Get the most from your benefits: Review your plan’s member guide

Get the most from your benefits: Review your plan’s member guide

November 7, 2018

They may not make the New York Times bestseller list, but the guides you get from your health plan are must-reads. Whether it’s an online or printed publication, reading your health plan’s member guide can help ensure that you know the most important aspects of your coverage.  (If you want more detailed information about what’s covered, consult your plan’s master benefits plan document which you can find on the plan website.)

Look for these icons throughout the website: light bulb icon is tip on maximizing you benefits, icon of piggy bank is tip for cost savings, and icon of trophy is activities that will earn you Blue PointsThe 2019 Medical Benefits Guide outlines the benefits for each of the health plans under the HealthSelectSM umbrella, including  HealthSelect of Texas and Consumer Directed HealthSelect.  (To have a  a printed copy of the Guide mailed to you, call a Blue Cross and Blue Shield of Texas Personal Health Assistant toll free at [800] 252-8039.)

When you click on the menu (located at the top-right side of your screen), you can review your plan, read more about your coverage and benefits and check out the wellness tools available to you.
For example, click on the Guide  and you can read more about virtual visits. The plan now covers mental health virtual visits, which gives you access to a broader network of mental health professionals. Make an appointment to consult online with a board-certified mental health professional for various mental health conditions.
The Guide outlines ways to stay connected, including through HealthSelect's website and Blue Access for Members, the online portal through which you can see your personal claims status and explanation of benefits (EOB) statements, download a temporary ID card, and much more.
Need help finding an in-network primary care physician (PCP) in the HealthSelect network? One section of the Guide explains why you need to designate a PCP and then gives you tips on how to do so.
In addition to helping you select or change your PCP,  the Guide shows how BCBSTX Personal Health Assistants can help you get the care you need. Personal Health Assistants can:

  • answer benefit questions,
  • help you find an in-network doctor or hospital,
  • explain health care costs and options for care,
  • schedule or cancel doctor appointments, and
  • assist with prior authorizations and referrals.

 Call a BCBSTX Personal Health Assistant toll free at (800) 252-8039, Monday–Friday 7 a.m. - 7 p.m. and Saturday 7 a.m. - 3 p.m. CT.
In an HMO?

Here is a quick look at your member guides.

Cover of  the Community First Texas employees GBP member handbook (PY 2108)
If you're enrolled in Community First Health Plans, your digital member guide has a clickable table of contents (TOC) so you can immediately move to the topic you want to review. Click the link to page 29 and brush up on your health insurance terminology. On page 32, your benefits for Plan Year 2019 are presented in a table for easy reference.

Call Community First Health Plans toll-free at (844) 434-2347 if you have questions or want a printed copy of the guide.

Cover of KelseyCare member handbook
Members of KelseyCare powered by Community Health Choice can also go online to find a digital copy of their member guide, which also has a clickable TOC. On page 7, learn more about covered Behavioral Health Services and Value-Added Programs. Not familiar with KelseyCare Concierge? Go to page 8 for details.

Call KelseyCare toll-free at (844) 515-4877 if you have questions or want a printed copy of the guide.

cover of Scott and White Benefit Plan Highlights
The Scott & White Health Plan 2019 ERS Benefit Plan Highlights Booklet packs a lot of information into seven pages. Do you know what an Accountable Care Organization (ACO) is? Find out on pages 2 and 4. Learn about the Online Wellness Programs available to you on page 7.

Call the Scott and White Health Plan toll-free at (800) 321-7947 if you have questions or want a printed copy of the guide.