Consumer Choice Plans
Blue Cross and Blue Shield of Texas offers two Small Group Employer Consumer Choice insurance plans in accordance with Texas insurance laws. The Consumer Choice options include:
Consumer Choice PPO Plan — This Consumer Choice plan is a PPO plan that does not include, in whole or part, coverage for the following health care benefits as mandated by state law:
- Treatment of Chemical Dependency
- Prescription Contraceptive Drugs and Devices and Related Drugs (Oral Contraceptives not excluded)
- In-Vitro Fertilization
- Serious Mental Illness (non-public entities only)
- Speech and Hearing
- Home Health Care
Our Consumer Choice PPO plan is available to clients through the BlueChoice Network, one of the largest networks in Texas. BlueChoice provides:
- Access to the national BlueCard® network when members are outside of Texas
- Over 600 participating hospitals and facilities in Texas
- More than 800,000 doctors and 6,000 hospitals contracting with Blue Cross and Blue Shield plans nationwide
Consumer Choice HMO Plan — The HMO Consumer Choice Plan provides benefits only when services are received from providers in the HMO Blue® Texas network when prescribed, directed, or authorized by the member's Primary Care Physician (PCP) or the HMO. Members electing the HMO are required to choose a PCP from a network of contracting doctors in the HMO Blue Texas network. If members receive care from a network provider other than their PCP and are not referred to that network provider by their PCP or if they receive services from a provider that does not participate in the HMO Blue Texas network, those services are not covered.
The Consumer Choice HMO Plan does not include, in whole or part, coverage for the following health care benefits:
- Treatment of Chemical Dependency
- Prescription Contraceptive Drugs and Devices and Related Drugs (Oral Contraceptives not excluded)
- In-Vitro Fertilization
- Serious Mental Illness (non-public entities only)
- Speech and Hearing
For more detailed information on the benefit 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 us for the phone number of the regional sales office near you.
