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Hill Country Transit Employees Access Virtual Care

SMARTCARE EHN Coverage with VirtualCare2go™Uploaded Image

When you or a family member feels unwell, leaving home and waiting in a clinic may add more stress to the day. VirtualCare2go™ provides convenient online medical visits for eligible patients from home, work, or another private location in Texas.

Hill Country Transit District employees enrolled in the SMARTCARE 500814 Rx 30-25 Plan may be eligible to receive virtual care through participating Employers Health Network providers. Benefits, network participation, and patient costs should be verified before scheduling an online appointment.

What Does the Hill Country Transit Plan Include?

Hill Country Transit District offers the SMARTCARE 500814 Rx 30-25 Plan.

According to the available plan information, members have:

  • A $30 copay for primary care visits

  • A $75 copay for specialist visits

These amounts may not automatically apply to a virtual medical visit. Telehealth services may be processed under a different benefit category depending on the service, provider, diagnosis, and plan requirements.

Laboratory testing, medications, medical supplies, and in-person follow-up services may also be processed separately.

Your final cost may depend on current eligibility, provider-network participation, medical necessity, prior authorization, the type of virtual service, and the care provided. An insurance card does not guarantee coverage or payment.

For scheduling assistance, call VirtualCare2go at (817) 508-8169.

Can Hill Country Transit Employees Use VirtualCare2go?

Eligible Hill Country Transit District employees and covered family members may be able to use VirtualCare2go for many non-emergency medical concerns that can be safely evaluated through an online visit.

The virtual medical team may evaluate concerns such as:

  • Cold and flu symptoms

  • Cough, congestion, or sore throat

  • Fever and body aches

  • Sinus symptoms

  • Mild allergy symptoms

  • Headaches and migraines

  • Nausea, vomiting, or diarrhea

  • Urinary symptoms

  • Minor infections

  • Rashes and minor skin concerns

  • Pink eye and other minor eye irritation

  • Medication-related questions

  • Certain primary care and follow-up concerns

Whether virtual care is appropriate depends on the patient’s symptoms, medical history, age, current condition, and the medical professional’s judgment.

An in-person examination, laboratory testing, imaging, or a higher level of care may be recommended when the concern cannot be safely evaluated through a virtual visit.

Call 911 or go to the nearest emergency room for chest pain, severe breathing difficulty, fainting, confusion, signs of a stroke, uncontrolled bleeding, major trauma, or another life-threatening emergency.

Who Administers the Hill Country Transit Plan?

Coastal Administrative Services, also known as CAS, is listed as the third-party administrator for the Hill Country Transit District SMARTCARE plan.

Elan Member Services and CAS can assist members and providers with:

  • Eligibility verification

  • Virtual-care benefit questions

  • Prior-authorization requirements

  • Claim-status assistance

  • Copays, deductibles, and coinsurance

  • Provider-network participation

For assistance:

  • Call Elan Member Services at (833) 845-8854

  • Call CAS at (800) 870-1831

  • Visit the CAS Member Website

Have the member identification number from your insurance card and the SMARTCARE 500814 Rx 30-25 Plan name available when requesting assistance.

How Do I Verify My Virtual-Care Benefits?

Before scheduling an online appointment, contact Elan Member Services at (833) 845-8854 or CAS at (800) 870-1831 and ask:

  • Does VirtualCare2go participate with my Hill Country Transit District plan?

  • Is telehealth or virtual urgent care covered?

  • How will the virtual visit be classified under my plan?

  • What copay, deductible, or coinsurance applies?

  • Are prescriptions, laboratory tests, or follow-up services billed separately?

  • Is prior authorization required?

  • Will I have a time-of-service responsibility?

  • Are there state, service-area, or provider-network restrictions?

Write down the representative’s name, the date of the call, and the reference number provided.

Final coverage is determined when the administrator processes the claim. VirtualCare2go can collect your insurance information before the appointment, but Elan Member Services or CAS provides the official explanation of plan benefits.

Is Prior Authorization Required?

Routine virtual visits may not require prior authorization, but requirements depend on the service being requested.

Members and providers should contact Elan Member Services at (833) 845-8854 or CAS at (800) 870-1831 before receiving a service that may require approval.

Prior authorization may be required for certain:

  • Diagnostic tests

  • Procedures

  • Medications

  • Medical supplies

  • Specialist services

  • Follow-up treatments

Prior authorization does not guarantee claim payment. Current eligibility, medical necessity, provider-network participation, plan exclusions, and other requirements may affect how a claim is processed.

What Network Does the Plan Use?

The Hill Country Transit District SMARTCARE plan uses the EHN Preferred Network.

This network includes Baylor Scott & White Quality Alliance providers who have elected to participate. Not every Baylor Scott & White Quality Alliance provider participates in the EHN Preferred Network.

Members should confirm that VirtualCare2go participates with their exact Hill Country Transit District plan before receiving care.

To locate or verify an in-network provider:

Provide the employer name, medical plan name, member identification number, requested virtual service, and the patient’s location when confirming participation.

Are Specialist Referrals Required?

The available Hill Country Transit District plan information does not list a specialist-referral requirement.

If the virtual medical professional recommends specialist care, contact Elan Member Services or CAS before scheduling. Certain specialist visits, diagnostic tests, procedures, or treatments may still require prior authorization.

Members should also verify that the specialist, facility, and requested service participate with the EHN Preferred Network.

How Should I Prepare for My Virtual Visit?

Before your appointment, prepare:

  • Your Hill Country Transit District insurance card

  • A photo identification card

  • A current medication list

  • Known medication or food allergies

  • Relevant medical records

  • Recent laboratory or imaging results

  • Any referral or authorization documents

  • A description of your symptoms

  • The date your symptoms began

  • Your preferred pharmacy information

Choose a quiet, private, well-lit location with a dependable internet connection. Make sure the camera and microphone on your phone, tablet, or computer are working before the visit begins.

If possible, have a thermometer and any relevant home readings available, such as blood pressure, heart rate, blood glucose, or oxygen saturation. Do not delay emergency care to collect these readings.

Claims Information for Providers

Hill Country Transit District claims are submitted through Employers Health Network.

Electronic claims: Payor ID IHS07

Mailed claims:

Employers Health Network
P.O. Box 507
Arnold, MD 21012

Providers should verify the member’s eligibility, SMARTCARE plan name, virtual-care benefits, provider-network participation, prior-authorization requirements, and current claim-submission instructions before sending a claim.

For benefit or claim-status assistance, contact Elan Member Services at (833) 845-8854.

Compassionate Care Wherever You Are

VirtualCare2go helps make non-emergency medical care easier to access when traveling to a clinic is inconvenient. The medical professional will listen to your concerns, determine whether virtual treatment is appropriate, and explain the next step in your care.

When you are ready, Book a Virtual Visit or call (817) 508-8169. Please have your Hill Country Transit District insurance card available so your eligibility, benefits, and network participation can be reviewed before the appointment.