Almost everyone has found themselves in this scenario: Your doctor tells you that you need to have a medical procedure or see a specialist. One of the first questions you’ll likely ask is: “What’s it going to cost me?”
As a participant in the HealthSelectSM plans administered by Blue Cross and Blue Shield of Texas (BCBSTX), you have a resource to help you find the answer. By logging into Blue Access for MembersSM, your online benefits portal, you can search Provider Finder to get estimates and compare costs for different providers.
Provider Finder also allows you to research specific procedures and their estimated costs at in-network providers.
By using Provider Finder, you’ll be able to:
- compare costs for in-network providers and procedures,
- compare quality ratings for those providers,
- estimate out-of-pocket costs,
- consider your treatment options and
- save money and make the best use of your health care benefits.
Where can I find the cost estimator tool?
To find the cost estimator and comparison tools, you’ll need to:
- Log in to Blue Access for Members.
- Click the “Doctors & Hospitals” tab at the top of the screen.
- Select “Find a Doctor or Hospital.”
Provider Finder will then display. You can use the dropdown menu (on the left-hand side of your screen) or enter the name of the test or procedure.
In this scenario, we will use the dropdown menu to find costs for an MRI.
Provider Finder will open to a dropdown selection box and a search box.
From the Browse by Category dropdown (on the left side of the screen), you can choose Cost Estimates and view a list of procedures. If you know the name of your procedure, you can type in a specific search term.
Both methods of searching reveal the same information for an MRI. Review your search results and choose up to four providers to compare.
If you choose only one provider and there is a lower-cost provider available, Provider Finder will show you the lower-cost options.
Select the provider you feel best meets your needs based on the compared cost, distance, specialty and reviews. Once you make your choice, you will see a more detailed cost breakdown that includes your estimated out-of-pocket cost.
Once you’ve chosen a provider for your procedure, consult with your primary care provider (PCP) about your choice. Your PCP will help you get a referral or prior authorization, if needed. (For more details, read: Referral vs. Prior Authorization: What’s the Difference?)
It’s also important to note that even if a hospital is in the HealthSelect network, the doctors, anesthesiologists, radiologists and other providers who practice at that hospital may not be. It’s important to find out if all your providers are in the network before scheduling a surgery or procedure. If you are planning a visit to a hospital or outpatient facility, check the Hospital-Based Physicians page on the HealthSelect website. This can help you see the network status for hospital-based doctors in Texas.
Savings for you, savings for HealthSelect
Comparison shopping for medical services can help you make the most of your benefits and save money on your health care. It also helps the HealthSelect plans save money, which ultimately affects your day-to-day expenses like copays, coinsurance and monthly premiums. ERS works hard to manage costs in our health plans while assuring high-quality coverage and care. Comparison shopping is one way you can support our efforts to provide competitive health benefits to all state employees, retirees and their families.
Log in to your Blue Access for Members account at healthselectoftexas.com to try the cost comparison tool today.
Remember: You must log in to Blue Access for Members to use the cost estimator tool to get the most accurate estimates for your medical procedure.
If you have questions about Provider Finder or the cost comparison tool, 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.
Source: ERS Update Express (February 2020)
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