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Blue Cross and Blue Shield of Texas Health Insurance in TEXAS – Health Plan Options

Blue Cross and Blue Shield of Texas — PPO Select Value Care - Plan I

A comparison of the PPO Select Value Care - Plan I offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	50% of Allowable Amount	50% of Allowable Amount
Copay	N/A	N/A
Deductible	N/A	N/A

Blue Cross and Blue Shield of Texas — PPO Select Value Care - Plan II

A comparison of the PPO Select Value Care - Plan II offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	50% of Allowable Amount	50% of Allowable Amount
Copay	N/A	N/A
Deductible	N/A	N/A

Blue Cross and Blue Shield of Texas — PPO Select Value Care - Plan III

A comparison of the PPO Select Value Care - Plan III offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	50%	50%
Office Visit	50% of Allowable Amount	50% of Allowable Amount
Copay	N/A	N/A
Deductible	N/A	N/A

Blue Cross and Blue Shield of Texas — Foundation Hospital Care

A comparison of the Foundation Hospital Care offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	BCBSTX pays 80%, insured pays 20%	BCBSTX pays 60%, insured pays 40%
Office Visit	Not Covered	Not Covered
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000	Individual: $10,000, Family: $30,000

Blue Cross and Blue Shield of Texas — Select Blue Advantage - Plan I

A comparison of the Select Blue Advantage - Plan I offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$250 Individual/$750 Family	$500 Individual/$1,500 Family

Blue Cross and Blue Shield of Texas — Select Blue Advantage - Plan II

A comparison of the Select Blue Advantage - Plan II offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Blue Cross and Blue Shield of Texas — Select Blue Advantage - Plan III

A comparison of the Select Blue Advantage - Plan III offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Blue Cross and Blue Shield of Texas — Select Blue Advantage - Plan IV

A comparison of the Select Blue Advantage - Plan IV offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,500 Individual/$4,500 Family	$3,000 Individual/$9,000 Family

Blue Cross and Blue Shield of Texas — Select Blue Advantage - Plan V

A comparison of the Select Blue Advantage - Plan V offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Blue Cross and Blue Shield of Texas — Select Blue Advantage - Plan VI

A comparison of the Select Blue Advantage - Plan VI offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$3,500 Individual/$10,500 Family	$7,000 Individual/$21,000 Family

Blue Cross and Blue Shield of Texas — Select Blue Advantage - Plan VII

A comparison of the Select Blue Advantage - Plan VII offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Blue Cross and Blue Shield of Texas — Select Blue Advantage - Plan VIII

A comparison of the Select Blue Advantage - Plan VIII offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	85% of the Allowable Amount for Eligible Expenses	75% of the Allowable Amount for Eligible Expenses
Office Visit	$25 office visit copay includes same day lab and x-ray, up to annual max of $750	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$10,000 Individual/$30,000 Family	$20,000 Individual/$60,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Choice - Plan I

A comparison of the PPO Select Choice - Plan I offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$250 Individual/$750 Family	$500 Individual/$1,500 Family

Blue Cross and Blue Shield of Texas — PPO Select Choice - Plan II

A comparison of the PPO Select Choice - Plan II offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Choice - Plan III

A comparison of the PPO Select Choice - Plan III offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Choice - Plan IV

A comparison of the PPO Select Choice - Plan IV offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$1,500 Individual/$4,500 Family	$3,000 Individual/$9,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Choice - Plan V

A comparison of the PPO Select Choice - Plan V offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Choice - Plan VI

A comparison of the PPO Select Choice - Plan VI offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$3,500 Individual/$10,500 Family	$7,000 Individual/$21,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Choice - Plan VII

A comparison of the PPO Select Choice - Plan VII offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Choice - Plan VIII

A comparison of the PPO Select Choice - Plan VIII offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% of the Allowable Amount for Eligible Expenses	70% of the Allowable Amount for Eligible Expenses
Office Visit	$25 copayment applies to office visit/consultation only	Physician office visits subject to deductible and coinsurance
Copay	$25	None
Deductible	$10,000 Individual/$30,000 Family	$20,000 Individual/$60,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Saver - Plan I

A comparison of the PPO Select Saver - Plan I offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$500 Individual/$1,500 Family	$1,000 Individual/$3,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Saver - Plan II

A comparison of the PPO Select Saver - Plan II offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,000 Individual/$3,000 Family	$2,000 Individual/$6,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Saver - Plan III

A comparison of the PPO Select Saver - Plan III offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$1,500 Individual/$4,500 Family	$3,000 Individual/$9,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Saver - Plan IV

A comparison of the PPO Select Saver - Plan IV offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$2,500 Individual/$7,500 Family	$5,000 Individual/$15,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Saver - Plan V

A comparison of the PPO Select Saver - Plan V offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$3,500 Individual/$10,500 Family	$7,000 Individual/$21,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Saver - Plan VI

A comparison of the PPO Select Saver - Plan VI offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$5,000 Individual/$15,000 Family	$10,000 Individual/$30,000 Family

Blue Cross and Blue Shield of Texas — PPO Select Saver - Plan VII

A comparison of the PPO Select Saver - Plan VII offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of the AllowableAmount for Eligible Expenses	60% of the Allowable Amount for Eligible Expenses
Office Visit	All physician office visits will be subject to deductible and coinsurance	All physician office visits will be subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	$10,000 Individual/$30,000 Family	$20,000 Individual/$60,000 Family

Blue Cross and Blue Shield of Texas — BlueEdge Individual HSA - Plan I

A comparison of the BlueEdge Individual HSA - Plan I offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% of Allowable Amount after Calendar Year Deductible	70% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,150, Family: $2,300	Individual: $2,300, Family: $4,600

Blue Cross and Blue Shield of Texas — BlueEdge Individual HSA - Plan II

A comparison of the BlueEdge Individual HSA - Plan II offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% of Allowable Amount after Calendar Year Deductible	70% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,750, Family: $3,500	Individual: $3,500, Family: $7,000

Blue Cross and Blue Shield of Texas — BlueEdge Individual HSA - Plan III

A comparison of the BlueEdge Individual HSA - Plan III offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% of Allowable Amount after Calendar Year Deductible	70% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Blue Cross and Blue Shield of Texas — BlueEdge Individual HSA - Plan IV

A comparison of the BlueEdge Individual HSA - Plan IV offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of Allowable Amount after Calendar Year Deductible	60% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,150, Family: $2,300	Individual: $2,300, Family: $4,600

Blue Cross and Blue Shield of Texas — BlueEdge Individual HSA - Plan V

A comparison of the BlueEdge Individual HSA - Plan V offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of Allowable Amount after Calendar Year Deductible	60% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $1,750, Family: $3,500	Individual: $3,500, Family: $7,000

Blue Cross and Blue Shield of Texas — BlueEdge Individual HSA - Plan VI

A comparison of the BlueEdge Individual HSA - Plan VI offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% of Allowable Amount after Calendar Year Deductible	60% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Blue Cross and Blue Shield of Texas — BlueEdge Individual HSA - Plan VII

A comparison of the BlueEdge Individual HSA - Plan VII offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% of Allowable Amount after Calendar Year Deductible	100% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $3,500, Family: $7,000	Individual: $7,000, Family: $14,000

Blue Cross and Blue Shield of Texas — BlueEdge Individual HSA - Plan VIII

A comparison of the BlueEdge Individual HSA - Plan VIII offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% of Allowable Amount after Calendar Year Deductible	100% of Allowable Amount after Calendar Year Deductible
Office Visit	Deductible and Coinsurance	Deductible and Coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Blue Cross and Blue Shield of Texas — SelecTemp PPO - Plan I

A comparison of the SelecTemp PPO - Plan I offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	80% of Allowable Amount after deductible	60% of Allowable Amount after deductible
Copay	N/A	N/A
Deductible	$500 Individual, $1,500 Family	$1,000, Individual, $3,000 Family

Blue Cross and Blue Shield of Texas — SelecTemp PPO - Plan II

A comparison of the SelecTemp PPO - Plan II offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	80% of Allowable Amount after deductible	60% of Allowable Amount after deductible
Copay	N/A	N/A
Deductible	$1,000, Individual, $3,000 Family	$2,000, Individual, $6,000 Family

Blue Cross and Blue Shield of Texas — SelecTemp PPO - Plan III

A comparison of the SelecTemp PPO - Plan III offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	80% of Allowable Amount after deductible	60% of Allowable Amount after deductible
Copay	N/A	N/A
Deductible	$1,500, Individual, $4,500 Family	$3,000, Individual, $9,000 Family

Blue Cross and Blue Shield of Texas — SelecTemp PPO - Plan IV

A comparison of the SelecTemp PPO - Plan IV offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	80% of Allowable Amount after deductible	60% of Allowable Amount after deductible
Copay	N/A	N/A
Deductible	$2,000, Individual, $6,000 Family	$4,000, Individual, $12,000 Family

Blue Cross and Blue Shield of Texas — SelecTemp PPO - Plan V

A comparison of the SelecTemp PPO - Plan V offered by Blue Cross and Blue Shield of Texas is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	60% after deductible
Office Visit	80% of Allowable Amount after deductible	60% of Allowable Amount after deductible
Copay	N/A	N/A
Deductible	$2,500, Individual, $7,500 Family	$5,000, Individual, $15,000 Family