This article is intended for members enrolled in an individual health insurance plan.
Has this happened to you: You call to make a doctor’s appointment. You’re hoping to get into the office the same day. The receptionist asks if you’re willing to see the physician assistant (PA) or nurse practitioner (NP).
Did you wonder how you should answer?
PAs and NPs generally work under the supervision of a physician as part of a medical team or office. You also may have met a PA or NP when visiting a retail or urgent/immediate care clinic.
They are licensed to provide limited health care services. If a prescription is needed, they may be able to handle that, too.
Today, there are more than 115,000 certified PAs and more than 234,000 licensed NPs in the U.S. The numbers continue to grow as PAs and NPs help doctors provide care for the over 8.1 million health care visits that occur each week.
Health Insurance Coverage: The Same Rules Apply
When using your Blue Cross and Blue Shield of Texas health plan, an important first step is to make sure you’re seeing a provider — whether it’s a doctor, PA or NP — who’s in your network.
If you visit a provider outside your network, you may have to pay more for your care. In some cases, you may have to pay the full cost.
Need to find a network provider? Here’s how to get started:
Start with a search. Your health plan works with a group of doctors, specialists and health care facilities. This is known as your provider network. Before you see a provider, log in to Blue Access for MembersSM (BAMSM) and select the Doctors and Hospitals tab. There you can search for providers and facilities in your network.
If you’re not already registered for BAM, register today. It’s easy. Just go to bcbstx.com/member/register and follow the instructions.
When in doubt, call. If you have questions after checking online, call the customer service number on the back of your member ID card for more information.
Sources: 2016 Statistical Profile of Certified Physician Assistants, National Commission on Certification of Physician Assistants Annual Report, 2017; NP Fact Sheet, American Association of Nurse Practitioners, 2018
*Virtual Visits, powered by MDLIVE, may not be available on all plans. Virtual visits are subject to the terms and conditions of your benefit plan, including benefits, limitations, and exclusions. MDLIVE operates subject to state regulations and may not be available in certain states. MDLIVE is not an insurance product or a prescription fulfillment warehouse. MDLIVE does not guarantee that a prescription will be written. MDLIVE does not prescribe DEA-controlled substances, non-therapeutic drugs and certain other drugs that may be harmful because of their potential for abuse. MDLIVE physicians reserve the right to deny care for potential misuse of services.
**Internet/Wi-Fi connection is needed for computer access. Data charges may apply. Check your cellular data or internet service provider’s plan for details. Non-emergency medical service in Idaho, Montana and New Mexico is limited to interactive audio/video (video only). Non-emergency medical service in Arkansas is limited to interactive audio/video (video only) for initial consultation. Behavioral Health service is limited to interactive audio/video (video only). Service availability depends on location at the time of consultation (audio only in Oklahoma).
MDLIVE, an independent company, operates and administers the virtual visit program and is solely responsible for its operations and that of its contracted providers.