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An Important Notice to HealthSelect℠ of Texas and Consumer Directed HealthSelect℠ Participants in Corpus Christi, McAllen, Brownsville and El Paso

11/28/2018

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 (HCA) hospitals in Corpus Christi, McAllen, Brownsville and El Paso. This is a normal process and we hope HCA will choose to remain in the BCBSTX HealthSelect network.

However, if HCA and BCBSTX do not reach agreement before January 1, 2019, HCA will no longer participate in the HealthSelect network. 

This means that claims for services incurred beginning January 1, 2019 or later from an HCA 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 or HealthSelect Out-of-State, virtual visits are always available at no cost to you. If you are enrolled in Consumer Directed HealthSelect, you will need to meet your annual deductible before medical virtual visits are covered.

After January 1, you may continue to use HCA 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 is important 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

  • Find a provider in the HealthSelect network or
  • Call a BCBSTX Personal Health Assistant toll-free at (800) 252-8039, Monday–Friday 7 a.m. - 7 p.m. or Saturday 7 a.m. - 3 p.m. central time
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 (HCA)?

BCBSTX has been discussing their contracts with HCA hospitals in Corpus Christi, McAllen, Brownsville and El Paso. BCBSTX and HealthSelect value their relationship with HCA. It is also important that the contracts be acceptable to both BCBSTX and HCA.

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?
 
We cannot discuss contract rates with anyone except HCA. We believe in fair reimbursement to all health care providers to ensure the most value of care for our members. HCA has requested rate increases that would result in additional costs for our community and local businesses, without any guarantees of better health outcomes.

Is it likely BCBSTX and HCA could still sign new contracts?

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

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

If the contracts aren’t renewed before January 1, 2019, HCA will no longer participate in the HealthSelect network beginning January 1, 2019. This means that claims for services incurred beginning January 1, 2019 or later from an HCA 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 HCA hospitals are affected?

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

         Facility                                              Address                        County 
East El Paso Surgery Center 7835 Corral Dr., El Paso, TX 79915 El Paso
Surgical Center of El Paso 1815 N. Stanton Street, El Paso, TX 79902 El Paso
Surgical Center of El Paso 4171 N. Mesa St., El Paso, TX 79902 El Paso
Valley Regional Medical Center 100-A Alton Gloor Blvd, Brownsville, TX 78526 Cameron
Rio Grande Regional Hospital 101 E. Ridge Road, McAllen, TX 78503 Hidalgo
Corpus Christi Medical Center - Northwest Regional 13725 Northwest Blvd, Corpus Christi, TX 78410 Nueces
Corpus Christi Medical Center - Bay Area 7101 South Padre Island Drive, Corpus Christi, TX 78412 Nueces
Corpus Christi Medical Center - Doctors Regional 3315 S. Alameda Street, Corpus Christi, TX 78411 Nueces
Corpus Christi Medical Center - The Heart Hospital 7002 Williams Dr., Corpus Christi, TX 78412 Nueces
Del Sol Medical Center 10301 Gateway Blvd W, El Paso, TX 79925 El Paso
Las Palmas Medical Center 1801 N. Oregon Street, El Paso, TX 79902 El Paso


Can I still use HCA’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 HCA doctors?

BCBSTX has informed doctors that contract discussions are underway with HCA.  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 an HCA provider?

If you are currently receiving ongoing treatment from a doctor who will no longer be in the network beginning January 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.

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

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