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Know your Medicare options

Check availability by service coverage area.

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Not sure if you might be at risk for kidney disease?

Complimentary phone evaluations are now available for BSW SeniorCare Advantage members. Click here for more information.

MyBSWHealth Member Portal Updates

The new MyBSWHealth 24/7 member portal experience is live. Learn more here.

The COVID-19 vaccine will be available to health plan members at zero out-of-pocket cost

We care about the health and well-being of all of our members and are committed to keeping you informed.

Click here for more information about the vaccine.

Click here for more information about your benefits during the COVID-19 pandemic.

Click here for ways to help protect yourself from COVID-19 fraud, waste and abuse schemes.

For Medicare Advantage members, effective March 6, 2020, and until further notice:

Scott and White Health Plan is waiving member cost-sharing for care related to COVID-19, which includes testing, telehealth services, outpatient office visits and inpatient hospital stays.

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Plan Year 2022 Enrollment Information

 


Plan Year 2021 Enrollment Information

For 2021 benefits information, call a licensed insurance sales representative. 1-800-782-5068 (TTY: 711)

 

Annual Notice of Change Presentations

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Medicare coverage the way it should be

Enroll Now

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Recently Applied Online? 

Check Online Application Status

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2022 BSW SeniorCare Advantage HMO Plan Members

Member Quicklinks

 

2022 BSW SeniorCare Advantage PPO Plan Members

Member Quicklinks


2021 BSW SeniorCare Advantage HMO Plan Members

Member Quicklinks

 

2021 BSW SeniorCare Advantage PPO Plan Members

Member Quicklinks

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As a Medicare member, you have the right to:

  • • Ask for coverage of a medical service or prescription drug. In some cases, we may allow exceptions for a service or drug that is normally not covered.
  • • File an appeal if your request is denied. An appeal is a formal way of asking us to review and change a coverage decision we made.

You can submit your request for medical service coverage or appeal to the following:

  • Mail:
  • Scott and White Health Plan
  • 1206 West Campus Drive
  • Temple, TX 76502
  • Fax: 1-800-626-3042
  • Phone: 1-866-334-3141 (TTY 711)

You can submit your request for Part D drug coverage or redetermination (appeal) as follows:

Coverage determinations

  • Mail:
 
  • OptumRx
  • Attn: Prior Auth Exceptions
  • P.O. Box 25183
  • Santa Ana, CA 92799
  • Fax: 1-844-403-1028
  • Phone: 1-844-230-9357 (TTY 711)
  • Online for Members:
    • SWHP Member Portal. *Once logged in, click on “Insurance & Billing” > “Scott & White Health Plan” > “Plan Benefits” > and click “View” Pharmacy Claims. When on the OptumRx website, you can submit a prior authorization request online.
  • Online for Providers:

Redetermination (appeal)

  • Mail:
 
  • OptumRx
  • Prior Authorization Department
  • c/o Appeals Coordinator
  • P.O. Box 25184
  • Santa Ana, CA 92799

* Standard Medicare Part D redetermination (appeal) requests must be submitted in writing and cannot be initiated via phone. If you believe waiting 7 days for a standard Medicare Part D redetermination decision could seriously harm the member's life, health, or ability to regain maximum function, you can ask for an expedited decision; expedited Medicare Part D redetermination requests can be initiated via phone.

  • Fax: 1-877-239-4565
  • Phone: 1-888-403-3398* (TTY 711)*
  • Online for Members:
    • SWHP Member Portal. *Once logged in, click on “Insurance & Billing” > “Scott & White Health Plan” > “Plan Benefits” > and click “View” Pharmacy Claims. When on the OptumRx website, you can submit a prior authorization request online.
  • Online for Providers:

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ATTENTION: If you speak Spanish, language assistance services, free of charge, are available to you. Call 1-866-334-3141 (TTY: 711).

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