| Blue Cross and Blue Shield of Texas / Office Copay and Major Medical / High Deductible - Major Medical / Dental / Short Term / Disclaimer / Rate Quotes / Apply Online |
SelecTEMP® PPO
In-network, this plan pays 80 percent and the policyholder pays 20 percent of eligible expenses
after the deductible has been met. Physician office visits are subject to deductible and
coinsurance.
Dental Indemnity USA
A $50 deductible will apply for dental services received during each benefit year. For family
coverage, the maximum deductible is $150. Deductibles do not apply to such procedures as oral
exams, cleaning, fluoride treatments, sealants, and x-rays.
Covered individuals must be enrolled in the Dental Indemnity USA plan for 12 months before
receiving dental benefits in the following coverage categories; major restorative, periodontics,
removable prosthetics, fixed bridge and orthodontia.
PPO Select® Saver Series III
In-network, this plan pays 75 percent and policyholder pays 25
percent of covered expenses after the deductible has been met.
All physician office visits will be subject to deductible and
coinsurance.
Select Blue Advantage Series III
In-network, this plan pays 85 percent and the policyholder pays 15
percent of covered expenses after the deductible has been met.
In-network $25 office visit copay includes same day lab and x-ray,
up to annual max of $750 - annual maximum per person, then
subject to deductibles and coinsurance.
Goebelt Insurance Services, Inc. and David Goebelt are an independent authorized agency/producer licensed to sell and promote products
from Blue Cross and Blue Shield of Texas (BCBSTX).
† A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue
Shield Association
from Blue Cross and Blue Shield of Texas (BCBSTX).
† A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue
Shield Association
| Authorized Blue Cross and Blue Shield of Texas Agent David Goebelt 800-918-1158 |
Individual Health Insurance Products from Blue Cross and Blue Shield of Texas
PPO Select® Choice Series III
In-network, this plan pays 80 percent and the policyholder pays 20 percent of covered expenses
after deductible has been met. In-network $25 office visit copay (physician consultation only).
Blue Edgesm Individual HSA
With this plan, benefits begin after the policyholder meets the
deductible. The policyholder's coinsurance level is determined by health insurance plan selection.
PPO Select® Value Care
In-network, this plan pays 50 percent and the policyholder pays 50 percent of eligible expenses.
Physician office visits paid at 50/50 coinsurance.
Foundation Hospital Care
In-network, this plan pays 80 percent and policyholders pay 20 percent of covered expenses
after they meet their calendar year deductible.
Goebelt
Insurance
Services, Inc.
Services, Inc.
| Office Copay and Major Medical |
| High Deductible / Major Medical |
| Short Term and Dental |
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