Plan Options:
The district’s medical plans are offered through TML Health. Your medical and pharmacy benefits have changed. The Blue Cross Blue Shield of Texas (BCBSTX) network provides coverage for the TML Health medical plans. Your network of doctors will stay the same.
Your pharmacy benefits will now be managed by Navitus. Walgreens pharmacies are excluded. If you use Walgreens to fill prescriptions, transfers your prescriptions to an in-network pharmacy.
You will receive 2 new Id Cards, one from BCBSTX and one from Navitus (for prescription drugs).
HMO plans will require that you select a Primary Care Physician (PCP) and Specialty Access requires a referral.
TML Health HSA 3000
- Not covered Out-Of-Network MD Live
- No charge In-Network for Routine Preventive Care
- Not Covered Prescription Drugs supply Out-of-Network
- In Network and Out-Of-Network
TML Health HMO 2500
- Not covered Out-Of-Network
- No charge In-Network for MD Live & Routine Preventive Care
- Copay for office visits & Urgent care facilities
- Find a Provider
TML Health PPO (Copay) 2500
- In-Network and Out-of-Network
- Not covered MD Live Out-of-Network
- No charge In-Network for Routine Preventive Care
- In-Network Copay for Urgent Care Facility
- Not covered Out-of-Network Prescription Drugs supply
TML Health HMO 1500
- Not covered Out-of-Network
- Copay In-Network for Office Visits
- No charge In-Network for MD Live & Routine Preventive Care
- Copay In-Network for Urgent Care Facility
- Find a Provider
Prescription Benefits
The prescription drug plan included with your new medical benefits is managed by Navitus and uses a network of participating (in-network) pharmacies. To receive benefits, you must use a participating pharmacy. Visit www.navitus.com or call 844-268-9789 for a list of participating pharmacies in your area. While all of your medications now fall under a copay arrangement, your medications may fall under a different cost tier. Reference your plan’s Summary of Benefits and Coverage (SBC) for more information.
Benefits Value Advisor
Overwhelmed with cross-checking hospitals, doctors, and your network to get the best prices? Then meet your Benefits Value Advisor (BVA). You have 24/7 access to an personal customer service concierge dedicated to getting you the best deals on any medical expenses in Texas. Contact a BVS via Blue Access for Members on the BCBSTX website, or the BCBSTX mobile app, or by calling the BCBSTX Helpline at 855-762-6084.
Wellness
Exciting News – Your TML Health Membership gives you access to TWO incredible programs: TML Health’s TML Well and BCBSTX Well onTarget! Between them, you have access to a robust collection of benefits that are completely FREE to use.
The TWO wellness programs include a health incentive program called Blue Points, a mobile app with fitness and nutrition tacking, lifestyle coaching, and a library of online resources.
Employee Assistance Program
The Headway Employee Assistance Program (EAP) is a free service included through our partnership with TML Health. Everyone residing in your household can use the EAP even if they are not enrolled in your medical plan. The program offers a wide variety of counseling, referral, and consultation services, all designed to help you resolve work/life, issues and live a happier, healthier, more balanced life. These services are confidential and can be easily accessed by calling the toll-free Helpline at 866-327-2400.
Referrals to Community Resources, Advantage Financial Assist and Online Tools and Resources visit at: https://headway.co/
MD LIVE
- 24/7 Nurseline
- Access TML Health Online www.tmlhealthbenefits.org
- Virtual Visits
- There is No Charge for general visits if you are enrolled in HMO 2500, PPO 2500 or HMO 1500
- Register for MD Live through Blue Access for Members or www.bcbstx.com/member
Preventive Health Services
