June 2017
2017 Blue EssentialsSM Benefit Option Highlights
Earlier this year, Blue Cross and Blue Shield of Texas (BCBSTX) announced the name change of their HMO Blue TexasSM network to Blue Essentials. BCBSTX appreciates your participation in the new network and is excited to share additional information about a few health plans with access to the network.
The Blue Essentials network will be coupled with plan designs that help manage costs, and allow flexibility and customization like predefined deductibles, coinsurance and copayments for certain health care services. Below are highlights of three health benefit plan options that access the Blue Essentials network.
Blue Essentials
- Helps members manage costs because they are required to select a primary care physician and get referrals for services with network providers.
- No out-of-network coverage, except for emergency services.
- Provides emergency and urgent care when members are traveling out of state.
- Offers customer support and reference tools to guide members with making informed decisions about their benefits.
Blue Essentials AccessSM
- Allows “open access” within the Blue Essentials provider network where primary care physician selection and referrals are NOT required (as of Jan. 1, 2017). This access gives opportunities to contracted physicians and hospitals throughout the state of Texas.
- Provides an alternative solution for members who are looking for cost savings while still having the freedom to choose in-network providers without selecting a primary care physician or obtaining a referral to see a specialist.
- Offers emergency and urgent care when members go out of network or are traveling out of state.
- Beginning Sept. 1, 2017, BCBSTX will administer HealthSelect of Texas and Consumer Directed HealthSelect for the Employees Retirement System of Texas (ERS). Eligible participants will access care through the Blue Essentials provider network in all 254 counties in Texas.
Our Blue Essentials network serves commercial employer groups in the state of Texas and we're pleased to offer it to support the HealthSelect product for ERS participants starting Sept.1, 2017.
Health Plans with Access to the Blue Essentials Network
Benefit Plan/Product Name |
Network Code |
Network |
Mid- and Large Market Availability |
Retail and Small Group Availability |
Network Coverage |
PCP Required |
Referral Required |
Out of Network Benefits |
Plan Design |
Blue Essentials |
HMO |
Blue Essentials |
51-151 Fully Insured; 151+ Fully Insured & Self-funded/ASO |
N/A |
Statewide |
Yes |
Yes |
No |
HMO |
Blue Essentials Access |
HMO |
Blue Essentials |
51-151 Fully Insured; 151+ Fully Insured & Self-funded/ASO |
N/A |
Statewide |
No |
No |
No |
HMO Open Access |
HealthSelect of Texas |
HME |
Blue Essentials |
ERS – Effective 9/1/2017 |
N/A |
Statewide |
Yes |
Yes |
Yes |
POS |
Consumer Directed HealthSelect |
HME |
Blue Essentials |
ERS – Effective 9/1/2017 |
N/A |
Statewide |
No |
No |
Yes |
Open Access HDHP/HSA |
Please note: If you are currently a participating provider in the Blue Essentials (formerly HMO Blue Texas) provider network, no action is required on your part. However, if you would like to be contracted for the Blue Essentials provider network, please go to the Blue Essentials Network Participation page on BCBSTX’s provider website or contact your Network Management Representative.
Watch for additional information regarding Blue Essentials in future editions of this newsletter and on BCBSTX’s provider website.