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Get access to your employer portal. Implants coverage available Orthodontic benefits are available on select plans for both children and adults Up to $75 deductible per member, per calendar year Choice of a $1,000, $1,250 or $2,000 calendar-year benefit maximum per member Coverage even when members use a non-network dentist. 4 Healthcare services provided to a health maintenance organization (HMO) member in exchange for a fixed, monthly premium paid in advance of the delivery of medical care. A review program that evaluates whether drugs are being used safely, effectively and appropriately. 15 49 For more detailed information on the plan designs available, covered benefits, services and supplies that are limited or excluded, general administration of the plan, or any other questions you may have regarding our products and services, please contact your account representative for the phone number of the regional sales office near you. Blue Cross and Blue Shield of Texas (BCBSTX) covers emergency dental services your child gets in a hospital or ambulatory surgical center. With the Premium plan preventive care is free and after 6 months the co-payment for fillings and simple extractions is just 20%. The application of managed care principles (techniques to reduce costs and improve quality of heallthcare) to 24-hour coverage. A free-standing center that performs various types of surgery. PDF Your Member Guide - BCBSMT You pay 50% after deductible before meeting your out-of-pocket max, and $0 after meeting your out-of-pocket max. A health maintenance organization (HMO) that contracts with a group of physicians with multiple specialties who are employees of the group practice. Also known as a chief medical officer. 0000003118 00000 n An employer that has offices or branches in more than one location, but offers uniform healthcare coverage of benefits to all of its employees. During this unprecedented time, we're taking action to support our members. benefits, keeping your smile healthy and protecting your overall health. 0000006259 00000 n External link You are leaving this website/app (site). In addition, some sites may require you to agree to their terms of use and privacy policy. A federal government program established under Title XVIII of the Social Security Act of 1965 to provide hospital expense and medical expense insurance to elderly and disabled persons. 0000005163 00000 n Our AskBlue. Our health plan advisors can help you choose a plan, calculate your costs and tell you whether you're eligible for a subsidy. Also known as disease state management. 0000010274 00000 n Find a planto get a quote. /E!{"I+e1m5 Ni!V4H b~G}.5]W=7)Rxk[L9S7)cb?4 01=G35`{uio)}li.\ Ne:~Mo)ccpsYSG#xE^-x9L)qEK,duLGJNek.