BCBS Plans Texas: Types, Pricing, and Coverage

If you're shopping for health insurance in Texas, Blue Cross Blue Shield (BCBS) is a popular option. BCBS offers a range of plans to fit different needs and budgets.

One thing to note is that BCBS plans in Texas are offered through a network of local and regional companies, each with their own unique plans and pricing. This can make it a bit confusing to navigate.

BCBS plans in Texas are generally categorized into three main types: bronze, silver, gold, and platinum. Each type offers a different level of coverage and premium cost. Bronze plans have the lowest premiums but offer the least coverage, while platinum plans have the highest premiums but offer the most comprehensive coverage.

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BCBSTX offers health plans that can be customized for individuals, children, and families, including consumer-directed plans, Health Savings Accounts, and Medicare Supplements.

If you're looking for a plan that fits your budget, you'll want to consider the deductible, which is a specified amount of money that the insured must pay before an insurance company will pay a claim. For example, the Blue Advantage Bronze HMO 006 plan has a deductible of $6,500.

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The out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services, including the deductible. This can range from $3,750 for the Blue Advantage Silver HMO 103 plan to $6,550 for the Blue Advantage Plus Bronze 104 plan.

You'll also want to consider the coinsurance, which is the percentage you pay after your deductible has been met and before your out-of-pocket maximum. For instance, the Blue Advantage Plus Bronze 104 plan has a coinsurance of 40%.

Here are some key plan details to consider:

BCBSTX no longer offers PPOs on the individual market, but Advantage Plus plans offer the added option of using providers other than Blue Advantage network providers, while still having some of the costs covered.

In Texas, BCBS offers two main network types: HMO and POS. The HMO is based on a medical group in your local area, with more managed care.

The POS network is similar to the old PPO networks, offering more flexibility out of network, but at a higher cost. It's a good option for those who want to refer themselves out to specialists and have a wider network with benefits outside the narrow HMO.

Here's a quick comparison of the two plans:

The POS plan can be expensive to get services out of the primary network, as the plan will pay what it would pay in the network, which usually has a big discount.

In 2017, the HSA (Health Savings Account) contribution limits increased to $3,400 for individual plans and $6,750 for family plans.

The HSA contribution limits are tied to the HDHP (High-Deductible Health Plan) out-of-pocket maximum limits, which also increased in 2017 to $6,550 for individual plans and $13,100 for family plans.

The 2017 HDHP minimum deductible was $1,300 for individual plans and $2,600 for family plans, and the maximum out-of-pocket expenses were $6,550 for individual plans and $13,100 for family plans.

The 2017 HSA contribution limits were also affected by age, with individuals under age 55 able to contribute up to the annual limit, and individuals age 55 and older able to make catch-up contributions of $1,000.

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Blue Cross offers two main types of plans: Silver and Bronze. Silver plans are ideal for people who need to visit the doctor or specialist more often, while Bronze plans are best for those with lower healthcare needs.

Silver plans offer higher coverage and may be eligible for cost-sharing reductions based on income, lowering deductibles and co-pays.

The out-of-pocket maximum for Silver plans is typically $7,900, with a deductible ranging from $1,000 to $3,250. Coinsurance rates vary between 20% and 50%.

Here's a comparison of Silver and Bronze plans:

Bronze plans have higher out-of-pocket costs, but two plans (106 and 104) also have HSA options for those looking for tax savings.

Health Savings Accounts (HSAs) can be a great way to reduce your out-of-pocket costs and tax burden. BCBSTX offers the only HSAs in Texas, and you can learn more about them in their HSA Guide.

HSAs are eligible for three of the plans mentioned: Blue Advantage Bronze HMO 006, Blue Advantage Plus Bronze 104, and Blue Advantage Silver HMO 103. All three plans have a deductible, out-of-pocket maximum, and coinsurance.

Here's a breakdown of the HSA eligibility for each plan:

With an HSA, you'll have to pay a deductible before your insurance kicks in. The deductibles for these plans range from $3,750 to $6,500, as shown in the plan comparison table.

HSAs can also help you save on prescription drugs. For example, under the Blue Advantage Bronze HMO 006 plan, you'll pay 0% after deductible for outpatient prescription drugs at a preferred pharmacy.

BCBS of Texas offers two basic networks, HMO and POS, which are identical whether you're on or off exchange.

The HMO network is based on a medical group in your local area, and care is more managed.

The POS network, on the other hand, is like the old PPO networks we had before, offering more flexibility out of network but at a higher cost.

In fact, the POS plan is $338 cheaper than the HMO plan at the silver level.

If you want to evaluate these two options, you should check if your doctors participate in both networks using the Doctor Finder link in your quote.

You can also ask your doctors which Obamacare plans they participate in, and if they're in both networks, it makes it easier to choose.

The POS plan gives you the flexibility to refer yourself out to specialists and have a wider network with benefits outside the narrow HMO.

However, be aware that getting services out of the primary network can be expensive, as the plan will only pay what they would pay in the network, which usually has a big discount.

If you demand maximum flexibility, the POS with BCBS is the only real choice on the individual family market these days.