You have the opportunity to enroll yourself, your spouse or your qualified domestic partner, and eligible children. It is extremely important that you understand the eligibility criteria and enroll only those dependents that meet the following criteria.
Eligible children until 26th birthday (regardless of martial or student status). "Children" are defined as your natural children, stepchildren, legally adopted children, and children under your legal guardianship.
There are four medical options available, each with different deductibles, out-of-pocket maximums and monthly/bi-weekly premiums. You are not required to select a primary care physician and you do not need a referral to see a specialist. You have the option to receive care from in-network or out-of-network providers, or both, depending on your needs.
Your options are:
Click on the links above for detailed information about how each option covers various health care services including physician office visits, hospital charges, x-rays, prescription drugs and much more. If you have additional questions about coverage for specific procedures or services, or about plan limitations and exclusions, please call BCBSTX at 877-768-2005.
Preventive Care Benefits
The PPO options cover 100% of the cost of annual in-network routine physicals, age-recommended screenings (including breast, prostate and colon screenings), and immunizations for you and your enrolled dependents. Please refer to SMU Preventive Care Guidelines for detailed information.
The Blue365® Program
If you participate in the SMU Medical Plan, then you are eligible to enroll in the Blue365® Program. For more information, please take a look at the Blue 365 Member Flyer or visit Blue365deals.com/BCBSTX.
Compass Professional Health Services
Did you know that charges for medical services vary widely – by location and by provider? Medical charges for a specific service can vary by as much as 300%, even within the BCBSTX network. For example, one in-network imaging center might charge $500 for a CT scan, and another center might charge $1,500. These cost variances apply to many other medical services, including surgical, anesthesia, and hospital room & board charges. A cost differential like this has a direct impact on your out-of-pocket expenses.
SMU has partnered with Compass Professional Health Services to provide a service that will enable you to identify high-quality doctors, hospitals, imaging centers, etc., and make choices that can significantly reduce your expenses. In addition, your Compass Health Pro can help you better understand your medical insurance and provide assistance with billion/claim disputes.
Compass services are paid by SMU at no cost to you. Your health information will not be shared with BCBSTX, your doctor, or anyone else – without your personal consent. Your health information will never be shared with SMU.
Watch the ACAP Price Transparency Video and review the Healthcare Consumer Tools and Support Presentation to learn how the service works. You can reach your Compass Health Pro at 800-513-1667.
Exchange Visitors on a J-1 Visa
If you are an Exchange Visitor on a J-1 Visa (visiting scholar, professor, or researcher), you and your dependents (J-2) are required by the Department of State to carry and maintain appropriate medical coverage while at SMU. Your medical coverage must include: medical benefits of at least $50,000 per accident or illness, repatriation of remains in the amount of $7,500, coverage for expenses associated with the medical evacuation of the exchange visitor to his or her home country in the amount of $10,000, and a deductible not to exceed $500 per accident or illness.
SMU has made special arrangements to provide a health plan that meets these requirements. You are required to enroll in this plan immediately upon your arrival. Please call the SMU Benefits Representative at 214-768-2072 for additional information and enrollment assistance.