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Blue Cross Blue Shield of Texas Network Coverage Update

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As we reported on July 22, 2016, Blue Cross and Blue Shield of Texas (BCBSTX) and Kelsey-Seybold Clinic have terminated certain contractual relationships, effective October 1, 2016.

 

Even though Kelsey-Seybold Clinic has made the decision to leave the BCBSTX BlueChoice PPO/POS and Traditional/Par Plan networks, members still have access to a robust network of participating providers in the Houston area.

 

Members can continue to utilize Kelsey-Seybold Clinic with out-of-network benefits, but may be responsible for a significant portion of the cost of provider visits if they continue to receive services from Kelsey-Seybold after October 1, 2016.

 

For more information about transitioning to an in-network provider please visit bcbstx.com/kelseyseybold.

 

Also, effective January 1, 2017, regardless of renewal date, CVS pharmacies and CVS pharmacies in a Target store will no longer be a part of the BCBSTX standard pharmacy network for members with pharmacy benefits administered by Prime Therapeutics.

 

Members will continue to have access to more than 55,000 nationwide pharmacies in network (without CVS), with more than 4,000 located within Texas. This includes many major pharmacy chains such as Walgreens, Walmart, Kroger, HEB, Brookshire's and many independent pharmacies.

 

BCBSTX is committed to helping their members find the most convenient alternative for their pharmacy coverage needs. Impacted members, who have had recent CVS claims, will be notified in October with a letter. This letter will provide information on how to find an alternative network pharmacy, as well as how to transfer any current refill/new prescriptions to their new pharmacy.

 

BCH is committed to bringing you updates on this matter as they develop. Please contact any member of your BCH Benefits Team for more information. 

 

 

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