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MyBSWHealth Member Portal Updates

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

COVID-19: What you need to know about the outbreak of the coronavirus

We care about the health and well-being of all of our members. As we continue to monitor the spread of COVID-19, we are committed to keeping you informed. Click here for more information.

ANNOUNCEMENT: New Kidney Care Program

New starting November 1, 2020, a no-cost kidney care program for Medicare Advantage members living with late-stage chronic kidney disease (CKD) or end-stage renal disease (ESRD). Find out more.

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.

Enable Mobile SMS Text Notifications in Member Portal Message Center

You may opt-in for SMS Text Notifications service by updating your preferences in the Member Portal. These steps show you how.

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The 2021 Annual Enrollment Period runs through December 7

  • Scroll down for enrollment information or call 1-800-782-5068 (TTY: 711) and a licensed insurance agent will be happy to speak with you.
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    Plan Year 2021 Enrollment Information

     

    Annual Notice of Change Presentations

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    Plan Year 2020 — Enrollment

    Select Your County of Residence

    Service coverage area eligibility is, by law, based on your county of residence. We offer one or more plans for the following Texas counties:

    Don't see your Texas County? Other Texas counties are outside our 2020 service coverage areas.

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    Medicare coverage the way it should be

    Enroll Now

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    Recently Applied Online? 

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    2021 BSW SeniorCare Advantage HMO Plan Members

    Member Quicklinks

     

    2021 BSW SeniorCare Advantage PPO Plan Members

    Member Quicklinks

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    2020 SeniorCare Advantage HMO Plan Members

    Member Quicklinks

     

    2020 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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