Have Blue Cross and Blue Shield and go to an Ascension hospital? You could pay more

Key Takeaways:

• The current contract between Ascension Texas and Blue Cross and Blue Shield of Texas ends on January 1.
• Local patients might pay higher out-of-network costs if a new agreement is not reached.
• Dell Children’s Hospital and multiple Ascension Seton facilities are among those potentially impacted.
• BCBSTX provides various insurance options, including PPO, HMO, and Medicare Advantage.
• Both parties aim to settle their differences before the deadline to ensure uninterrupted coverage.

Contract Negotiations

Ascension Texas and Blue Cross and Blue Shield of Texas (BCBSTX) are in discussions to renew a contract set to expire on January 1. If the two parties cannot reach a new agreement by that date, patients covered by BCBSTX may find themselves facing out-of-network costs for care at Ascension facilities, a move that could significantly increase medical bills.

What’s at Stake for Patients

Patients in Central Texas who receive healthcare from Ascension-run hospitals and clinics may see changes in their out-of-pocket expenses if the contract is not renewed. According to the existing arrangement, Blue Cross and Blue Shield policyholders benefit from in-network rates at Ascension facilities. An expired contract could mean higher deductibles or copays, putting financial strain on patients seeking essential medical services.

Affected Facilities

Ascension Texas operates a wide network of hospitals and clinics in the region, including Dell Children’s, Ascension Seton Hays, Ascension Seton Williamson, and other sites across Austin, Waco, Burnet, Bastrop, and beyond. While these facilities provide a range of specialized care and services, their continued in-network status depends on the outcome of negotiations with BCBSTX.

Coverage Under Multiple Plans

Blue Cross and Blue Shield of Texas offers various plans, from health maintenance organization (HMO) and preferred provider organization (PPO) options to Medicare Advantage and the Teacher Retirement System plan. All these coverage types could be affected if an agreement is not reached, potentially causing a ripple effect on many Texas policyholders.

Negotiation Outlook

Both Ascension Texas and BCBSTX are working to reach a resolution before the contract’s expiration on January 1. While the exact details of the discussions remain undisclosed, the possibility of increased costs for patients underscores the importance of these negotiations. With the deadline fast approaching, the healthcare landscape for many Texans hangs in the balance.