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An Important Notice to HealthSelect℠ of Texas and Consumer Directed HealthSelect℠ Participants in North Texas

03/04/2019


We want you to know that Blue Cross and Blue Shield of Texas (BCBSTX) is in the process of discussing new contracts with HCA Healthcare hospitals in North Texas, known as Medical City Healthcare (Medical City). This is a normal process and we hope Medical City will choose to remain in the BCBSTX HealthSelect network. 

However, if Medical City and BCBSTX do not reach an agreement before April 1, 2019, Medical City will no longer participate in the HealthSelect network.

This means that claims for services incurred beginning April 1, 2019 or later from a Medical City hospital will be treated as out-of-network.

Out-of-network services can be significantly more expensive and we recommend you stay within the HealthSelect network to keep your costs as low as possible. Emergency services will continue to be covered at the in-network benefit level.

Don’t forget, if you are enrolled in HealthSelect of Texas, HealthSelect Secondary or HealthSelect Out-of-State, medical virtual visits are always available at no cost to you.

After April 1, you may continue to use Medical City for non-emergency services, but your out-of-pocket costs may be much higher because they will be processed at the out-of-network benefit level. You are responsible for out-of-network costs that exceed the amount the plan pays for out-of-network services and your cost responsibility can be significant.

We understand the importance of having a strong network of hospitals and any change to the HealthSelect network can cause worry.

If you are planning to undergo a procedure or surgery and would like to know your options for in-network care, you can call a BCBSTX Personal Health Assistant at (800) 252-8039.

To find in-network doctors or hospitals

To verify network status

Check back on this website or call a BCBSTX Personal Health Assistant to verify network status. We are here to help you meet your health care needs.

Questions/Answers:

What is the issue between Blue Cross and Blue Shield of Texas (BCBSTX) and HCA Healthcare in North Texas?

BCBSTX has been discussing their contracts with HCA Healthcare in North Texas, known as Medical City Healthcare (Medical City). BCBSTX and HealthSelect value their relationship with Medical City. It is also important that the contracts be acceptable to both BCBSTX and Medical City.

Why does BCBSTX negotiate reimbursement rates with health care providers?

HealthSelect’s goal is to provide you access to a broad network of providers at fair prices. BCBSTX watches the market closely to make sure competitive rates are offered to providers. This helps keep the cost of your premiums low. The rates BCBSTX negotiates with providers affect the amount you pay for your insurance.

We heard that BCBSTX isn’t paying providers enough. Is this true?

We cannot discuss these contract rates with anyone except Medical City. We believe in fair reimbursement to all health care providers to ensure the most value of care for our members.

Is it likely BCBSTX and Medical City could still sign new contracts?

Yes. There is still a chance agreement will be reached before April 1, 2019, and that is certainly the goal. We’ll update this page with new information as it becomes available.

If Medical City doesn’t renew its contracts with BCBSTX, how will this affect me?

If the contracts aren’t renewed before April 1, 2019, Medical City will no longer participate in the HealthSelect network beginning April 1, 2019. This means that claims for services incurred beginning April 1, 2019 or later from a Medical City hospital will be treated as out-of-network. Out-of-network services can be significantly more expensive, and we recommend you stay within the HealthSelect network to keep your costs as low as possible.

Which Medical City hospitals are affected?

If the contracts aren’t renewed before April 1, 2019, the following Medical City hospitals will be out-of-network beginning April 1, 2019.

Facility                           Address           City             County                       
Medical City Alliance 3101 N. Tarrant Parkway                                  Fort Worth        Tarrant
Medical City Arlington 3301 Matlock Road Arlington Tarrant
Medical City Dallas 7777 Forest Lane Dallas Dallas
Medical City Denton 3535 South Interstate 35 Denton Denton
Medical City Fort Worth 900 Eighth Avenue Fort Worth Tarrant
Medical City Las Colinas 6800 N. MacArthur Blvd. Irving Dallas
Medical City Lewisville 500 W. Main Street Lewisville Denton
Medical City McKinney 4500 Medical Center  Drive McKinney Collin
Medical City North Hills 4401 Booth Calloway Road North Richland Hills Tarrant
Medical City Plano 3901 W. 15th Street Plano Collin
Medical City Weatherford 713 E. Anderson Street Weatherford Parker
Calloway Creek Surgery Center 4300 City Point Drive, #100 North Richland Hills Tarrant
GI Endoscopy of Plano Building 1, 1600 Coit Rd #401a Plano Collin
Medical City Ambulatory Surgery Center 7777 Forest Lane C-150 Dallas Dallas
Medical City Surgery Center Denton 3316 Colorado Blvd. Denton Denton
Medical City Surgery Center Ft. Worth 909 9th Avenue Fort Worth Tarrant
Medical City Surgery Center Las Colinas 4355 North MacArthur Blvd. Irving Dallas
Medical City Surgery Center McKinney 4510 Medical Center Drive, Ste. 150 McKinney Collin
Medical City Surgery Center Park 12200 Park Central Dr. 3rd Floor Dallas Dallas
Surgery Center of Plano 4005 West 15th Street Plano   Collin
Texas Pediatric Surgery Center 4375 Booth Calloway Rd #100 North Richland Hills       Tarrant
Trinity Park Surgery Center 3501 Matlock Road Arlington Tarrant
Can I still use Medical City’s emergency rooms?

In the case of a life-threatening illness or emergency, you should visit the nearest emergency facility right away. Emergency services are covered at the in-network level of benefits.

What is BCBSTX telling Medical City doctors?

BCBSTX has informed doctors that contract discussions are underway with Medical City. BCBSTX will work with doctors to help transition patients and, if needed, schedule procedures at other in-network hospitals and facilities in the area.

How do I find a new in-network hospital, doctor or specialist?

To find in-network providers, call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039 Monday–Friday, 7 a.m. - 7 p.m. and Saturday, 7 a.m. - 3 p.m. central time.

You also can search for a doctor or hospital through our Provider Finder® tool.

What if I am pregnant or being treated for a serious medical condition with a Medical City provider?

If you are currently receiving ongoing treatment from a doctor who will no longer be in the network beginning April 1, 2019, you may be able to continue treatment with that doctor temporarily. This is called “transition of care.” To continue with your care, certain eligibility guidelines need to be met. If you wish to apply for transition of care benefits, fill out and submit a transition of care form as soon as possible. You can submit the form by mail or fax to BCBSTX. Call a BCBSTX Personal Health Assistant if you have questions about transition of care benefits. Please note prior authorizations for services may not be approved after March 1, 2019.

To find out if you qualify for transition of care, BCBSTX may need to request medical information from your current doctor(s). Medical conditions that may be eligible for transition of care benefits include:

  • Pregnancy in the second and third trimester
  • Long-term treatment of cancer, heart disease or transplants
  • Terminal illness if life expectancy is less than six months

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.

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