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Sign up for the LifeTimes newsletter to get health and benefits articles delivered to your inbox every month. Our trusted community experts can give you the one-on-one help you need to shop for health insurance.

Search articles and watch videos; ask questions and get answers. Topics include everything from improving your well-being to explaining health coverage. Want to keep up with the latest news from Connect? Sign up for the LifeTimes newsletter to get new articles delivered to your inbox every month. Blue Cross and Blue Shield of Texas is a statewide, customer-owned health insurer.

We believe Texas consumers and employers deserve the best of both worlds: access to affordable, quality health care and top-notch service from a company that focuses solely on customers, not shareholders. Customer value is our cornerstone. For more than 90 years, we have forged alliances with local nonprofit organizations to show our commitment to help build healthy communities.

We want to continue to foster health improvements through these alliances so that together we can offer sustainable, measurable programs that strengthen and enrich our communities. Welcome Employers Producers Providers. Pharmacy Find a Pharmacy Pharmacy Programs. Forms Form Finder. Sign Up or Login. Welcome to Your Health Plan Learn about your new health insurance benefits and how to start using them.

Get Started. Pay My Bill Pay Now. Pharmacy Coverage. Learn More. Dental and Vision. The health of your eyes and teeth can affect your overall health.

Review Plans. More Insurance Products. Planning means expecting the unexpected. More Offerings. Small Business Plans. Make a Payment. Pay Now. As you transition to Medicare, we hope you'll Stay with Blue and get Medicare coverage from a company you trust. Blue Access for Members SM is a powerful tool for managing all your health plan benefits. You can:. Request a new replacement member ID card, or download a temporary copy. New to Blue Access for Members? Create an account. Want to be part of our amazing team?

Join us as we build the next generation of health insurance. Sign up for the LifeTimes newsletter to get health and benefits articles delivered to your inbox every month.

Our trusted community experts can give you the one-on-one help you need to shop for health insurance. Search articles and watch videos; ask questions and get answers.

Topics include everything from improving your well-being to explaining health coverage. We are also the largest provider of health benefits in Illinois, serving more than 8. Welcome Employers Producers Providers. Breastfeeding Counseling. Sign Up or Login. Welcome to your Health Plan Learn about your new health insurance benefits and how to start using them.

Get Started. Pay My Bill Pay Now. Pharmacy Coverage. Learn More.

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Members have a right to receive information about the health Plan, its services, its practitioners and providers, and members' rights and responsibilities. Members have a right to participate with practitioners in decision making regarding their health care. Members have a right to a candid discussion of appropriate or medically necessary treatment options for their conditions, regardless of cost or benefit coverage. Members have a right to make recommendations regarding the organization's members' rights and responsibilities policies.

Members have a right to voice complaints or appeals about the health Plan or the care provided. Members have a responsibility to provide, to the extent possible, information that the health Plan and its practitioners and providers need in order to care for them. Members have a responsibility to understand their health problems and participate in developing mutually agreed upon treatment goals to the degree possible. Members have a responsibility to follow the plans and instructions for care that they have agreed on with their practitioners.

Members have a responsibility to pay member copayments or coinsurance at the time of service. Have a question about individual or family plans? Visit our contact us page. Skip Navigation. Login Register.

Explore our Insurance Basics pages. Need Insurance? Log In or Register. Find a Doctor. Shop Insurance Plans. Employer Solutions. Insurance Basics New. Introducing CloseKnit A new patient-centric, virtual-first primary care practice. About Us. Company Overview. Community Partnerships. Transforming Healthcare. For Providers. Careers at CareFirst. Remember this page? Save My Preference.

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Individuals interested in purchasing insurance Reporters and journalists can contact Media Relations. For information on how to obtain grants or sponsorships contact Community Affairs.

For job opportunities at CareFirst, search and apply using our careers site. Interested in CareFirst, but waiting for the right opportunity? Join our talent network.

If you are a current or former CareFirst employee and need employment verification or related support, please send your request for assistance. Learn more about fraud. Report suspected fraud form. Concerned about privacy? Please review our Notice of Privacy Practices. If you have a concern, you may contact the Privacy Office at Please call Technical Support at , Monday-Friday, 8 a.

Whether you are an existing member or looking to buy a CareFirst plan, send us your questions and a representative will reach out to you to help resolve your issue. You will then see an option to search Primary Care Providers.

This tool will show you primary care physicians who are in-network for CareFirst's Blue Cross Blue Shield coverage, with their specialty, whether they are accepting new patients, what languages they speak, where they went to medical school, and their practice address and phone number. Learn more about selecting a doctor. Members may seek specialty care and behavioral healthcare from in-network or out-of-network providers. Be sure to talk with your primary care provider about your preferences.

Depending on your plan, you may need a referral from your primary care provider in order to access specialty care. Refer to your member benefit booklet for details. Members can log in to My Account to find participating in-network providers and facilities with the Find a Doctor tool.

Certain nonemergency hospital and other medical services require preapproval from CareFirst. Customer Service can assist you with the directory or help you locate a practitioner or facility within a specific geographic area. Video Visit doctors are U. HMO and POS plans: When you see an out-of-area participating BlueCross BlueShield doctor or hospital for emergency or urgent care, you only pay out-of-pocket expenses, like a copayment.

Your provider files the claim, which is paid at the in-network level. If your plan provides out-of-network benefits, those covered services are paid at the out-of-network benefit level. After you receive medical attention, your provider will file the claim. CareFirst pays all participating and preferred doctors and hospitals directly.

You are only responsible for any out-of-pocket expenses non-covered services, deductibles, copayments or coinsurance. If the provider does not participate with a BCBS plan, you must pay at the time of service.

However, if you visit a non-participating provider or non-participating pharmacy for service, you must submit the claim yourself. You can submit your claim one of two ways:. To ensure you are receiving the most appropriate medication for your condition s , additional information may be required from your doctor before filling certain prescriptions. In those instances, CareFirst will work with you and your doctor to manage the process. To see whether your drug is excluded or requires prior authorization, step therapy or quantity limits, visit the Drug Search page and select your plan year to find your specific formulary.

If the drug does not meet the needs of your particular condition or is excluded from the formulary, your doctor can request an exception with a Prior Authorization Form.

To ensure our members have access to safe and effective care, CareFirst reviews new developments in medical technology and new applications of existing technology for inclusion as a covered benefit.

We evaluate new and existing technologies for medical and behavioral health procedures, medications and devices through a formal review process. We also consider input from medical professionals, government agencies and published articles about scientific studies. If you have concerns regarding a decision that adversely affect coverage, such as a denial, a reduction of benefits, or a denial of authorization for services, you may call the Member Services telephone number on the back of your member ID card.

A representative can assist you with resolving the issue or initiating the appeal process. If needed, language interpretation is available. If you would like to review the procedure for filing an appeal, visit carefirst. For a printed copy, call Member Services at the telephone number on the back of your member ID card. In addition, many members have a right to an independent external review of any final appeal or grievance decision.

Refer to your Evidence of Coverage for more specific information regarding initiating an external review, a final appeal determination or a complaint. If you need language assistance or have questions, call the Member Services telephone number on the back of your member ID card. Get a Quote. Skip Navigation. Login Register. Have questions about health insurance?

Explore our Insurance Basics pages. Need Insurance? Log In or Register. We know healthcare can be complicated. To learn more, choose a topic from the list below. Expand All Collapse All Covered benefits.

All of our plans include core health benefits, including: Office visits Maternity and newborn care Prescription drugs Laboratory tests and X-rays Preventive and wellness care Dental and vision for children under age 19 Emergency services Hospitalization Behavioral health and substance use disorder Physical, speech and occupational therapy.