Blue Cross Blue Shield of Texas in negotiations with Texas Health

SMU’s medical plan administrator, Blue Cross and Blue Shield of Texas (BCBSTX), is negotiating new contracts with Texas Health Resources and Texas Health Physicians Group (Texas Health). BCBSTX is seeking to negotiate an agreement with Texas Health that will keep health care costs down and protect access to Texas Health doctors and facilities. However, the parties have not yet agreed to contract terms.

If an agreement is not reached, Texas Health will no longer be part of our medical plan’s BCBSTX network as of April 1, 2018.

BCBSTX is mailing members a postcard that summarizes the status of negotiations and will provide updates online at www.bcbstx.com/texashealth2018. SMU and BCBSTX will notify you in the event an agreement is reached before April 1.

If no agreement is reached before April 1, you and your covered dependents will not receive in-network benefits if you use a Texas Health facility, doctor or other provider starting in April, unless you are currently receiving treatment. If you choose to use a Texas Health provider after April 1 and there is no agreement in place, you will be responsible for a significant out-of-network portion of the cost for care.

However, you will continue to have access to more than 25,000 in-network doctors and 60 in-network hospitals in North Texas. If you would like to know your options for in-network care, log on to Blue Access for Members for personalized search results. You also may text the word “THR” to the number 33633 to gain quick access to updated information and the in-network provider finder.

If you are currently in treatment with a Texas Health provider and plan to receive care in February or March, this potential network change will not affect coverage. If you or a covered family member are in active care for an acute condition or life-threatening illness, you will be eligible for continuation of care by your current Texas Health provider, on an in-network basis.

UPDATE: If you are past the 13th week of pregnancy, you also will be eligible for continuation of care by your current Texas Health provider, on an in-network basis.

If you have any questions, please email benefitsu@smu.edu.