Get Answers To Our Most Frequently Asked Questions
Get Answers To Our Most Frequently Asked Questions
If you’re having trouble getting online access to your account using Blue Access for MembersSM (BAMSM), these Frequently Asked Questions may help you troubleshoot.
First, check your password by pressing the eyeball icon after typing it in, this will ensure that you’ve entered it correctly.
If you still get an error message, this is a quick and easy way to reset your password:
Password must have:
Password can't have:
Once your password has been reset, try again to log in to BAMSM.
You can call the customer service number listed on the back of your Blue Cross and Blue Shield of Texas (BCBSTX) member ID card to make sure the right email and mobile number is linked to your account or to change your contact preferences. Or you can use our online form to update your preferences using your member ID number.
If you are unsure that your username is correct or don’t remember it, you can get your username using these easy steps:
You can use the same steps above to have your username sent to you.
Because your account includes private health and financial information, we pledge to keep your account information safe. This passcode is a security feature we’ve added to protect your account from hackers, malicious actors and cyber threats. It is an extra step, and that can be annoying. But you will have the option to check a box when entering the one-time verification code that will allow you to skip the verification steps on that device for 30 days.
Our “Shop Plans and Prices” site is a tool used to pick a plan and enroll. For security reasons, it isn't part of our member accounts system. That means you’ll need to sign up for BAMSM, as well – even if you use the same username and password.
We've updated Blue Access for Members to give you a better experience, so the website address you saved may have changed. Access the new BAMSM website and use Sign Up or Log In within the Member Login window on the top right of the webpage. You can save the new BAMSM link, but don’t forget to delete the old one.
Go to BAMSM and click Sign Up or Log In and follow these simple steps:
For technical questions about the BAMSM website:
Internet Help Desk
TTY, dial 711
24 hours a day, 7 days a week
Most often, your health care provider will submit a claim on your behalf. If your health care provider does not send the claim for you, you can file a claim yourself.
To submit your completed form, you can:
If you’ve already paid for a health care service that you believe should be covered, you can submit a claim to be paid back.
To submit your completed form, you can:
There are three types of claims statuses that you may see:
Please note that BAMSM and Customer Service agents will not have updates on your claim until it is processed.
You have the right to know why a claim was denied. Learning why your claim has been denied is also the first step to appealing or re-filing your claim.
You can always check your Explanation of Benefits (EOB) for why your claim was denied and to make sure your claim information is correct. If a claim is denied, a reason for the denial will be listed at the end of your EOB.
You always have the right to know why a claim was denied and to appeal a denied claim. Every EOB has instructions on what to do if a claim has been denied. It is also explained in your benefit book. You may get your EOB in the mail. If you have a BAMSM online account, your EOB and benefit book can also be found there.
While some appeals can be faster, a standard appeal takes about 30 days for review. Some appeals may take up to 60 days.
If your life or health could be at risk by waiting, you can ask for an urgent appeal. If you qualify, the review will be handled within 72 hours. You and your doctor will get a phone call from us explaining the decision and next steps.
When you go to your doctor and pay your copay – you’ll get an Explanation of Benefits (EOB) after your claim is final. An EOB shows costs from your health care provider and how the claim was processed. Charges change according to what your plan covers and what services you receive.
If you get paper EOBs, an EOB will be mailed to you after a claim has been finalized. If you have a BAMSM online account, your EOB and benefit book can also be found there. If you are signed up for paperless statements, you can opt in to get an email or text when your EOB is ready to view in your BAMSM account.
It can be confusing when you go to the doctor for a covered routine or diagnostic visit and still get a bill. There can be a few reasons this happens:
You may have gone to a doctor that’s out of network, or you may have had lab work done that was sent out of network. When you go out of network, this may incur a charge.
When you go to a routine visit, only certain services are covered at 100%. If you ask for or choose to have other services performed, or talk about other issues that are not covered as routine, you may be charged.
It can be confusing if you believe that a claim was approved, and you still get a bill. First, double check your EOB to make sure all the services you received were covered. Sometimes when you visit a provider, only certain services are covered at 100%. Your health plan may have only covered part of your total bill.
If you have checked your EOB and believe you were billed for a service that was covered, call your provider. If you are still having issues you can call the customer service number on the back of your ID card.
When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.
There may be several reasons why your prescription drug claim has been denied:
If your medication is not on your drug list, you or your prescribing doctor can request a coverage exception. To request this exception, your prescribing doctor will need to send us documentation, or you can fill out and submit the Prescription Drug Coverage Exception form.
We will usually let you or your doctor know the coverage decision within 72 hours of receiving your request.
You or your doctor may be able to ask for an expedited review if:
We will usually let you or your doctor know the coverage decision on an expedited review within 24 hours of receiving your request.
If the coverage request is denied, we will let you know why it was denied and may advise you of a covered alternative drug. You can also appeal the benefit determination.
If you’re covered by two health plans, your doctor may file a claim with both. Insurance companies decide which plan covers what costs. This is called Coordination of Benefits (COB).
You may get a COB Questionnaire from your insurer to set up the coordination of benefits so claims get paid correctly. If you do, please be sure to fill it out, even if you do not have any other coverage. You may also want to document any other coverage you have when your plan renews each year.
BCBSTX and Equian have partnered to review the medical claim listed on your letter to determine if another person or insurance company should be responsible for the claim. The claim we are investigating may be for treatment you received from an injury experienced at work or from an auto accident.
The information could help to get back money that should be paid by someone else, like another insurance carrier. This is one of several tools used by BCBSTX to help control rising costs of health care. Call the number on the letter to answer the claim question.
You should get your member ID cards in the mail soon after your application is approved. Individual and family PPO members will receive no more than 2 member ID cards. Please note that all member ID cards will have only the subscriber name’s but can be used by all the dependents enrolled under the policy. HMO Individual and family plans will get a card for each member enrolled.
You can print a temporary ID card and request additional cards through your Blue Access for Members SM (BAMSM) account. You will need your member identification number and group number to log in to BAMSM. These numbers can be found on the new member welcome letter you will receive within days of enrolling.
Your member ID cards will only have the primary subscriber's name on them, but they can be used by all the dependents (in this case your spouse) enrolled under your policy.
Don’t worry if your ID card is lost or misplaced. We know this happens, so we’re ready to help. Find out more about your card and how to replace it.
Your trusty smartphone now safely stores your health information. Your mobile phone/device can:
Log in to Blue Access for MembersSM (BAMSM) 24/7 to access your benefits information or call Customer Service at the number listed on your Blue Cross and Blue Shield of Texas (BCBSTX) member ID card.
Yes. We are committed to protecting your medical records. We have strict rules to keep all your member information confidential. This includes our staff and anyone who needs to see your records. If your medical records or claims details need to be reviewed, precautions are taken to keep your information safe. In many cases your identity, such as name and address, will not be included in the information provided during the review.
Within days of your application being accepted, you will receive a welcome letter from BCBSTX that includes your member identification number and group number. This information can be used by providers and pharmacies to verify your coverage until you get your member ID card. Your ID card will be sent separately soon after.
Your policy information is available through your BAM account once your plan is in effect.
Moving? Expecting a new arrival? When your life changes, let us help. Find out more about making a seamless transition.
Blue Access Members can tweak how you receive communications from Blue Cross and Blue Shield. To make changes, go to your communication preferences page.
You may have received this error message during your registration for several reasons. Many times, the information you entered may not have matched the data in our system. Please remember to have your group and member ID numbers handy when you register. These numbers can be found on your welcome letter and your member ID card. Register now.
Members can receive Explanation of Benefits (EOB) statements in Spanish. Check here for available Spanish communications. You can also call the customer service number listed on your member ID card. Customer Service will record your preference.
We also have the following tools available to meet the Spanish language preference of our members:
Spanish Resources (Video)
All our health plans will cover your essential health benefits and services. That said, you’ll want to find the one best suited to you and your family’s needs. Learn more about your choices and how to make your best decision.
Getting the best answers starts with asking the right questions. You’ll want to know what you need to know before making your decisions. Find out more about how to go about seeking the best plan for you.
Taking advantage of open enrollment requires planning in advance. We can help you make your list, check it twice and be ready when the time comes to act. Learn more about how this works.
In most cases, you can only sign up for a health insurance plan during the open enrollment period. If you missed open enrollment, you may be able to enroll during the special enrollment period. To be eligible, you must have had a qualifying "life event" within the past 60 days or experienced other complications that did not allow you to complete your enrollment.
This Contact Guide has the phone numbers and instructions you’ll need. Find the change you’d like to make, then learn where to get started.
A Health Maintenance Organization (HMO) is a type of health plan that gives you access to certain doctors and hospitals that have contracted with the HMO, often called a provider network or just network.
The following doctors can be selected as a PCP:
Use our Provider Finder online directory to find a PCP in the HMO network who best fits your needs. Be sure the doctor you select is accepting new patients.
It's easy to use the Provider Finder by registering for Blue Access for MembersSM (BAMSM):
You must have a primary care provider assigned. If you don't select your own, we will assign one to you.
Yes. However, if the specialist is not in your plan's network, in most cases, you may have to pay for services that are considered out-of-network.
Yes, if your current doctor is a part of the HMO’s network. If your doctor is not in the network, you will need to select a new PCP. To make sure a provider is in the HMO network, search Provider Finder.
Search for an in-network doctor under your plan on Provider Finder. Also:
Log in to BAMSM and choose your primary doctor.
In an emergency, go directly to the nearest hospital. For non-emergencies, some HMO plans allow you to get health care services from a BCBS affiliated doctor or hospital when you are traveling outside of Texas.
If you aren't sure, contact customer service at the number listed on your member ID card before you go. And always remember to carry your current BCBSTX member ID card. It contains helpful information for accessing health care at home or away.
If you or a covered family member will be temporarily living outside Texas for 90 days or more, you may be eligible for guest memberships in a BCBSTX affiliated HMO. In some circumstances, moving can also qualify you to be able to enroll in a new plan in your new location.
We'll work with you to provide coverage for the most appropriate care for your medical situation, especially if you are pregnant or receiving treatment for a serious illness. You may still be able to see your current provider for a brief time. Call us at the customer service number listed on your BCBSTX member ID card for more information.
Your BCBSTX HMO benefits also cover prescription drugs. Not all drugs are covered. You can visit our website to view the list of prescriptions your plan covers. This list is called a preferred drug list. To look for your medicines, you will need to know:
While costs can vary depending on your benefit plan, you usually pay less for generic drugs and more for brand name drugs. Your plan may cover some of the costs of drugs not on your preferred drug list. You can learn more by looking in your benefit book or calling the customer service number listed on your member ID card.
If your plan offers a preferred pharmacy, save money by filling prescriptions at these places. Subscribers pay less for a 90-day supply of covered medicines in the store or by home delivery.
Be prepared. Learn your options before you find yourself in need of medical care, You may not know when you’ll need care but you’ll know where to go when the need arises. Find out more about the different resources available.
Don’t wait until you are sick to find a personal doctor. You’ll want the practice best suited to you and your family’s needs. Get started with some expert advice.
We build and test our webpages and apps so they work with assistive tools used by the disabled. We follow the standards set by the global Web Content Accessibility Guidelines 2.1 (WCAG 2.1). We also meet US law, Section 508 Accessibility Standards.
To get language or communication help (hearing or sight) free of charge, please call us at 1-855-710-6984.
Please got to Our Accessibility Statement Page for more information on our accessibility efforts.
Last Updated: Aug. 30, 2023