Children's Plan
Blue PathwaySM
Open Enrollment for Blue PathwaySM runs May 1, 2013 – June 30, 2013.
Our children's health insurance plan, Blue Pathway, provides coverage for individuals ages 1 through 18 and includes:
- Benefits for preventive care services
- Diagnostic testing
- Hospital services
- Emergency care
- Prescription drug coverage
- Physical, occupational and speech therapist therapy services
Blue Pathway provides guaranteed acceptance for applicants who are at least one year old and under 19 years of age.
View the features, options and costs of the Blue Pathway plan 
to find out if it's right for you.
If you need more information about eligibility for coverage, you may contact Blue Cross and Blue Shield of Texas Individual Products Customer Service at (888) 731-0406.
Health insurance costs include monthly premium payments, individual/family deductibles, out-of-pocket expenses, copayments and coinsurance. For Blue Pathway plans, here’s what you can expect:
- Individual in-network deductible of $2,500/$5,000 for out-of-network
- Family in-network deductible of $7,500/$15,000 for out-of-network
- Coinsurance levels of 75% in-network/60% out-of-network
- Benefits for preventive care services covered of 100% in-network/60% out-of-network
For more information on costs, including out-of-pocket costs, see the Outline of Coverage document under What's Included with Blue Pathway below.
At Blue Cross and Blue Shield of Texas (BCBSTX), we understand your concerns about coverage continuity. BCBSTX will never terminate or refuse to renew your Policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a policy may be terminated or a renewal refused:
- Failure to pay premiums
- The Blue Pathway plan is discontinued (90 days notice given with an option to convert to any plan we offer)
- Discovery of fraud or an intentional misrepresentation of facts (30 days prior written notice given)
- Failure to continue residing, living or working in an area where we are authorized to do business
For more information on renewability, see the Blue Pathway Outline of Coverage .
It’s important to know the features of the health insurance plan you are considering. Our Outline of Coverage documents give you brief descriptions of the basic details of our Blue Pathway product, as well as details on renewability, exclusions and limitations.
The Individual Dental plan is available as an optional benefit with your individual Blue Cross and Blue Shield of Texas insurance plan. There is an additional premium associated with this plan.
Learn more about the Dental Indemnity USA plan.
- Generic Drugs (Tier 1*) - $15 copayment in-network
- Preferred Brand Drugs (Tier 2*) – 75% coinsurance level in-network
- Your benefit plan includes a mail service program that offers you the convenience of having covered maintenance medications delivered directly to you.
- Your out-of-pocket cost for prescription drugs usually is less when you choose generic or formulary
*Tier 1 and 2 benefits are paid after the plan medical deductible has been satisfied
