Member Rewards Program FAQs
What is the Member Rewards Program?
It’s a program offered through BlueCross BlueShield of Texas to encourage you to explore certain treatment options before choosing your care. You might be surprised by how much you can learn and save by contacting a BCBSTX Benefits Value Advisor (BVA). With the Member Rewards Program, you’ll also receive a check for making cost-effective medical choices.
How does the program work?
Start by contacting a Benefits Value Advisor (just call the Customer Service number on the back of your BCBSTX ID card) or use the Member Rewards tool online at
www.bcbstx.com to get benefits information and find contracting, in-network providers for health care services such as:
CAT or CT scans (precertification through BVA is required to avoid a $200 surcharge)
MRIs (precertification through BVA is required to avoid a $200 surcharge)
Endoscopy procedures
Colonoscopy procedures
Back or spinal surgery
Knee surgery
Shoulder surgery
Hip or joint replacement surgery
Bariatric surgery
You will be presented with several cost-effective treatment options from in-network providers located near you. If you select the most cost-effective option for your procedure, a reward check will be mailed directly to you after you have the procedure and the claim is paid. If you choose the second or third most cost-effective option, you may be eligible for a smaller reward.
How much are the rewards?
Reward checks can vary in value up to several hundred dollars depending on the procedure and facility you choose. This chart shows examples of reward payments, which are based on how cost-effective your choice of care is.
| Provider A | Provider B |
| COST | MEMBER REWARD | COST | MEMBER REWARD |
Knee MRI | $374 | $125 | $2,779 | $0 |
Hip Replacement Surgery | $32,293 | $500 | $52,307 | $0 |
Maternity Delivery Services | $10,696 | $250 | $13,677 | $50 |
NOTE: The payments above use allowable in-network cost data from Tarrant County. These examples are estimates only — costs may not be the same for every member’s situation. |
All rewards are subject to tax. You should allow 4–6 weeks for receipt of your rewards check after the provider files a claim and BCBSTX verifies the claim.
How else can a Benefits Value Advisor help me?
A Benefits Value Advisor can also help you plan for your health care by:
Helping you better understand your benefits
Giving you a cost estimate for health care services
Scheduling a doctor or procedure appointment
Helping you get general health information about your condition
Telling you about online educational tools
Helping you with precertification
Precertification
Precertification is required for outpatient MRIs, CAT or CT scans. If you don’t contact a Benefits Value Advisor BEFORE receiving these services, you will be responsible for a $200 surcharge, as well as any deductibles and coinsurance. The cost for these procedures varies widely, and the surcharge encourages you to consider more cost-effective options before deciding on a provider.