An Important Update for BCBSTX Members
Thank you for entrusting Medical Center Health System with your care. We want to inform you about our work to protect your in-network access to the physicians and other caregivers you know and trust at Medical Center Hospital, its clinics and MCH ProCare.
For several months, we have been negotiating in good faith with BCBSTX to come to a mutually agreeable contract before our current agreement expires on December 15, 2026.
As the region’s only safety-net hospital and leading trauma center, our community depends on MCH to provide the high-level care you need and deserve. Achieving contracts with insurance companies that provide fair market value for the care we provide is crucial to our ability to continue serving our 17 counties. MCH is currently reimbursed less (often 40% to 60% less) than BCBSTX pays other health systems in Texas for the same services.
We are working diligently and collaboratively to reach an agreement with BCBSTX quickly so there is no disruption in care for our patients. However, if we are unable to come to acceptable terms before our contract expires, Medical Center Hospital, its outpatient clinics and ProCare physicians will be out of network with BCBSTX’s employer-sponsored and federal healthcare marketplace plans after December 15, 2026.
What you can do:
- It is important to know that nothing will change before December 15. You should keep any scheduled appointments and continue to see your MCH providers as normal.
- Call the number on the back of your health insurance card. Ask BCBSTX to reach a new agreement to protect your in-network access to Medical Center Health System.
- If you receive your health insurance through your employer, talk to your human resources representative about your options.
- If you receive your insurance coverage through the federal marketplace, visit HealthCare.gov to learn about your insurance options during Open Enrollment (November 1-January 15).
We have a long history of working with BCBSTX and other health insurance companies to advocate for your access to essential, local healthcare. We will continue doing everything we can to come to an agreement with BCBSTX as quickly as possible.
Affected Plans
The following BCBSTX plans may be affected by the current negotiations. This list may not include every affected BCBSTX plan. Because BCBSTX offers many different plans, please call the number on your insurance card to confirm whether your plan could be impacted.
- BlueCard PPO
- Blue Choice PPO
- PPO High Performance Network (HPN)
- Health Select PPO
- Blue Edge PPO
- MyBlue Health
- HMO Employer Group Variants
- Blue Advantage HMO
- Blue Advantage Plus
- Blue Advantage Bronze
- Blue Advantage Silver
- Blue Advantage Gold
- Blue Advantage Plus Bronze
- Blue Advantage Plus Silver
- Blue Advantage Plus Gold
BCBSTX Medicare Advantage plans are NOT part of the current negotiation and remain in network for the 2027 plan year.
Frequently Asked Questions
What is happening?
For several months, we have been negotiating in good faith with Blue Cross and Blue Shield of Texas (BCBSTX) to reach a mutually agreeable contract before our current agreement expires on December 15, 2026.
Currently, MCH is reimbursed less (often 40% to 60% less) than BCBSTX pays other health systems in Texas for the same services. Our goal is to achieve a fair market-based agreement that recognizes the care we provide and supports continued access to essential, local healthcare.
Is MCH going out-of-network with BCBSTX?
If we are unable to come to acceptable terms before our contract expires on December 15, 2026, Medical Center Hospital, its outpatient clinics and ProCare physicians will be out of network with BCBSTX’s employer-sponsored and federal healthcare marketplace plans after December 15, 2026.
Nothing will change before December 15, 2026. Patients should keep any scheduled appointments and continue to see their MCH providers as normal. We are working diligently and collaboratively to reach an agreement with BCBSTX quickly so there is no disruption in care for our patients.
Which BCBSTX plans may be affected?
BCBSTX’s employer-sponsored and federal healthcare marketplace plans are part of the current negotiations. BCBSTX Medicare Advantage plans are not affected.
Because BCBSTX offers many different plans, call the phone number on your insurance card to confirm whether your plan could be impacted.
What should I do now?
You can take the following actions to help protect your in-network access to MCH:
- Call the number on the back of your health insurance card. Ask BCBSTX to reach a new agreement to protect your in-network access to Medical Center Health System.
- If you receive health insurance through your employer, talk to your human resources representative about your options.
- If you receive insurance coverage through the federal marketplace, visit HealthCare.gov to learn about your insurance options during Open Enrollment, November 1-January 15.
- Visit mchodessa.com/accesstocare for more information.
If MCH becomes out of network, can I still receive care there?
By law, emergency care at MCH is always covered as in network. While you may still receive other services from MCH, if we are no longer considered in network after December 15, 2026, the terms of BCBSTX benefit plans may make patients responsible for a greater portion of the cost of their MCH care. Please consult your plan documents for details of your out-of-network coverage and benefits.
Patients undergoing active courses of treatment may qualify for benefits to continue receiving care at an in-network rate. We will work with BCBSTX members on an individual basis regarding possible continuing care benefits after December 15, 2026, but we are doing everything possible to reach an agreement before December 15, 2026.
Will my costs go up if MCH becomes out of network?
Your out-of-network coverage and benefits are described in your BCBS plan documents and may vary, but it is possible your out of pocket costs could go up after December 15, 2026, if MCH is out of network. Please consult your benefit plan documents for details of your out-of-network coverage and benefits. Please know that we are working diligently and collaboratively with BCBSTX to reach an agreement before our current contract expires to avoid disruption for our patients.
How can I learn more?
We are here to help you navigate this situation and answer any questions you may have. At this time, we are hopeful we will achieve a contract with BCBSTX soon and that our patients will not see any disruption in care.
Continuity of Care: How to Extend Your In-Network Benefits
We are continuing to negotiate with BCBSTX, but in the event that our contract expires before we reach an agreement, we may be out of BCBSTX’s network beginning as early as December 16, 2026.
Patients who are receiving treatment for certain serious or ongoing health conditions may be eligible for Continuity of Care benefits. These benefits would allow you to continue receiving in-network care for a limited period of time, even if our contract with BCBSTX expires.
You must request this benefit directly through BCBSTX by calling the number on the back of your insurance card.
What to expect:
- BCBSTX will provide a Continuity of Care form at your request
- You and your provider will need to complete portions of the form
- You will return the form to BCBSTX for review
- BCBSTX will review the request and notify you of their decision
Frequently Asked Questions
Why are we asking patients to fill out the Continuity of Care form?
We’re making every effort to reach an agreement with BCBSTX before our current contracts expires on December 15, 2026. In the event that we do not do so by then, we may be out of BCBSTX's network beginning as early as December 16, 2026.
We’re encouraging patients to contact BCBSTX and begin the application process if you believe you may be eligible for Continuity of Care benefits.
How will patients know if they’re eligible for Continuity of Care?
Patients who are receiving treatment for certain serious or ongoing health conditions may be eligible for Continuity of Care benefits. These benefits may enable you to continue seeing your MCH provider at in-network rates for a limited period of time, even if BCBSTX goes out of network with MCH.
Eligibility and approval are determined by BCBSTX. If you believe you may qualify, contact BCBSTX directly using the number on the back of your insurance card to learn more and begin the application process.
What types of medical conditions may qualify for Continuity of Care benefits?
Continuity of Care benefits may apply to patients who are in active treatment for:
- Pregnancy
- Cancer
- Serious or complex medical conditions that require ongoing treatment
- Transplant candidacy or complications that require ongoing care
Eligibility and approval decisions on Continuity of Care are made by BCBSTX. MCH does not control these determinations.
How does the application process work?
Patients must request a Continuity of Care form through BCBSTX. This typically begins by contacting BCBSTX, which will provide the appropriate form. You and your provider will complete and submit the form, and BCBSTX will review the request and make a determination of eligibility.
Patients will be notified directly by BCBSTX regarding whether the application has been approved.
What if a patient’s Continuity of Care application is denied?
If BCBSTX denies your application, you may continue your treatment using out-of-network benefits, if you have them, or pay out of pocket.
We know this process can be frustrating for patients, and we’re making every effort to reach an agreement with BCBSTX before our current contract terminates.
We will continue to keep you updated and provide additional information as negotiations continue.
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