MyBlue Health HMO: Overview
- In January 2020, Standard Products launched the Texas high performance network in the Dallas and Harris Markets to establish a competitive product aimed to deliver value and offer a competitiaaaave offering for subsidized market providing access to high quality care at an affordable price.
While the MyBlue Health network is mirrored after the Blue Advantage HMO product, Blue Advantage HMO and Blue Advantage Plus are different products that do not have relation/combination with MyBlue Health.
- A consumer not located in the zip codes where MyBlue Health is available, will not have the ability to enroll in the product.
- A key feature of the MyBlue Health HMO is the Sanitas Medical Group collaboration model.
MyBlue Health HMO: Sanitas Benefits
- All BCBSTX members (all lines of business) can utilize Sanitas Medical Group professionals and Sanitas Medical Centers but only MyBlue Health HMO members who selected a Sanitas PCP have a $0 PCP cost share when at a scheduled PCP visit with their Sanitas PCP
MyBlue Health HMO members don't have to use Sanitas PCPs; if they don't, they're encouraged to stay in network on their MyBlue Health HMO plan and would pay applicable cost shares
The Sanitas $0 PCP benefit is only for members who:
1. live in Dallas or Harris county
2. select a MyBlue Health HMO policy in the Retail ACA QHP market (on & off exchange)
3. choose a PCP from the Sanitas Medical Group
- General plan benefits apply to services excluded from or not listed as included at $0
- General plan benefits apply to all services provided outside of Sanitas Medical Group, even if referred from a Santas PCP
Select PCP Practice Groups
Bexar County:
CentroMed
Dallas County:
Sanitas Medical Centers
Harris County:
Sanitas Medical Centers
Travis County:
CommUnityCare
Lone Star Circle of Care
Williamson County:
CommUnityCare
Lone Star Circle of Care
Select PCP Practice Groups for Expansion Counties
Cameron County:
Su Clinica Familiar
Harlingen Physician Network
BHS Physicians Network (dba Baptist Medical Network)
Collin/Denton/Tarrant County:
VMO Primary Providers N TX PLLC
El Paso County:
Centro De Salud Familiar La Fe Inc
Project Vida Health Center
Hidalgo County:
South Texas Health System Clinics
*other independent community physicians may be eligible to serve as a Select PCP
