Blue Cross and Blue Shield of Texas

Baylor Scott & White Health (BSWH) is currently negotiating a new contract to cover care for patients with Blue Cross and Blue Shield health insurance. This includes Blue Cross and Blue Shield of Texas (BCBSTX) as well as Blue Cross and Blue Shield plans from other states. We are working to reach an agreement by July 1, 2024, to keep BCBSTX plan holders in-network for care with our providers and facilities.  Our patients are our top priority, and we are working to minimize any potential disruptions.

Right now, nothing is changing. Patients should continue to visit Baylor Scott & White hospitals, facilities, and providers as they normally would through the month of June. If an agreement is not reached by July 1, 2024, Blue Cross and Blue Shield of Texas (BCBSTX) will be considered out of network for care delivered by Baylor Scott & White Health (BSWH) doctors and facilities for most BCSBTX members. This could mean increased costs for BCBSTX patients who want to continue receiving care from a Baylor Scott & White Health facility or provider.

At this time, we are advising patients to keep the appointments they have scheduled on or after July 1, 2024. Canceling services could delay care and it may not be necessary if an agreement is reached before the current contract expires. In addition, some patients may be eligible for Continuity of Care through BCBSTX. (A link to BCBSTX’s Continuity of Care form can be found at the top of this webpage.)

If an agreement is not reached before the last week of June, BSW will begin reaching out to patients who have appointments scheduled in July. If you are unable to obtain a Continuity of Care exception through BCBSTX, services provided after July 1, 2024 will be considered out of network, and your BCBSTX benefits may not cover your care. If that happens, first ask BCBSTX if you have out-of-network coverage.

In the event an agreement is not reached before July 1, 2024, and a continuity of care form is not obtained, BSW will give patients the option to reschedule to a later date or sign an out of network form to accept responsibility for the charges that would have otherwise been billed to BCBSTX. Your provider can give you specifics based on the services delivered.

If an agreement is not reached by July 1, 2024, some services may still be covered for a short period of time if they already began and are not yet complete; however, we encourage patients to talk with their medical team if they have clinical questions about their care. Certain patients, including those who are hospitalized or undergoing an active course of treatment before the contract end date, may qualify for Continuity of Care through BCBSTX. If you think you may qualify, call the phone number on the back of your BCBSTX health insurance card today to request a Continuity of Care form and apply. You may also find a link to the Continuity of Care form at the top of this webpage.

If an agreement is not reached by July 1, 2024, you will need to obtain a Continuity of Care exception through BCBSTX; Otherwise, services provided after this date will be considered out of network and your out-of-pocket costs may be greater. (A link to BCBSTX’s Continuity of Care form can be found at the top of this webpage.)

If you experience a medical emergency, you should always visit the nearest emergency department. BCBSTX will pay for services you receive to evaluate and stabilize an emergency medical condition, regardless of whether your care is received from an in-network or out-of-network emergency department.

We recommend scheduling as needed in late July or August.

BCBSTX Medicare supplement plans are not included in this negotiation. The following plans are included in this negotiation:

• ParPlan
• Health Select
• Blue Choice PPO
• Blue Essentials
• Blue Advantage HMO
• Blue Premier / High Performance Networks (HPN)
• Blue Cross Medicare Advantage (PPO)
• Blue Cross Medicare Advantage (HMO)
• Managed Medicaid STAR Kids

All Baylor Scott & White locations, including hospitals, urgent care, imaging centers, ambulatory surgery centers and free-standing clinics are included in this negotiation.

Yes. BCBSTX negotiates network contracts on behalf of all Blue Cross and Blue Shield plans. Patients with a policy from an out-of-state Blue Cross and Blue Shield plan utilize the BCBSTX network.

Pharmacy benefits are part of a separate contract and are not impacted by this network negotiation.

BCBSTX approves or denies requests for its members to receive Continuity of Care. It lists the following as potentially “applicable” for Continuity of Care: 

• Pregnancy or undergoing a course of treatment for pregnancy
• Surgery scheduled or recently performed 
• Scheduled for nonelective surgery
• Postoperative care 
• Transplant list 
• Undergoing a course of treatment for a serious and complex condition
• Undergoing institutional or inpatient care from the provider
• Having been determined to be terminally ill