With Baylor Scott & White Health Plan (BSWHP), you have access to the renowned doctors, specialists and facilities of the Baylor Scott & White Health system plus thousands of additional providers throughout North, Central and West Texas.
Your card contains important information including your plan name, member ID number, copay/coinsurance amounts and customer service phone numbers to call if you have questions.
Be sure to always show your new Member ID card to your provider, even if your coverage has not changed. You may have a new Member ID number or a phone number may have changed. Your provider will need this information to confirm coverage and process your claims.
TIP: Once your new card is in effect (any time after Jan. 1, 2025), take it to your pharmacy counter so your account will be up to date the next time you need a prescription. This simple step can save you time and frustration in the future.
Effective Jan. 1, 2025, BSWHP is changing our Pharmacy Benefits Administrator to Capital Rx. They will oversee your prescription benefit plans on behalf of BSWHP. Together we will work hard every day to ensure your prescription plan is cost-effective while never losing sight of our ultimate mission: YOUR HEALTH.
Select a plan to check the costs of your medications, look-up drug coverage and search for pharmacies.
Access health plan information from any computer, tablet or smartphone device. To download:
Or text "BETTER" to 88408
Members have access to board-certified doctors, pediatricians, licensed therapists and more using your smartphone, tablet or desktop computer.
Receive care from the comfort of your home, or anywhere in Texas, 24/7. Simply log into MyBSWHealth.com or download the app.
Our Procedure Cost Estimator can help you plan for future expenses and make informed choices about where to receive care. You can research any treatment (like chemotherapy) or procedure (such as a colonoscopy) in any of our in-network facilities, and receive a breakdown of all potential costs, including physician fees, laboratory tests, and medications. You can also see progress toward meeting deductibles and out-of-pocket maximums.
Try it! Simply log into the member portal and use the menu at the left to select the Cost Estimator.
The calculation for out-of-pocket expense is for the current plan year and is a good-faith estimate based on the information members provide. Actual out-of-pocket expenses may vary depending upon many factors, including the intensity of the condition, the complexity of treating the condition, or the medical provider. Estimates are given for procedures performed by in-network providers.
Coming soon...
The BSWHP Specialty Pharmacy Program offers the choice of two specialty care pharmacies to help manage and access specialty drugs.
BSWHP has certain medications that are restricted to the Pharmacy or Medical Benefit. For more information on these medications, visit the link below:
Under the Affordable Care Act, also known as the healthcare reform law, BSWHP covers preventive care medications at 100% without charging a copay, coinsurance or deductible. The following list of drugs and products require a prescription (including over-the-counter medications) and must be filled at a network pharmacy to be covered at no cost share.
Treating yourself right isn't a trend, it's a good habit. And it's a habit anyone can pick up. Take advantage of these Health and Wellness Programs to help you improve the areas of your life that need a boost.
The Wellbeing Assessment is a simple, digital health survey that helps you take steps toward a more vibrant and healthier life. The Wellbeing Assessment asks questions about your life and delivers customized action steps from our Lifestyle Management Program. Modules are self-paced, available online, and convenient for promoting physical and mental health, all things to help you feel your best.
The WebMD digital wellness platform encourages members to be healthy, while providing personal health support for various health conditions and health risks.
Well-being Assessment – Take an online health assessment to access recommendations and daily habits to improve your health and well-being. The well-being assessment is a simple digital health survey that helps you take steps towards a healthier and more vibrant life. Assessment for members.
Digital Wellness Coaching – Stay engaged, track progress and accomplish well-being goals by utilizing Daily Habits. Daily Habits offers you a personalized set of activities based on your health information and personal interests.
Digital Health Library – The Resource card offers articles, videos, recipes and motivational apps to support a healthier life. You can search for condition-specific information or explore other health topics of interest.
From Your Health Plan – Find the latest information on additional wellness offerings available through the health plan.
Wellness Challenges – Join a wellness challenge for the motivation to go the extra mile. Wellness Challenges encourage sustainable, healthy habits through competition and accountability. Gamify drinking water, taking the stairs and other activities that challenge and boost your well-being.
We are pleased to offer a maternity program for expectant Baylor Scott & White Health Plan members. Focused on helping expectant mothers enjoy a healthy pregnancy journey, members can benefit from diverse program features for the duration of their pregnancy and one year postpartum.
As part of your coverage, you have access to in-network certified nurse midwives, home nurse visits and board-certified lactation specialists during your prenatal and post-partum period at no cost to you.
Sign up by calling the customer service number on the back of your ID card or send an email to: HPMaternityCaseManagement@BSWHealth.org.
Coverage is for adults 21 years of age and above. For additional information and coverage details, please see your 2025 Plan Brochure.
Programs that help treat obesity include:
Anti-obesity medications may be covered under the pharmacy benefit. Refer to your formulary for a list of covered products. Medications may be subject to prior authorization review and quantity limits.
Preventive medications with USPSTF recommendations of A and B are covered at no cost to you—even if you get them over the counter—as long as they are prescribed by a healthcare professional and filled at a network pharmacy. See current USPSTF recommendations.
Covered procedures include Roux-en-Y Gastric Bypass (RYGB) Inpatient, Biliopancreatic Diversion with Duodenal Switch Inpatient, Sleeve Gastrectomy or Laparoscopic Adjustable Gastric Band Outpatient.
Obesity surgery may be covered when ALL of the following criteria are met:
Coverage is subject to prior authorization and includes pre-surgical visits, surgery-related services and follow-up visits.
Have you ever wondered why some people can eat the foods they love and not gain weight? WondrTM is a skills-based digital weight loss program offered by Baylor Scott & White Health Plan — at no cost to you* — that has helped hundreds of thousands of people in different stages of health.
If you have Type 2 Diabetes, you should be aware of the risks and take it seriously. Without proper management, diabetes can lead to other serious health issues. In fact, this "silent killer" is the eighth leading cause of death in adults in the United States (Centers for Disease Control and Prevention).
But you can be well, even with diabetes.
That's what this program is all about. BSW Be Well with Diabetes provides support to help improve your health, better manage your diabetes, and save you money.
Making positive change for your health can be difficult, but you don't have to do it alone. Our BSW Be Well Coaching program offers a one-to-one coaching experience tailored to fit your needs and help you achieve your personal best.
Case Management can help with:
It's an added benefit for our members at no cost to you. The program is completely voluntary, so you may opt-in or out at any time.
To request Case Management:
Finding help just got easier. findhelp is a Texas-based platform created to connect all people in need with programs that serve them. You can search for local resources like medical care, food, job training, transportation and more. Organizations in your community are ready to help.
findhelp is free, private, and easy to use. Search and connect at:
Did you know BSWHP has free health education opportunities you can access from the comfort of home? There's a whole series of topics, from nutrition to happiness, and you can come to one or all. Webinars take place midday, so grab your lunch and plan to join us!
Be Well is a collection of news, tips and reminders designed to help you and your family make the most of your wellness benefits and live a healthy lifestyle. We email the newsletter to Baylor Scott & White Health Plan employer group members who are registered for MyBSWHealth. You can always find the current issue here.
Nurses are available to our members 24/7. Our nurses can give you information about how to take care of yourself at home or help you decide if an appointment, an urgent care visit or an emergency room visit is best for your symptoms. If you want to talk to a nurse, call:
When services have not been rendered and require an expedited decision. You may submit an urgent care appeal two ways:
A decision will be rendered within 72 hours of the time of submission/receipt of the appeal.
Non-urgent Care claim appeals must be submitted in writing. These appeals will be reviewed, and a decision will be made within 30 calendar days of receipt of the appeal.
You must submit appeals within 6 months of the initial decision. You and/or your provider may receive a request for additional information. This information must be submitted within 60 calendar days of the request. Once this information has been provided, the health plan has an additional 30 calendar days to review and render a decision on the appeal.
Let us help you with any questions. We're here serving Texans, so call us weekdays between 7 AM and 7 PM to speak live to another Texan. Customer Service Center: 844.633.5325
1206 W. Campus Drive Temple, TX 76502 254.298.3000 888.633.5325
Our Customer Service Representatives will be happy to help you by phone at the numbers above. You also have access to your 24/7 Self-Service portal.