If you are enrolled in HealthSelect of Texas®, you must have a primary care provider (PCP) on file with Blue Cross and Blue Shield of Texas (BCBSTX) to get the highest level of benefits and save the most money. However, anyone can benefit from having a PCP!
A study by the National Institutes of Health shows that people who have a PCP to provide and coordinate their health care live longer, healthier lives.
Here are five more reasons why choosing a PCP is one of the most important health care choices you can make:
- Your PCP serves as your first point of contact when you need non-emergency care. When a PCP coordinates your care, you have a designated resource that knows you and your health history.
- Your PCP can take care of your preventive health needs and many non-emergency health issues, such as colds, flu, rashes and allergies.
- A PCP handles your overall care and can connect you with specialists when needed. If you are a HealthSelect of Texas participant, you must get a referral from your PCP before you see a specialist. If you do not have a referral on file with BCBSTX, you will pay more out of pocket–even if you see an in-network specialist.
- Seeing a PCP is one of your lowest-cost options for care. Visits to your PCP are less expensive than visits to specialists or urgent care clinics. Unless you are scheduling your annual wellness exam, which is at no cost to you, your copay to visit your in-network PCP as a HealthSelect of Texas participant is $25.
- If you’re sick, it’s easier to schedule an appointment as an established patient than to find a doctor accepting new patients and have to fill out new patient paperwork.
If you’re a HealthSelect of Texas participant, you can change your PCP selection at any time by doing one of the following things:
- 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.
- Go to www.healthselectoftexas.com and click Log In in the top right corner. If you already have a Blue Access for MembersSM account, log in using your username and password. Otherwise, register for Blue Access for Members following the instructions on the screen. Once you’re logged in to your account, go to the Doctors and Hospitals tab and click Select Primary Care Physician.
Choose an in-network doctor to be your primary care provider today and find a partner for your health!
Important reminders for HealthSelect of Texas participants:
- You have 60 days from the date your HealthSelect coverage starts to choose an in-network PCP. Your PCP is responsible for coordinating your care, making referrals to see specialists and writing orders for lab and imaging services. All of your health care services must be coordinated through your PCP for you to get in-network benefits. If you have not chosen a PCP after those 60 days, out-of-network benefits will apply for any services you receive–even from in-network providers.
- If your PCP is in the Kelsey-Seybold group, you must get all care through Kelsey-Seybold providers. If you see providers outside the Kelsey-Seybold group, you will pay out-of-network costs.