Following several days of ambiguity, policyholders of Blue Cross Blue Shield of Texas can now relax as the company has at last struck a deal for a new contract with Southwestern Health Resources.
The firms disclosed the agreement in announcements issued late Friday night, April 4.
"Blue Cross and Blue Shield of Texas has reached an agreement with Southwestern Health Resources ensuring that our members can continue to receive high-quality care from their providers at reasonable costs," stated the state’s biggest health insurance provider in a communiqué sent to the Star-Telegram.
Blue Cross Blue Shield of Texas provides coverage for more than 10.4 million individuals across the state.
Every member who had their access revoked over two dozen prominent hospitals across the Dallas-Fort Worth Metropolitan Area On Tuesday, access to Southwestern’s medical facilities within your network will be restored, with coverage effective retrospectively, according to Blue Cross Blue Shield.
“A Blue Cross representative stated that all claims handled as out-of-network on or after April 1st will be reprocessed at the in-network benefits level," according to the announcement.
According to a representative from Southwestern Health Resources, the pact will be valid for three years.
This indicates that all Texas Health and UT Southwestern hospitals, facilities along with their employed and associated healthcare providers are considered part of the network," stated the spokesperson. "Individuals may proceed with their planned appointments or arrange new ones knowing they'll benefit from in-network pricing. It’s a privilege for us to remain an in-network provider serving (Blue Cross Blue Shield of Texas) members.
The agreement reinstates coverage for the subsequent Blue Cross Blue Shield plans:
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ParPlan
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Blue Choice PPO
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Blue Essentials
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Medicaid
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Blue Cross Medicare Advantage Preferred Provider Organization
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Blue Cross Medicare Advantage Health Maintenance Organization
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Blue Advantage HMO and MyBlue Health Plans
More than a dozen members of Blue Cross Blue Shield contacted the Star-Telegram earlier this week to voice their irritation about disruptions in their medical treatments. Some of these individuals were coping with newly discovered conditions or continuing care for severe diseases like breast and thyroid cancer.
This shouldn't occur to individuals who obtain insurance to maintain their health," stated Melanie Perry, who attends regular monthly appointments with an oncologist as part of her post-surgery breast cancer treatment. "The greed from all parties significantly impacts peoples' lives—I feel extremely vulnerable and frightened.
Talking to the Star-Telegram on Wednesday regarding the consequences following the contract expiry Jonathan Gruber, a healthcare economist from MIT, stated that this scenario illustrates why the government needs to control pricing within the healthcare sector.
"If price regulation were implemented, this issue would not exist," Gruber stated.