Your Questions

BSW sent us a termination notice. The current contracts were set to expire on July 1, 2024, but we’ve extended them to Oct. 1, 2024, to work on reaching a new agreement.

We’re working closely with BSW leadership and hope to sign new contracts before Oct. 1. We want agreements that compensate BSW fairly while being good stewards of your health care dollars. We value our relationship with BSW, but it’s also important that the contracts we agree to are fair for our members and the local businesses we serve.

Our goal is to keep giving you access to a broad network of providers at fair prices. We watch the market closely to make sure we offer competitive rates to providers. This helps lower the cost of your premiums. 

As a member-owned organization, we know you expect us to protect your health care dollars. The rates we negotiate with providers impact the amount you pay. Health care is a major cost for many people, and we owe it to you to keep prices down.

We’re hopeful and believe BSW is as well. We’ll update this site when we have news to share.

If we can’t agree to fair terms with BSW, and you’d like to stay in-network for your care, we’ll be here to make your move to other doctors, hospitals and facilities in your network as seamless as possible. We have a robust network of providers to ensure you have access to quality in-network health care.

PPO members: Not necessarily. If you have a PPO plan that provides coverage for out-of-network benefits, you can choose to get care anywhere you want, including BSW. Out-of-pocket costs may be higher if you do. We recommend verifying your out-of-network benefits and weighing your options to maximize your health benefits. 

HMO members: If you have an HMO plan, you must seek in-network care for your benefits to apply, except in emergencies. 

Emergency services for PPO and HMO:  In the case of a life-threatening illness or injury, go to the nearest emergency facility right away. Emergency services are covered at your in-network benefit level for PPO and HMO. Your responsibility for any additional charges will depend on your health plan and applicable law. Learn about surprise billing  at bcbstx.com.

If your PCP is with BSW and leaves our networks on Oct. 1, 2024, we can help you find a new PCP. 

• Visit our online Provider Finder® or your provider directory

• Register for or log in to Blue Access for Members℠. If you don’t have access to BAM, go to the website on the back of your member ID card. 

• Call the customer service number on your member ID card  

After Oct. 1, 2024, if you haven’t selected a new PCP, we will choose one for you. Once you receive your new member ID card with your new PCP name, you can change this selection at any time with a provider who may better meet your medical needs. To change your PCP, log in to Blue Access for Members or your online member portal, or use our BCBSTX mobile app to make the switch.

No, this does not impact you. Under our standard Medicare Supplement plans, you can keep using any provider that takes Medicare at your current benefit coverage level.

If BSW is no longer in our networks, Blue Cross Medicare Advantage Flex (PPO) and Blue Cross Group Medicare Advantage Open Access (PPO) members can continue to receive care at their same coverage level for covered benefits at BSW, if BSW:

• Agrees to see you

• Accepts Medicare assignment, and 

• Will submit the claims to BCBSTX

This negotiation may affect Blue Cross and Blue Shield members with plans in other states who access BSW. Call the number on your member ID card to review your plan’s coverage or for help finding in-network options.

When scheduling future procedures, we’ll let doctors know of the possible contract expiration and work with them to avoid disrupting your care. If needed, we’ll help them transition your care or schedule procedures with other in-network hospitals or facilities.

You have many choices for quality, cost-effective care. For personalized search results based on your health plan and network, you can log in to Blue Access for Members^SM. If you don’t have access to BAM, go to the website on the back of your member ID card. You can also call the customer service number on your member ID card.

Yes. In the case of a life-threatening illness or injury, go to the nearest emergency facility right away. Emergency services are covered at your in-network benefit level. Your responsibility for any additional charges will depend on your health plan and applicable law.

If you are pregnant or being treated for a disability, acute condition or life-threatening illness, you may qualify as a continuity-of-care patient. This means you may still be able to receive care at BSW at in-network rates even if they are no longer in our networks.

If you are eligible for continuity of care, you will not be balance billed or have to pay more than the amount covered by your plan, even if BSW charges more.

If you have questions, call the customer service number on your member ID card. Customer Advocates will help answer questions about your specific benefits and provide guidance. Your doctor may also start the continuity-of-care process by calling the prior authorization number on your member ID card.

BCBSTX members: You may start the process by completing a Request for Continued Access to Providers form or by calling the number on your member ID card. Forms should be faxed to the number on the form. Once reviewed, you and/or your doctor may be contacted for more information, like medical records. A decision will be made and shared with you or your doctor.

Members of other Blue Cross and Blue Shield Plans: If you are a member of a Blue Plan other than BCBSTX, you may call the number on your member ID card for help.

View the list of BSW facilities.

Not necessarily. Many doctors have privileges at other hospitals, or they can apply for privileges at other in-network hospitals. We encourage you to talk with your doctors about your care options.

Additionally, some health plans allow you to choose to go out-of-network. If you do, you will pay more out-of-pocket for any care you receive by out-of-network providers or at out-of-network facilities.

Yes, the doctors at BSW are part of this negotiation. If we don’t come to an agreement, both the doctors and the hospitals will no longer be in network as of Oct. 1.

If your doctor only has privileges at BSW facilities, we want to help. We’re offering doctors who only have privileges at BSW facilities and surgery centers the chance to send you to other in-network hospitals and facilities. 

Talk with your doctor. Ask if he or she is thinking about getting admitting privileges at another in-network hospital.

If you have a procedure scheduled at a BSW facility on or after Oct. 1, 2024, please call the customer service number on your member ID card to ask about your benefit coverage.

If you have a procedure performed before Oct. 1, 2024, and your hospital stay goes past Oct. 1, 2024, your care may be covered at the in-network level. We’ll work closely with BSW to avoid issues with your bill, so you can focus on getting better.