When it is you or someone you care about that is in need of heart care, you want to find a facility you can trust.
Blue Distinction Centers for Cardiac Care® have demonstrated their commitment to quality care, resulting in better overall outcomes for cardiac patients. Each facility meets stringent clinical criteria, developed in collaboration with expert physicians' and medical organizations' recommendations*, including the American College of Cardiology (ACC) and the Society of Thoracic Surgeons (STS), and is subject to periodic reevaluation as criteria continue to evolve.
Blue Distinction Centers for Cardiac Care provide a full range of cardiac care services, including inpatient cardiac care, cardiac rehabilitation, cardiac catheterization and cardiac surgery (including coronary artery bypass graft surgery).** To date, we have designated approximately 500 Blue Distinction Centers for Cardiac Care across the country.
To view the list of Blue Distinction Centers for Cardiac Care, please click on the link to launch a PDF. You will need Adobe Acrobat Reader® to view the document. If you do not have Acrobat, please click here to download it for free.
if you are a physician or hospital administrator interested in learning more or applying for the 2012 Blue Distinction Centers for Cardiac Care designation for your medical facility, please visit Blue Distinction for Providers.
Some Blue Cross and Blue Shield companies may already participate in local cardiac care programs. The Blue Distinction Centers for Cardiac Care program neither disrupts nor replaces the Plans' own existing programs.
*These organizations have provided information and input, but do not formally endorse the Blue Distinction Centers® program.
** At the discretion of the local BCBS Plan and under a specified contingency process, a facility that provides the full range of cardiac services but does not provide on-site coronary artery bypass graft (CABG) surgery may be considered for Blue Distinction designation if it is part of a cooperative system with a qualifying facility that provides emergency backup CABG for percutaneous coronary intervention (PCI) and meets our contingency criteria. Blue Distinction Centers for Cardiac Care without on-site CABG will be differentiated from full-service Blue Distinction Centers for Cardiac Care in program listings.
Complex and Rare Cancers
Complex and rare cancers comprise approximately 15 percent of new cancer cases each year. Blue Distinction Centers for Complex and Rare Cancers® are the first in a line of anticipated Blue Distinction Centers® focused on cancer treatment.
This initial phase evaluates facilities on patient assessment, treatment planning, complex inpatient care and major surgical treatments for adults; all delivered by teams with distinguished expertise and subspecialty training for complex and rare cancers. The program focuses on the following 13 cancers:
Bladder cancer
Brain cancer – primary
Esophageal cancer
Gastric cancer
Liver cancer – primary
Pancreatic cancer
Rectal cancer
Acute leukemia (inpatient, non-surgical)
Bone cancer – primary
Head and neck cancers
Ocular melanoma
Soft tissue sarcoma
Thyroid cancer – medullary or anaplastic
To date, approximately 90 of the nation's cancer facilities have been designated as Blue Distinction Centers for Complex and Rare Cancers.
To view the list of Blue Distinction Centers for Complex and Rare Cancers, please click on the link to launch a PDF. You will need Adobe Acrobat Reader® to view the document. If you do not have Acrobat, please click here to download it for free.
Additional Resources
Blue Distinction Centers for Complex and Rare Cancers were developed in strategic collaboration with the National Comprehensive Cancer Network (NCCN).** View a complete listing of NCCN member institutions.
Click here for additional resources regarding complex and rare cancers.
The Blue Cross and Blue Shield System recognizes that the majority of patients' multidisciplinary treatment may be best accomplished by integrating the expertise available in a Blue Distinction Center with locally available treatment resources, especially for outpatient chemotherapy and radiotherapy, based on individual circumstances and patient preference. Optimal support of a patient's comprehensive cancer care needs may be achieved by coordination of care between the patient and their family, local physicians, the Blue Distinction Center and their local Blue Cross and Blue Shield company.
Some Blue Cross and Blue Shield companies may already participate in local cancer care programs. The new Blue Distinction Centers for Complex and Rare Cancers program neither disrupts nor replaces the Blue Companies' own existing programs.
* Specific subtypes of complex and rare cancers for which each facility met our selection criteria are identified alongside its name but are not intended as a comprehensive list of all cancer care services that the facility may offer.
**This organization has provided information and input, but does not formally endorse the Blue Distinction Centers® program.
Knee and Hip Replacement
If your joints have suffered damage from arthritis or injury, you may find it difficult to complete everyday activities such as walking or climbing stairs. Whether you're exploring treatment options with your doctor or have already decided to have knee or hip replacement surgery, Blue Distinction® can help by identifying medical facilities that have demonstrated a commitment to providing quality care and better overall outcomes for knee and hip replacement procedures.
Blue Distinction Centers for Knee and Hip Replacement® demonstrate an expertise in quality care, resulting in better overall outcomes for patients, by meeting objective clinical measures developed with input from expert physicians and medical organizations. To date, we have designated approximately 540 facilities nationwide as Blue Distinction Centers for Knee and Hip Replacement.
Blue Distinction Centers for Knee and Hip Replacement provide comprehensive inpatient knee and hip replacement services, including total knee replacement and total hip replacement surgeries. Find a Blue Distinction Center for Knee and Hip Replacement near you:
You will need Adobe Acrobat Reader® to view the List of Blue Distinction Centers Knee for and Hip Replacement document. If you do not have Acrobat, please click here to download it for free.
Expert panelists contributed to BCBSA's development of the Blue Distinction Centers for Knee and Hip Replacement by providing professional advice in connection with proposed selection criteria, request for information survey questions, and related features for this Blue Distinction Centers Program. Expert Panel Roster
If you are a physician or hospital administrator interested in learning more or applying for the 2012 Blue Distinction Centers for Knee and Hip Replacement designation for your medical facility, please click here.
Spine Surgery
Studies confirm that as many as eight out of 10 Americans suffer from some sort of back pain. Many treatment options for back pain may be appropriate, at the recommendation and guidance of your doctor. For those with severe and/or chronic pain, spine surgery may be a treatment option. If you or someone you care about is in need of spine surgery, look to medical facilities you can trust – look to Blue Distinction Centers®.
Blue Distinction Centers for Spine Surgery® have demonstrated their commitment to quality care, resulting in better overall outcomes for spine surgery patients. Each Blue Distinction® facility meets objective clinical measures that are developed with input from expert physicians' and medical organizations' recommendations. To date, we have designated approximately 310 facilities across the country as Blue Distinction Centers for Spine Surgery.
Blue Distinction Centers for Spine Surgery provide comprehensive inpatient spine surgery services, including discectomy, fusion and decompression procedures.
Expert panelists contributed to BCBSA's development of the Blue Distinction Centers for Spine Surgery by providing professional advice in connection with proposed selection criteria, request for information survey questions, and related features for this Blue Distinction Centers Program.
If you are a physician or hospital administrator interested in learning more or applying for the 2012 Blue Distinction Centers for Spine Surgery designation for your medical facility, please click here.
Transplants
More than 100,000 people in the United States were registered for organ donations from one of the nation's 800+ transplant programs.* The Blue Distinction Centers for Transplants® program can help you find the transplant program that meets your needs.
Blue Distinction Centers for Transplants have demonstrated their commitment to quality care, resulting in better overall outcomes for transplant patients. Each facility meets stringent clinical criteria, established in collaboration with expert physicians' and medical organizations' recommendations**, including the Center for International Blood and Marrow Transplant Research (CIBMTR), the Scientific Registry of Transplant Recipients (SRTR) and the Foundation for the Accreditation of Cellular Therapy (FACT), and is subject to periodic re-evaluation as criteria continue to evolve.
Blue Distinction Centers for Transplants provide a range of services for transplant, including:
heart
lung (single or bilateral)
liver (deceased and living donor)
simultaneous pancreas kidney (SPK)
pancreas (PAK/PTA)
bone marrow/stem cell (autologous and allogeneic)
To date, approximately 100 Blue Distinction Centers for Transplants have been designated, representing more than 400 specific transplant programs across the country.
To view the list of Blue Distinction Centers for Transplants, please click on the link to launch a PDF. You will need Adobe Acrobat Reader® to view the document. If you do not have Acrobat, please click here to download it for free.
More Information
Additional resources and facts about transplant services, including sources of potential financial assistance and a directory of available patient advocates and education are available.
* Source: The Organ Procurement and Transplantation Network (OPTN), the unified transplant network established by the United States Congress under the National Organ Transplant Act (NOTA) of 1984. Visit www.optn.org to learn more.
** These organizations have provided information and input, but do not formally endorse the Blue Distinction Centers® program.
For Hospitals or Physicians
If you are a physician or hospital administrator interested in learning more or applying for the Blue Distinction designation for your medical facility, please click here. Note: Designation as Blue Distinction Centers means these facilities' overall experience and aggregate data met objective criteria established in collaboration with expert clinicians' and leading professional organizations' recommendations. Individual outcomes may vary. To find out which services are covered under your policy at any facilities, please call your local Blue Cross and/or Blue Shield Plan; and call your provider before making an appointment, to verify the most current information on its Network participation and Blue Distinction status. Neither Blue Cross and Blue Shield Association nor any of its Licensees are responsible for any damages, losses, or non-covered charges that may result from using this website or receiving care from a provider listed in this website.
Health Equity - Closing the Gap
The Blue Cross and Blue Shield Association (BCBSA) and the 38 Blue Cross and Blue Shield (BCBS) companies, encourage care delivery that is safe, effective and equitable. To reach this goal, it is important to identify and address issues that prevent consumers from receiving the best care possible.
However, research shows that disparities do exist among minority groups within the population. These gaps in quality of care or health outcomes observed when comparing different populations are referred to as healthcare disparities.
According to the Agency for Healthcare Research and Quality (AHRQ) 2011 National Healthcare Disparities Report, data indicate that racial and ethnic minorities populations, on average, receive poorer healthcare and suffer higher rates of avoidable complications (e.g., late stage cancers, amputations, healthcare-associated infections) compared to non-minorities populations. According to the report:
Black women are more likely to die in childbirth or be diagnosed with advanced stage breast cancer compared to White women.
Asians are less likely than Whites to have a primary care doctor and those age 65 and over are also less likely to receive recommended pneumococcal vaccinations.
Hispanics are less likely to receive recommended diabetes care, heart failure inpatient care and timely emergency care compared to non-Hispanics.
American Indians and Alaskan Natives are less likely than Whites to receive recommended colorectal cancer screenings.
Collectively, Blue Cross and Blue Shield companies provide coverage for 100 million individuals and are working to meet the needs of the nation’s increasingly diverse population. Additionally, the Blue System supports the goals of the Department of Health and Human Services (HHS) National Stakeholder Strategy for Achieving Health Equity, which promotes raising awareness, strengthening leadership, focusing on outcomes, promoting cultural competency and utilizing data to help reduce healthcare disparities. See what the Blues are doing to address healthcare disparities in their local communities.
The Blue Cross and Blue Shield Association and its 38 independent, locally based companies envision a transformed healthcare system that provides people with the best, most affordable care possible.
Building Tomorrow's Healthcare System
The Blue Cross and Blue Shield System is working to help our customers stay healthy and ensure that, when they do get sick, healthcare is safe, coordinated, evidence-based and affordable. To achieve these goals on a larger scale, we propose a comprehensive action plan with specific recommendations that the government should take to:
Reward Safety: National and local leadership along with new provider incentives are needed to eliminate preventable medical errors, infections and complications that cause tens of thousands of people to die each year.
Do What Works: The incentives in our system must be changed to advance the best possible care and reward quality outcomes, instead of paying for more services that are ineffective or redundant and add unnecessary costs to the system.
Reinforce Front-Line Care: A higher value must be placed on primary care and on ensuring there is an adequate workforce of professionals to deliver necessary, timely and coordinated care that results in better outcomes and lower costs.
Inspire Healthy Living: With 75 percent of today’s healthcare dollar spent on the treatment of chronic illnesses — many of which are preventable — consumers must be empowered and encouraged to make better choices, live healthier lives and better manage their health.
Healthcare Reform Timeline
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This document provides representative examples, but is not exhaustive of what the 38 independent Blue Cross and Blue Shield companies are doing to help transform the U.S. healthcare system. As leaders in the healthcare community for more than 80 years, serving all 50 states and federal territories and offering coverage in every market and every ZIP code, we are committed to collaborating with all stakeholders — consumers, hospitals, physicians, payers and policymakers — to build tomorrow’s healthcare system today.
Blue Cross and Blue Shield companies are committed to working with the Administration and all other parties to implement this new law. As we have done throughout our 80-year history, we will continue to work in our local communities in every ZIP code to serve the more than 100 million Blue Cross and Blue Shield members worldwide.
Common Questions and Answers for Individuals
As we continue to analyze the new healthcare law, we have prepared these frequently asked questions to help Blue Cross and Blue Shield members better understand what healthcare reform will mean to them. These answers are meant to provide guidance. You should consult legal and tax experts to understand how the law will affect your individual or business circumstances.
I currently have health insurance coverage through a Blue Cross and Blue Shield Plan, do I need to do anything now?
No. The new law will be implemented over the next several years. Blue Cross and Blue Shield companies will continue to provide excellent service and will work to implement the new healthcare laws to best serve their members. The 38 independent Blue Cross and Blue Shield companies are reviewing the legislation and any potential impact on our members. We will also be working to ensure a smooth transition with state and federal regulators who will be drafting the required regulations.
When will these new reforms become effective?
In 2014 - Individuals and small businesses will be able to purchase coverage through state-based exchanges. Consumers will be able to purchase health insurance regardless of health status and premiums cannot vary because of health status. Individuals will be required to purchase health insurance or pay a penalty. Subsidies will be available on a sliding scale to help individuals or families with incomes up to 400 percent of the federal poverty level to purchase insurance through new state-based exchanges.
Will insurers have to cover everyone regardless of their health status?
Yes. Blue Cross and Blue Shield companies have long supported guaranteeing that everyone could purchase health insurance coverage regardless of their health condition coupled with a requirement for everyone to obtain and maintain coverage. Beginning in 2014, the new law requires that all individuals have coverage and insurers must offer coverage to anyone regardless of health status and cannot vary premiums based on health status.
How will health reform affect my premiums?
There are a number of factors that are driving health insurance premiums. Increasing utilization attributable to an aging population, obesity and chronic illnesses; new treatments; prescription drugs and expensive new technologies are the biggest causes of increasing healthcare premiums. The new law establishes a few pilot programs, but does not aggressively attempt to control rising healthcare costs. We believe that premiums will increase as a result of provisions in the reform legislation that will guarantee richer levels of benefits than most consumers who obtain their own insurance purchase today. Insufficient discounts for the young and healthy will encourage many of them to forgo coverage. New fees and taxes mandated by the new law will also likely increase the cost of premiums as they are phased in. Blue Cross and Blue Shield companies will continue to work with doctors, hospitals, employers and consumers to rein-in costs and insurance premiums while improving access to quality healthcare. In doing this, many of the Blue Cross and Blue Shield companies have initiatives to reduce unnecessary hospital readmissions, eliminate infections acquired during hospital visits and promote paying doctors and hospitals for quality outcomes to help achieve this goal.
I am currently uninsured. How will I obtain coverage in the future?
Many Blue Cross and Blue Shield companies already offer low-cost health insurance options that you may be able to enroll in today. You can find coverage options through your local Blue Cross and Blue Shield company. Beginning in 2014, state health insurance exchanges will enable consumers to compare benefits, prices and networks of providers and purchase coverage. Prior to the establishment of state exchanges in 2014, a temporary high risk pool program will be created by the federal government to provide coverage to high-risk individuals who have not been covered during the prior 6-month period or do not have access to coverage, to purchase coverage. A majority of states already have high-risk pools for their residents.
I am graduating from college this year. Will I be able to obtain coverage under my parents’ health plan?
As of Sept. 23, 2010, the law allows dependents up to age 26 to obtain coverage under their parents’ plans that offer dependent coverage. In April 2010, the 38 independent Blue Cross and Blue Shield companies offered to voluntarily extend coverage in their group and individually insured health plans to allow young adults to remain on their parents’ policies.
What if I can't afford to purchase coverage?
Blue Cross and Blue Shield companies offer many different options, including many that are much more affordable than many people realize. Talk with your local Blue Cross and Blue Shield company about options that could fit your needs. AskBlue or use our guide to find health care coverage options near you. Consumers who purchase coverage on their own may qualify for federal subsidies to help offset higher premiums beginning in 2014. Federal agencies must work out how subsidies would be paid. The Congressional Budget Office estimates that about 20 million American households will be eligible for subsidies. In addition, eligibility in Medicaid, the federal-state program that provides health coverage to millions of Americans, will expand to cover families with incomes up to 133 percent of the federal poverty level. If you are looking to purchase individual health insurance coverage, enter your ZIP code here: AskBlue.
Common Questions and Answers for Employers
Looking to find answers to your billing, claim forms, and other questions? Use our frequently asked questions to find answers.
My Coverage
I am a member but I do not see where I can log in on this website. Where do I find access to my member benefits, coverage, etc?
Bcbs.com is the Blue Cross and Blue Shield Association website. The Blue Cross and Blue Shield Association does not have access to member information. We regulate the brand and licenses to all 38 Blue Cross and Blue Shield local companies. To access specific information about your coverage, EOBs, prescriptions, paying a bill, or any other questions related to your individual or group health insurance, please contact the customer service number on the back of your member card. Otherwise you may enter your 3-letter member ID number here on our Company Finder.
I was denied coverage, a claim, or received erroneous charged on my EOB, whom do I contact?
To access specific information about your coverage and claims related to your individual or group health insurance, please contact the customer service number on the back of your member card. Otherwise you may enter your 3-letter member ID number here on our Company Finder. Bcbs.com does not maintain member information.
How can I get maximum coverage for my claims or benefits?
To receive maximum coverage for your claims and benefits, there are steps you can take prior to seeing your healthcare provider.
Check with your provider to ensure they are accepting Blue Cross Blue Shield insurance.
If possible, call your local Blue Cross and Blue Shield company customer service prior to seeing your provider and ask if the service and/or provider is covered under your benefit plan.
Ask what your coverage benefits are. For example, your PPO in-network provider benefits may be 80% compared to 20% of out-of-network provider benefits.
For HMO coverage, please see your primary care provider before seeing a specialist.
Call customer service or log on to your local Blue Cross and Blue Shield company website and see what your out of pocket limit is as well as your remaining out-of-pocket balance. You will not receive maximum benefits until your deductible, out-of-pocket maximum, and any other benefit plan restrictions are met.
If admitted to a hospital, call your local Blue Cross and Blue Shield company at the customer service number on the back of your card to register for hospital admittance. If it is an emergency, go to the emergency room first to get treated, then contact your local Blue Cross and Blue Shield company to see what procedures and/or stays are allowed for the illness/treatment.
If possible, request generic prescriptions to save on costs.
If you have Medicare and/or a Blue Cross and Blue Shield Medicare suppliment product, make sure your provider accepts Medicare patients. If so make sure your provider contacts Medicare and your Blue Cross Blue Shield company first to verify if the service, device, or admittance to a hospital/care facility are covered. For further information on Medicare, please go to the Medicare.gov website, use our AskBlue Medicare tool, or see a listing of participating Medicare Advantage and Prescription Blue Cross and Blue Shield companies
Claims and Billing
Whom do I contact when I have a billing questions, get claim forms or talk to if a claim has been rejected?
Contact your local Blue Cross and Blue Shield company for details regarding billing.
Not sure which Blue company you belong to? Enter your zip code here to use our Plan Finder. Be sure to have your account number, paperwork and any important information such as dates or doctor references handy when you call.
Where do I file a claim for medical care received outside the United States?
For hospitalization arranged by the BlueCard Worldwide Service Center, the provider will file the claim for you.
For outpatient and professional services and hospitalizations not arranged by the Service Center, you will have to pay the provider and then send a completed BlueCard Worldwide claim form with original invoices to the BlueCard Worldwide Service Center. The claim form with filing address and instructions can be found here.
Purchasing Insurance
How can I get information on purchasing health insurance?
Click here for information on obtaining health insurance coverage for yourself, your family or a group. You may also use our AskBlue tools to find out more information on individual health insurance, Medicare, or questions about healthcare reform and how it may impact you.
How can I find out information about coverage that is supplemental to Medicare?
There are lots of Medicare choices, including Medicare+Choice, medical savings accounts and private fee-for-service plans. For plans available to you, use our AskBlue Medicare guide. You can also view a listing of Blue Cross and Blue Shield companies who participate in Medicare Advantage and Prescription Drug choices. Contact your local BlueCross and Blue Shield representative for details regarding claims or coverage. Not sure which Blue company you belong to? You can find out by typing your home or work ZIP code in our Plan Finder.
Doctors, Hospitals and Specialties
What is a Primary Care Physician (PCP)?
A physician or other medical professional who serves as a group member's first contact with a company's health care system. Also known as a primary care provider, personal care physician or personal care provider.
What is a Provider?
A provider is a hospital, health care facility, physician or other medical professional that provides health care services.
Do all family members have to select the same Primary Care Physician (PCP)?
How often is your BlueCard Doctor and Hospital Finder updated?
Each one of our Blue Cross and Blue Shield independent licensees (our member companies) collect and provide information for our PPO finder via different timetables and methods. While we make every effort to keep the Provider Finder "up-to-date," it is always best to confirm any provider information you select from this utility with your local Blue Cross and Blue Shield representatives.
Where can I get a list of hospitals and doctors outside the United States?
You can search for hospitals and doctors worldwide by going here.
How often is the international hospital and doctor information updated?
The information is updated as soon as new information becomes available from our local Blue Cross and Blue Shield companies.
Who do I call if I need to access a provider outside the United States?
If you need to access a provider outside the United States, you can call the BlueCard Worldwide Service Center at 1.800.810.BLUE or collect at 804.673.1177 for information on hospitals and doctors or you can use this web site to locate providers.
If you are hospitalized you must call the Service Center in order for them to arrange cash-less access with the hospital.
In an emergency, go to the nearest hospital and then call the BlueCard Worldwide Service Center if you are hospitalized. Contact your Blue Cross and Blue Shield company located on the back of your insurance card for pre-authorization, if necessary.
I'm a doctor. Who do I talk to about providing health care services through Blue Cross and Blue Shield programs?
A Preferred Provider Organization (PPO) is an arrangement designed to supply health care services at a discounted cost by providing incentives for members to use designated health providers (who contract with the PPO at a discount), but which also provides coverage for services rendered by health care providers who are not part of the PPO network.
What is an HMO?
HMO stands for Health Maintenance Organization, a health care system that assumes or shares both the financial risks and the delivery risks associated with providing comprehensive medical services to a voluntarily enrolled population in a particular geographic area, usually in return for a fixed, prepaid fee.
For more insurance terms and definitions, please see our Glossary.
I will be working in another country via my employer. How can I maintain coverage?
BlueWorldwide Expat is a comprehensive system of global medical coverage for active employees and their dependents spending more than six months outside the United States.
What is the BlueCard Worldwide® program?
The BlueCard Worldwide program provides Blue Cross and Blue Shield eligible members with access to a network of hospitals and doctors and assistance in obtaining medical care worldwide.
Are you looking for a comprehensive coverage health insurance plan that you can customize to suit your needs and budget? If so, one of our Series V Products is right for you. These health insurance plans offer you a comprehensive package of benefits to meet your needs now and in the future.
Our Series V Products include:
PPO Select® Blue Advantage Series V (policy form # PPO-SELBLUE-ADV-5-1),
PPO Select® Choice Series V (policy form # PPO-SELCHOICE-5-1) and
PPO Select® Saver Series V (policy form # PPO-SELSAVER-5-1).
Key coverage and health insurance plan features include:
Inpatient hospitalization services
Medical and surgical expenses
Preventive care, such as routine physicals, immunizations, diagnostic tests and more
Three-tier prescription drug program
24-Hour Worldwide Care
100% coverage in or out of network for childhood immunizations up to age 8.
Access to one of the largest provider networks in Texas, BlueChoice®
BlueChoice® Network: The BlueChoice® network allows you to save on premiums and the cost of covered services when you use a contracting BlueChoice® hospital, doctor or specialist. You do not need to select a primary care physician or obtain a referral to see a specialist.
A Series V health insurance plan may be right for you if you are an individual or family who:
Seeks coverage comparable to that of an employer
Seeks the flexibility to meet your individual needs, family situation and budget, not a “pre-packaged, one-size-fits-all” health insurance plan
Wants a choice of deductibles and coinsurance maximum levels to help control premium costs
Regularly visits a doctor
Needs coverage for prescription medication
We offer three Series V Products that provide different levels of out-of-pocket expense limits, deductibles, coinsurance and network coverage to allow you to select the health insurance plan that best meets your budget. Compare the coverage to find the one that's right for you.
For more information on costs, including out-of-pocket costs, see the Outline of Coverage documents under What's Included with Series V Products — More Health Insurance Plan Details.
* Represents estimated cost range for in-network coverage only. Out-of-network coverage costs can be significantly higher. Your greatest coverage and savings are realized when you use the services of participating providers within the network.
Series V Products pays 75–85 percent and you pay 15–25 percent of covered expenses, after you meet your deductible
Doctor's office visits covered 75–100 percent after $25 copayment or deductible, depending on the health insurance plan you choose
Easy claims processing—no forms to file in most cases
BlueCard® PPO benefits
More Health Insurance Plan Details
It's important to know the features of the health insurance plan you are considering. Our Outline of Coverage documents give you brief descriptions of the basic details of our Series V Products, as well as details on renewability, exclusions and limitations.
You can customize any Series V health insurance plan with the following option: Optional Dental Coverage
Coverage can be used to provide dental benefits to an individual, spouse, children or any combination of dependents.
A $50 deductible, based on fee schedule allowances, applies for dental procedures or services received by a covered individual during each benefit year.
Maximum deductible amount of $150 for family coverage
Prescription drug coverage is included with Series V Products.
Copayments for prescription drugs vary based on the health insurance plan options you choose.
If you take medications for birth control, high blood pressure, cholesterol or other long-term needs, you can also receive up to a 90-day supply at retail. In some cases, you'll pay less for the same amount of medication than at a retail pharmacy.
View the individual health insurance plan Preferred Drug List to see if your prescriptions are included.
Prescription Drug Utilization/Benefit Management Programs for policies with effective dates on or after 3/1/2012. See Compare Plans Chart for more information.
Policy form # PPO-BLUEEDGE-INDL-HSA-3-1
Are you looking for the kind of health insurance plan that gives you more control? If so, BlueEdgeSM Individual HSA may be right for you. This health savings account (HSA) health insurance plan enables you to decide how, when and where your health care dollars are spent. A high deductible affords you low monthly premiums, plus you gain tax advantages.*
BlueEdgeSM Individual HSA Coverage Overview
This health insurance product provides cost-sharing health coverage for inpatient settings with the freedom to choose your hospitals. Other key coverage and health insurance plan features include:
Medical services and surgical expenses
Accident and emergency care
100% Preventive Care for adults and children
100% coverage in or out of network for childhood immunizations up to age 6
Three-tier prescription drug program
An HSA, high deductible health insurance plan may be right for you if you:
Want affordable premiums and need a wide range of benefits
Don’t expect to have a lot of medical expenses
Have money saved just in case you have to pay unexpected out-of-pocket health care expenses
Are looking for more control over your health care choices
BlueChoice® network: You can save money on the cost of covered services when you use a participating network hospital, doctor or specialist.
* A Health Savings Accounts (HSA) has tax and legal ramifications. Blue Cross and Blue Shield of Texas does not provide legal or tax advice, and nothing herein should be construed as legal or tax advice. These materials, and any tax-related statements in them, are not intended or written to be used, and cannot be used or relied on, for the purpose of avoiding tax penalties. Tax-related statements, if any, may have been written in connection with the promotion or marketing of the transaction(s) or matter(s) addressed by these materials. You should seek advice based on your particular circumstances from an independent tax advisor regarding the tax consequences of specific health insurance plans or products.
BlueEdgeSM Individual HSA provides different levels of out-of-pocket expense limits, deductibles and coinsurance to allow you to select the plan that best meets your budget. With BlueEdgeSM Individual HSA, here’s what you can expect:
PPO benefits begin after you meet the deductible
Coinsurance level determined by health insurance plan selection
Individual deductibles ranging from $1,200 to $5,000*
Individual maximum out-of-pocket expenses ranging from $3,000 to $5,000*
Family deductibles ranging from $2,400 to $10,000*
Family maximum out-of-pocket expenses ranging from $6,000-$10,000*
Copayments ranging from 75–100 percent of allowable amount after calendar year deductible for office visits (doctor consultation only) and emergency care
Coinsurance — you pay 0–25 percent of allowable amount and the health insurance plan pays 75–100 percent of allowable amount*
View the plan's Outline of Coverage, which provides brief descriptions of the basic provisions of BlueEdgeSM Individual HSA, including costs and out-of-pocket expenses.
* These cost ranges represent in-network coverage only. Out-of-network coverage costs can be significantly higher. Your greatest coverage and savings are realized when you use the services of participating providers within the network.
BlueEdgeSM Individual HSA pays 75–100 percent of allowable amount and you pay 0–25 percent of allowable amount for covered expenses after you meet your deductible (in-network).
In-network doctor's office visits for routine physicals, immunizations and diagnostic tests are covered at 75–100 percent of the allowable amount, subject to deductible.
Easy claims processing—no forms to file in most cases
Emergency room visits are covered at 75–100 percent of allowable amount after calendar year deductible and coinsurance.
The tax-favored advantages that come with a Health Savings Account*
Access to online decision tools to help increase your knowledge of health issues and track your health care expenses
More Health Insurance Plan Details
It’s important to know the features of the health plan you are considering. Our Outline of Coverage document gives you brief descriptions of the basic details of our BlueEdgeSM Individual HSA health insurance plan, as well as details on renewability, exclusions and limitations.
* Health Savings Accounts (HSAs) have tax and legal ramifications. Blue Cross and Blue Shield of Texas does not provide legal or tax advice, and nothing herein should be construed as legal or tax advice. These materials, and any tax-related statements in them, are not intended or written to be used, and cannot be used or relied on, for the purpose of avoiding tax penalties. Tax-related statements, if any, may have been written in connection with the promotion or marketing of the transaction(s) or matter(s) addressed by these materials. You should seek advice based on your particular circumstances from an independent tax advisor regarding the tax consequences of specific health insurance plans or products.
You can customize any Series V health insurance plan with the following option:Optional Dental Coverage
Coverage can be used to provide dental benefits to an individual, spouse, children or any combination of dependents.
A $50 deductible, based on fee schedule allowances, applies for dental procedures or services received by a covered individual during each benefit year.
Maximum deductible amount of $150 for family coverage
Prescription drug coverage is included with this plan.
Copayments for prescription drugs vary based on plan options you choose.
If you take medications for birth control, high blood pressure, cholesterol or other long-term needs, you can also receive up to a 90-day supply at retail. In some cases, you'll pay less for the same amount of medication than at a retail pharmacy.
Prescription Drug Utilization/Benefit Management Programs for policies with effective dates on or after 3/1/2012. See Compare Plans Chart for more information.
Open enrollment is now closed for this product. The next open enrollment period is scheduled for May 1 through June 30 (5/1/2013 – 6/30/2013).
Our children's health insurance plan, Blue Pathway, provides coverage for individuals ages 1 through 18 and includes:
Benefits for preventive care services
Diagnostic testing
Hospital services
Emergency care
Prescription drug coverage
Physical, occupational and speech therapist therapy services
Blue Pathway provides guaranteed acceptance for applicants who are at least one year old and under 19 years of age.
View the features, options and costs of the Blue Pathway plan to find out if it's right for you.
2012 open enrollment period is closed for this product. Annual Open Enrollment Period
The annual Open Enrollment period runs from May 1 through June 30 (5/1 – 6/30).
Use this time to enroll in Blue Pathway for the first time or to switch plans.
If you need more information about eligibility for coverage, you may contact Blue Cross and Blue Shield of Texas Individual Products Customer Service at 1-888-731-0406.
Health insurance costs include monthly premium payments, individual/family deductibles, out-of-pocket expenses, copayments and coinsurance. For Blue Pathway plans, here’s what you can expect:
Individual in-network deductible of $2,500/$5,000 for out-of-network
Family in-network deductible of $7,500/$15,000 for out-of-network
Coinsurance levels of 75% in-network/60% out-of-network
Benefits for preventive care services covered of 100% in-network/60% out-of-network
For more information on costs, including out-of-pocket costs, see the Outline of Coverage document under What's Included with Blue Pathway below.
At Blue Cross and Blue Shield of Texas (BCBSTX), we understand your concerns about coverage continuity. BCBSTX will never terminate or refuse to renew your Policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a policy may be terminated or a renewal refused:
Failure to pay premiums
The Blue Pathway plan is discontinued (90 days notice given with an option to convert to any plan we offer)
Discovery of fraud or an intentional misrepresentation of facts (30 days prior written notice given)
Failure to continue residing, living or working in an area where we are authorized to do business
It’s important to know the features of the health insurance plan you are considering. Our Outline of Coverage documents give you brief descriptions of the basic details of our Blue Pathway product, as well as details on renewability, exclusions and limitations. Blue Pathway Outline of Coverage
The Individual Dental plan is available as an optional benefit with your individual Blue Cross and Blue Shield of Texas insurance plan. There is an additional premium associated with this plan.
Learn more about the Dental Indemnity USA plan.
Your benefit plan includes a mail service program that offers you the convenience of having covered maintenance medications delivered directly to you.
Your out-of-pocket cost for prescription drugs usually is less when you choose generic or formulary
*Tier 1 and 2 benefits are paid after the plan medical deductible has been satisfied
Policy form #PPO-STM-3
Short-term Health Insurance Overview
SelecTEMP® PPO provides temporary health coverage for you, your spouse and your children. It offers various benefit periods and deductibles to give you the control to tailor coverage, premium rates and out-of-pocket expenses according to your own needs.
SelecTEMP PPO Coverage Overview
Key features include:
Inpatient and outpatient medical, surgical and hospital services
Diagnostic services
Emergency care
Office visits
Childhood immunizations up to the child’s eighth birthday
Prescription drug coverage
SelecTEMP PPO is your short-term health insurance solution if you are:
Experiencing a gap in employer coverage or can’t afford COBRA
Waiting for employer coverage to begin
A recent graduate and still seeking employment
Age 64 and about to retire, but not yet eligible for Medicare
Who is eligible for SelecTEMP PPO?
Texas residents at least 60 days of age and under 65 years of age
Non-expectant parents
Unmarried dependent children at least 60 days of age and under 25 years of age
U.S. citizens or non-U.S. citizens living in the United States for at least two years (a copy of your Alien Registration Receipt Card must be submitted with your application)
Health insurance costs include monthly payments, individual deductibles, drug coverage deductibles, out-of-pocket expenses, copayments, and coinsurance. For SelecTEMP PPO plans, here’s what you can expect:
Individual deductibles for individuals ranging from $500 to $2,500*
Family deductibles ranging from $1,500 to $7,500*
Copayment of $100 for emergency room facility visit - waived if admitted to Hospital immediately following the visit. (This copayment amount applies to the facility visit only. The facility and physician services and supplies are subject to the deductible and coinsurance amount.)
Coinsurance—you pay 20 percent of allowable amount after deductible with a maximum of $1,000, family coverage coinsurance maximum is $3,000*
* These cost ranges represent in-network coverage only. Out-of-network coverage costs can be significantly higher. This plan uses the BlueChoice® network, which enables you to save on premiums and the cost of covered services when you use a participating hospital, doctor or specialist.
Freedom to choose doctors and hospitals (out-of-pocket expenses will be less when using the services of doctors and hospitals in the BlueChoice Network)
24 hour worldwide coverage
Choice of deductible amount, payment type and length of benefit period (one to six months)
Prescription Drug Program (Generic, Preferred and Non-preferred drugs)
Mail Order Prescription Drug Program (90-day supply of covered prescription drug for two copay amounts)
More Health Insurance Plan Details
It’s important to know the features of the health insurance plan you are considering. Our Outline of Coverage documents give you brief descriptions of the basic details of SelecTEMP PPO, as well as details on renewability, exclusions and limitations. View the SelecTEMP PPO Outline of Coverage.
Prescription drugs and medicines (not used in a hospital) are covered up to a maximum benefit of $750 per participant per benefit period.
There is a separate $200 prescription program deductible that must be satisfied before benefits are available.
Once the deductible has been met, a copayment will apply, the amount based on whether your prescription is filled at a participating pharmacy or through the Prescription Drug Mail Service and the type of drug dispensed (generic, preferred or non-preferred).
You have the option to order your prescription drugs through the mail with our 90-Day Supply Program.
Every insurance plan has limitations. These limits are there to keep health care costs down for everyone. A pre-existing condition is just one example of a limitation. For example, a pre-existing condition will be excluded from your participation in a health insurance plan. This means your health care expenses related to a pre-existing condition will not be covered.
It’s important to know the limitations of your health insurance plan. For a full list of exclusions and limitations, see our SelecTEMP PPO Outline of Coverage document.
View the Complete Prescription Drug List to see if your prescriptions are included.
Dental Indemnity USA Plan
The Individual Dental plan is available as an optional benefit with your individual Blue Cross and Blue Shield of Texas insurance plan. There is an additional premium associated with this plan.
Some highlights of Dental Indemnity USA coverage:
Coverage can be used to provide dental benefits to an individual, spouse, children or any combination of dependents.
A $50 deductible, based on fee schedule allowances, applies for dental procedures or services received by a covered individual during each benefit year.
Maximum deductible amount of $150 for family coverage.
Deductibles do not apply to oral exams, cleanings, fluoride treatments, sealants and X-rays.
You must enroll in a BCBSTX health plan in order to enroll in the dental plan (excluding SelecTemp PPO). You have up to 31 days from the effective date of your policy to enroll.
All members on that health plan must be enrolled in Dental Indemnity USA.
Once your dental plan is dropped for any reason, you cannot re-enroll unless you reapply for a new health insurance plan.
