UT SELECT Medical Plan
There is a slight increase in the monthly premium for the UT SELECT plan for the 2009-2010 plan year.
UT offers UT SELECT, a self-funded medical PPO plan, administered by Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.
For the 2009-2010 plan year, the State and UT will continue to pay 100% of the premium cost for full-time employees and 50% for part-time employees. For employees with spouse or children coverage, your out-of-pocket cost will increase approximately $10 per month. For employees with family coverage, your out-of-pocket cost will increase approximately $20 per month. The Family Care Physician and Specialist office visit copayments, the Prescription Drug annual deductible, and the prescription drug brand name copayments are increasing. In addition, several medications have been added to the Preferred Step Therapy Program and the Medco drug programs that require authorization. Please read this section for more information.
Choice of Doctors — Each Time You Need Health Care
When you enroll in UT SELECT, you can receive care from any licensed doctor you choose; no referrals are required. If you use a Network doctor, you will receive the highest level of benefits, pay less out of pocket, and will usually not have to file any claims. If you use an Out-of-Network doctor, you will still be covered, but your out-of-pocket costs for health care services will be higher.
Access to One of the Largest Networks in Texas with Worldwide Coverage
UT SELECT members have access to one of the largest networks of contracting doctors and hospitals in Texas, with more than 60,000 physicians and specialists and over 400 hospitals. If you are traveling outside Texas, there are even more Blue Cross and Blue Shield Network providers from which to choose. More than 85 percent of all doctors and hospitals throughout the United States contract with Blue Cross and Blue Shield plans. Outside of the U.S, you will have access to doctors and hospitals in over 200 countries. With UT SELECT, you have worldwide coverage for both emergency and non-emergency care.
To find a physician or specialist near you, search online at www.bcbstx.com/ut or contact UT SELECT Customer Service toll free at 1-866-882-2034.
Even if you visit an Out-of-Network doctor, you may still save money.
Blue Cross and Blue Shield of Texas contracts with many out-of-network doctors and hospitals. ParPlan providers accept the Blue Cross and Blue Shield of Texas allowable amounts for covered services and cannot bill you more. In most cases ParPlan providers will file claims, too. Look for participating doctors and hospitals for UT SELECT at www.bcbstx.com/ut under ParPlan.
International SOS
When traveling abroad, coverage is provided for your medical needs through your UT SELECT program; however, additional services are available through the UT System—wide International SOS program. This is a comprehensive, 24-hour medical response organization that provides international assistance services worldwide through the use of multilingual Alarm Centers on duty 24 hours a day, 365 days a year. International SOS responds to calls for help and advice from students, travelers and expatriates, managing issues from the simplest task of a doctor referral to the most complex emergency evacuation. Membership is included for no charge for staff, faculty and students when traveling abroad on official UT business, and is available at a discount when traveling for a personal trip. You may obtain a membership card from your institution travel office. All UT-related travel abroad not booked using one of the University’s contracted travel agencies should be reported to International SOS in advance. This can be done via the UT System SOS portal at http://www.internationalsos.com (use U.T. System Membership # 11BSGC000037 to log on).
Your Health Care Benefits Travel With You
Your UT SELECT ID card features the Blue Cross and Blue Shield symbols and the PPO in a suitcase logo telling providers that you are part of the BlueCard program. This means you and your covered dependents have access to Blue Cross and Blue Shield network providers throughout the United States and around the world. Follow these steps to receive the network (highest) level of benefits while traveling or away from home.
IF YOU NEED TO:
Locate the nearest network doctors and hospitals - Refer to your UT SELECT ID card and call BlueCard Access at 1-800-810-BLUE (2583)
Be admitted to a hospital and/or preauthorize care - Refer to your UT SELECT ID card and call 1-800-441-9188 to preauthorize care for medical or 1-800-528-7264 to preauthorize care for behavioral health (mental health and chemical dependency)
Receive medical attention - Pay any applicable deductible, copayment or coinsurance amount and pay for any non-covered services
File a Claim - BlueCard (network) providers will file your claims for you. BlueCard providers have also agreed to accept Blue Cross and Blue Shield’s allowable amount for covered services and will not balance bill you for any costs exceeding the allowable amount.
If you do not use a BlueCard provider for care, you will need to pay the doctor or hospital at the time of service. Then, you will need to complete and submit a claim form. The claim form is available online at www.bcbstx.com/ut.
Transitional Benefits
If you or a covered dependent are being treated for a chronic or ongoing medical condition at the time you enroll in UT SELECT, and your doctor is not in the UT SELECT PPO network, ongoing care with your current doctor for up to three months may be requested. Some medical conditions that are eligible for transitional benefits include
- Pregnancy (if you are in your third trimester on September 1 or at the time of your enrollment);
- Cancer;
- Allergy Treatments;
- Organ Transplant;
- Heart Failure;
- Physical Therapy;
- Behavioral Health Care; and
- Diabetes.
Transitional benefits are subject to approval. To request transitional benefits, complete a “Transitional Benefits Form” available from your institution Benefits Office or online at www.bcbstx.com/ut. Instructions for submitting the request to Blue Cross and Blue Shield of Texas are on the form. If the transitional care request is approved, you or your covered dependent may continue to see the Out-of-Network doctor and receive the Network level of benefits from the UT SELECT plan for up to three months. If the transitional care request is denied, you may still continue to see your current doctor, but benefits will be paid at the Out-of-Network level.
If your doctor under your previous plan is in the UT SELECT PPO Network, you do not have to complete a “Transitional Benefits Form.”
Helping You Achieve a Healthier Life
Sometimes managing your health requires more than doctor visits, lab tests and prescriptions.
Blue Care Connection from Blue Cross and Blue Shield of Texas is an umbrella of programs that helps you achieve higher levels of wellness. Through outreach, educational resources and health advocacy, Blue Care Connection guides you through the often-complex health care system so you can focus on what matters most — getting healthy and staying well.
Blue Care Connection programs assist UT SELECT plan participants living with current serious medical conditions, as well as those considered "at risk." If you, or a covered dependent, are considered "at risk," the Blue Care Connection programs are uniquely designed to detect health care needs early. Early detection allows Blue Cross and Blue Shield of Texas to provide appropriate outreach and meaningful intervention to help prevent future medical complications.
Blue Care Connection programs are available at no additional cost and include
24/7 Nurseline
Around the clock access through a toll-free number to experienced registered nurses who understand and can help with your health care concerns. To take advantage of this free service and to talk to a nurse, call 1-888-315-9473 toll free, anytime 24 hours a day, 7 days a week.
Special Beginnings®
A maternity program that offers on-going contact with obstetric nurses who provide prenatal risk assessment education and can coordinate care with your physician. UT SELECT offers a $50 reward card from Target for women who enroll in their first trimester and complete the Special Beginnings program through six weeks after delivery. Call 1-800-462-3275 to enroll or ask questions about the program.
Condition Management
Voluntary, health improvement programs that can help members with cancer, congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, asthma, diabetes, metabolic syndrome (high cholesterol, high blood pressure and obesity) and low back pain. Note: A contracted care management company, LifeMasters Supported Selfcare Inc., administers some of the program components on behalf of Blue Cross and Blue Shield of Texas and may contact you directly via telephone or automated message to inform you about the condition management program and determine if you are interested in participating (Program participation is voluntary). These contacts are monitored and controlled by Blue Cross and Blue Shield of Texas as part of UT SELECT’s health care coverage. If you decline, LifeMasters will not contact you again. If you decide to participate, the LifeMasters’ staff will provide you with information about participating. LifeMasters and Blue Cross and Blue Shield of Texas keep all contact and program information confidential and private.
Blue Care Advisors
Blue Care Advisors are a multi-disciplinary team composed of Registered Nurses, Licensed Professional Counselors and Licensed Masters-Level Social Workers. Blue Care Advisors reach out to at-risk plan participants, providing early chronic disease prevention in hopes of achieving overall improved health.
Blue Care Advisors
- Simplify the coordination of your health care benefits;
- Educate and empower you to make informed choices about your health care;
- Support wellness by aiding your understanding of preventive care guidelines, personal risk assessments and preventive screenings;
- Support behavior modification and readiness to change with techniques that promote a healthy lifestyle;
- Champion your care when assistance is needed; and
- Provide lifestyle coaching through the Weight Management Program (as needed).
Lifestyle Management: Weight Management and Tobacco Cessation Programs
For participants who want to lose weight or stop smoking, UT SELECT coverage also features lifestyle management programs, comprised of Licensed Masters Level Social Workers and Licensed Professional Counselors, who promote wellness through a holistic approach of behavioral coaching, clinical coaching, education and condition management.
Enroll Today
To enroll in any Blue Care Connection program, or ask questions about the condition and lifestyle management programs, please call toll-free at
1-800-462-3275.
Blue Access® for Members - Information is a Powerful Tool
Go to www.bcbstx.com/ut and log onto Blue Access for Members,
- Check the status of a claim and your claims history;
- Confirm who in your family is covered under your plan;
- View and print an Explanation of Benefits (EOB)* for a claim;
- Locate a doctor or hospital in the Network;
- Sign up to receive claim status e-mail alerts;
- Request e-mail notification of finalized claims;
- Request a new or replacement ID card or print a temporary ID card; and
- Access the Personal Health Manager and earn Blue Points;
To register for Blue Access® for Members, you will need your group and identification numbers from your UT SELECT ID card. You will be asked to create a user ID and password for immediate and secure access to your personal information.
*BCBSTX no longer mails an Explanation of Benefit (EOB) statement to UT SELECT participants unless they specifically request that their EOBs continue to be mailed. EOBs can be accessed electronically via Blue Access for Members. Always review your EOBs following medical treatment to ensure the accuracy of provider billing and payment.
Personal Health Manager
With Personal Health Manager, the support and resources you need to manage your health online will be just a click away. By logging onto Blue Access® for Members though www.bcbstx.com/ut and clicking on Personal Health Manager you can
- Request fitness and weight loss advice with Ask A Dietitian;
- Receive help on managing stress, workplace conflicts or other issues with Ask A Life Coach;
- Ask registered nurses health-related questions online with the Ask A Nurse feature;
- Request exercise and fitness with Ask A Trainer;
- Receive targeted wellness information via e-mail to help manage specific medical conditions, including alerts for screening tests, and set up reminders for medical appointments and medication refills;
- Access wellness tracking tools, videos and interactive tutorials;
- Get information on exercise, nutrition and lifestyle issues in the For Your Health section; and
- Earn Blue PointsSM every time you use the health and wellness features in the For Your Health section. Receive up to 1,000 points a week when you set up and track the progress of an exercise or meal program, read and rate health and wellness related articles, or e-mail your health-related questions to licensed professionals.
Other Online Resources for Health Care Information from Blue Cross and Blue Shield of Texas
Hospital Comparison Tool
When your physician has recommended a surgical treatment, you can easily find and review the outcome history of procedures previously performed at hospitals.
You can review a hospital’s performance based on factors such as:
- Mortality;
- Length of stay;
- Complications;
- Number of procedures performed; and
- Cost.
To review hospital outcome data, log onto Blue Access® for Members, click on the My Health section and select Compare Hospitals.
Treatment Cost Advisor
Through the Treatment Cost Advisor* tool, you can find the typical cost of a health care procedure from a list of common medical conditions. You simply need to enter information, such as age, gender, and state or ZIP code to help determine a cost estimate for a specified medical procedure. To get started, log onto Blue Access® for Members, click on the My Health section and select Treatment Cost Advisor.
* All information is intended for your general use only and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for specific health issues and consult your physician before taking any action on your health conditions. Use of this online service is subject to Terms and Conditions.
BlueExtrasSM: Ways to save money with your UT SELECT ID card
Through the BlueExtras discount program, all Blue Cross and Blue Shield of Texas (BCBSTX) members, including UT SELECT plan participants, are eligible to save money on value-added health care products and services that help support healthy lifestyles. These discounts are for health care products and services not usually covered by your health care benefits plan. There are no claims to file, no referrals or pre-authorizations, and no additional fees to participate – it’s just one more benefit of being a BCBSTX member!
To use BlueExtras, simply show your BCBSTX/UT SELECT ID card to a BlueExtras provider to receive your discount. For additional information about the products and services offered through BlueExtras, log into Blue Access® for Members (BAM) at www.bcbstx.com/ut. Click on the My Coverage tab, and then the BlueExtras Discount Program link.
Pharmacy Benefits
Your Pharmacy Benefits under UT SELECT are administered by Medco Health Solutions (Medco) and require a $100 annual deductible per person, per plan year. Read more about Pharmacy Benefits
