At Covenant Health, it is our mission to provide the best care for our patients – body, mind, and spirit. Though we do all we can to avoid it, that care can occasionally be affected by normal business activities like insurance contract negotiations. Such an issue has recently arisen for those of our patients covered by a BlueCross BlueShield of Texas insurance plan. We are working diligently to resolve this dispute with BCBSTX and hope to avoid any interruption of care for our patients. Please read below for answers to some frequently asked questions.
Q: What is happening and why?
The contract between BlueCross BlueShield of Texas is up for renewal and we have not been able to reach the terms for a new agreement. This is a standard process that occurs with all health insurance companies, and we hope will be resolved as soon as possible.
Q: Why is a fair market rate important?
As a non-profit healthcare provider for our region, fair relationships with insurance companies like BCBSTX are critical to ensure we are able to provide access to services that our patients want and deserve. Without fair agreements in place, our mission to deliver high quality healthcare to the region could be threatened. Just like every household and business in our community, we also experience inflation in costs of medical supplies and medications. We also want to ensure wages for our caregivers are at market rate so we maintain exceptional staff to care for our patients.
Q: When does the contract end?
The current contract is set to terminate on August 1, 2025; however, we hope an agreement is reached prior to this date.
Q: Which Covenant entities will be affected?
In Texas, all Covenant Health hospitals, ancillaries, Covenant Medical Group, Grace Clinic, Grace Surgical Hospital, and employed physicians would be affected by this termination. New Mexico facilities are not impacted.
Q: Will Covenant Health still provide care to BCBSTX members if they go out-of-network?
Yes, Covenant Health will continue to provide care to all patients, including BCBSTX members, even if we are considered out-of-network. Our doors remain open to you.
Q: What happens on August 1, for BCBSTX patients?
You will continue receiving the same high-quality and compassionate care on August 1 that we provided on July 31st, whether in or out-of-network. We encourage you to review your benefits to ensure you can continue to seek care at a non-network provider under your benefit plan provisions.
If we are out-of-network with BCBSTX, your out-of-pocket costs may vary. To understand your specific benefits, we encourage you to call BCBSTX customer service at the phone number on the back of your insurance card. In addition, we encourage you to call BCBSTX today to let them know you want to keep Covenant Health in your network and let your employer or agent know that Covenant is your preferred choice for health care.
Q: What if I need prescriptions written or refilled?
Covenant and Grace providers will continue to write prescriptions as needed until this contract dispute is resolved.
Q: What will happen if the contract ends?
If an agreement is not reached, Covenant providers will be considered out-of-network. The affected BCBSTX plan members may pay more to continue seeking care from Covenant providers.
Q: What steps is Covenant Health taking to resolve this issue?
Covenant Health is actively negotiating in good faith with BCBSTX to reach a mutually beneficial contract with BCBSTX prior to any patient disruption.
Q: I am in my last trimester of pregnancy. Will I be able to deliver my baby with my Covenant doctor at a Covenant hospital?
Yes, BCBSTX has a “continuity of care” program, which is considered when a member has extraordinary circumstances such as:
- A high-risk pregnancy, or a pregnancy past the 13th week or beyond (for both PPO & HMO members)
- Acute or disabling conditions
- Life-threatening illness
According to BCBSTX, this coverage is only applicable to the requested doctor. If you need more information about your specific situation, or how the BCBSTX transition process works, please refer to the phone number on the back of your insurance ID card to reach a BCBSTX representative.
Q: If I am receiving chemo treatments at Joe Arrington Cancer Center and I am covered by BCBSTX, what happens?
First, we are committed to your health and reaching an agreement with BCBSTX. Should we be unable to reach an agreement, we expect BCBSTX will work to facilitate continuity of care in accordance with your member benefit plan, so that you can still be treated at Joe Arrington Cancer Center. We will continue to assist BCBSTX members to ensure you get appropriate access to care. Please work with your physician to complete the Continuity of Care Form- Blue Cross and Blue Shield of Texas Continuity of Care Transition of Care Form required by BCBSTX.
Q: Will Emergency Care needed after a major accident cost me more?
Emergency care is covered under your in-network benefits under federal laws. You should not have to pay more out-of-pocket in an emergency.
Q: What resources are available to help me during this transition?
Covenant Health has established a phone number where you can speak with a local representative to help you navigate your healthcare needs. Please contact us at 806-725-6663 for more information.
Q: How can you help?
Contact BCBSTX customer service at the phone number on the back of your insurance card or call 1 (888) 697-0683 and let them know you prefer Covenant providers and facilities.
