UHD Summer Benefits Enrollment began July 9 and runs until July 22. During this time it is important to remember participants enrolled in HealthSelect of Texas need to select a primary care physician (PCP) to receive network benefits. A participant who sees a doctor without designating a PCP may have to pay more, even if the doctor is in the HealthSelect network.
The PCP coordinates the participant’s health care and manages referrals to network specialists. The custodial parent of an enrolled dependent child needs to select a PCP for that child. Participants can select different PCPs for each person or one PCP for the whole family.
Current PCP designations on file with UnitedHealthcare will be transferred to BlueCross and BlueShield of Texas (BCBSTX) as part of the HealthSelect transition to BCBSTX. Each new medical ID card will list the name of the PCP if the participant has designated one. Participants whose current PCP will be in the BCBSTX HealthSelect network do not need to do anything.
Participants who currently have a PCP that will not be in the BCBSTX HealthSelect network on September 1, 2017, will receive a letter from BCBSTX this summer letting them know they need to select a new PCP. Participants in this situation should call a BCBSTX Personal Health Assistant as soon as possible to select a PCP.
Selecting a PCP
All HealthSelect participants should make sure their PCP and other providers will be in the BCBSTX HealthSelect network starting September 1, 2017. They can go to http://www.bcbstx.com/hs and click on “find a doctor or hospital” in the Find a Provider box. Then they need to click on the box that applies to the health plan they will be enrolled in on September 1. They can also call a BCBSTX Personal Health Assistant at (800) 252-8039 toll-free Monday – Friday 7 a.m. – 7 p.m. CT or Saturday 7 a.m. – 3 p.m. CT for help with designating a PCP.
Nominating a provider
If a provider you see is not in the BCBSTX network, you can nominate a health care provider to join the network. They should go to https://www.bcbstx.com/hs/ and click on “Publications and Forms,” then go to “Nominate a Provider.” The recommendation does not guarantee that the provider will sign on to the BCBSTX network and the process may take up to 90 days.
Remember: it pays to stay in the HealthSelect network! Before getting any kind of health care under HealthSelect coverage, be sure to find out if all of their providers are in the BCBSTX network.