UT Southwestern, Texas Health Resources no longer in-network for Blue Cross Blue Shield

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Street_Celery2745@reddit

Ppl concerned about pcps. Imagine being a chemo patient. Selfish disgusting

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These-Slip1319@reddit

God will we ever get universal healthcare?

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I wish but not a chance in hell. United Healthcare and Cigna are two of the largest companies by revenue in the entire world, no way are they going to let go of the choke hold they have on our healthcare system.

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CatteNappe@reddit

Sounds like the usual game of "chicken" that insurance companies and health care providers get into when contracts need renewal or updating. Both entities expect their customers to raise a ruckus with the other party until somebody blinks, or both find a compromise. It sucks for anybody on those plans who gets treatment through those providers in the near future, but usually they work this stuff out in a few weeks or months.

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Rich-Breakfast8844@reddit

I keep seeing people say this same line of "they usually work it out" but everywhere I read says they have never let the contract actually expire before. I am sure they will eventually come to an agreement but who knows how long that will take and how may people will have to reschedule surgeries/appointments by then. https://www.dallasnews.com/business/health-care/2025/04/03/what-we-know-about-blue-cross-blue-shields-dispute-with-two-north-texas-hospital-systems/

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Common-Risk4317@reddit

Wonder if this “stalemate” on BCBSTX’s side is politically motivated. Medicaid members are going to be greatly impacted by this. And Texas has some of the highest rates of Medicaid subscribers.

Seems like “babies first” doesn’t really cover them out of the womb. 🤬

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cassadia420@reddit

They're screwing me over HORRIBLY man 😔 I was just diagnosed with cancer and have surgery on the 22nd to remove said cancer. These are the only people I had IN network that had a good reputation 😞 I sent in a continuity of care but that can take several weeks and I'm sure they're run down with requests right now. Their provider portal doesn't even work anymore. 🥲😒

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all2neat@reddit

My PCP is now out of network. Hopefully they figure their shit out soon.

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oldfuturemonkey@reddit

Same. I've been going to the same doc for 10+ years and I don't want to have to start seeing someone else! Great timing, because my employer just switched to BCBS this year.

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adjust_your_set@reddit

Same, and I just switched to them because my insurance changed to BCBS. Plus my specialist and imaging center doing cancer surveillance.

For profit medical insurance is a broken idea.

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all2neat@reddit

Remember when Obamacare was being debated, oh the death panels! Guess what, we have those, they are called insurance companies.

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csonnich@reddit

Same. I'm so pissed.

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June_Fatality@reddit

I just lost access to my psychiatrist of 7 years.

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IAmSoUncomfortable@reddit

Feel like this happens every year

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yesitsyourmom@reddit

Yeah but they usually have an agreement before the deal expires. Not this time.

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blue_sky99@reddit

That’s what I keep saying, is this wrong. Yes contracts are negotiated all the time but has it ever reached where they didn’t come to an agreement BEFORE customers lost coverage?? From what I’m reading the answer is no, and that’s why this is such a big deal.

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tacmed85@reddit

It certainly feels like it. Its definitely not the first time they've played this game

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SevoIsoDes@reddit

Yeah, it’s the one downside of the No Surprises Act. It’s good that out of network doctors and hospitals can’t hit you with an enormous bill (at least not as easily as they could before. But now that insurance companies have this advantage, they use it during negotiations and dare hospitals to go out of network.

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worstpartyever@reddit

It does. Contracts are renegotiated all the time.

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SlimMoe22@reddit

I think it is time for a new insurance company. I like my doctors at UTSW.

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Organic-Class-8537@reddit

Ditto. I have a rare medical condition and one of a handful of specialists in the US is there.

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Travelfool_214@reddit

Even if you pay for private insurance, you can't do anything without a qualifying life event until open enrollment at the end of the year.

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DowntownComposer2517@reddit

As if people get a choice of insurance company

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SlimMoe22@reddit

My company, my decision. We have been with Blue Cross since 1998 and they have generally been very good. My specialist at UTSW is the only one in North Texas. My next option is to go to MD Anderson. No way.

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adjust_your_set@reddit

Good luck. People like you voting with their dollars are the way they’ll stop doing this. Considering writing my large employer to at least exert some pressure on BCBS, it I doubt that’ll go anywhere.

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CatteNappe@reddit

I can pretty much guarantee that any new insurance company you go with will, at some point, end up in a contract dispute with UTSW, and you'll be facing the same situation. Not to mention it's not always that easy to change insurance companies.

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SameSadMan@reddit

To be clear, not all BCBS plans are out.

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jtrage@reddit

Unfortunately it’s in the details. It’s BCBS of TX. Just because you are in TX doesn’t mean you have BCBS of TX. My company is based in Chicago. I have BCBS of Illinois. Anthem BCBS is another in the area that is not affected. Plus under BCBS of TX it is only certain plans.

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jojo_86@reddit

You may way to call your insurance. I’m on BCBS of IL too, and this change does include BCBSIL, according to the rep I talked to this afternoon.

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SameSadMan@reddit

A microcosm of the F'd condition of the American healthcare model.

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chocolate_boogers@reddit

Affected plans:
ParPlan. Blue Choice PPO. Blue Essentials. Blue Advantage HMO. Medicaid. Blue Cross Medicare Advantage (PPO). Blue Cross Medicare Advantage (HMO).

The plans are primarily Medicare (Dis)Advantage plans and others that cover and reimburse poorly. You know, the plans that expect physicians and hospital staff to work for free while CEOs reap the rewards.

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opheliapickles@reddit

Doing something that no one else in your area does is something that gives you negotiating power. I was able to contract an optometrist at a higher than preferred rate bc of something similar- they were the only clinic in their area with some sort of advanced equipment for retinopathy and they had long wait times. I’d say hold out. If you can’t get anywhere then a complaint to TDI from one of your patients covered by that plan might move the needle. It all depends. But yeah these large hospital groups have a ton of power.

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Cali_Longhorn@reddit

Yes and this is why the American health care system is kind of whack. Because of insurance through work, and my work happens insurance happens to be with BCBS, then I can’t go to certain doctors (or it’s prohibitively expensive).

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JRLDH@reddit

It’s funny that UTSW employees are covered by a BCBS PPO administered plan:

https://www.utsouthwestern.edu/employees/hr-resources/benefits-insurance/

“UT SELECT Medical is a self-funded PPO plan administered by Blue Cross and Blue Shield of Texas.”

LOL!!!!

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clem_kruczynsk@reddit

but-but what about the healthcare CEOs? they need a 4th yacht

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jtrage@reddit

It’s not just BCBS fault. It’s SWHR too. It’s a game they always play when the contract is up. But usually both sides figure it out before it actually expires. Both sides use the news for fear. There is continuity of care. Pregnancy being one that will continue regardless. They will likely reach an agreement and backdate to 4/1 and reprocess claims that might have denied.

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wosbur1@reddit

I’m registered to have my baby at a Texas Health Hospital in June 🙃 why must they be like this

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jtrage@reddit

This is one of the fear tactics they use. Both sides. If you are already pregnant you are covered.

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downhilldrinking@reddit

Just postponed it

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Fournier_Gang@reddit

Has she tried a 3 month trial of physical therapy first?

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HashKing@reddit

Can you tell the baby to just wait a few months until they finish their negotiations?

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wosbur1@reddit

Honestly would not put it past these big wigs to ask that lmao

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BigBootsMills@reddit

That is horrible... I'm sorry you have to deal with this added stress.

The article mentions some people might qualify for continuation of care at in-network prices.

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fivespeedmazda@reddit

Looks like we need a green plumber

Fuck Trump Fuck DOJ Fuck DOGE Fuck fELON Fuck Abbot Fuck Cruze Fuck every corrupt politician that has slithered us into these positions

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Dallas-ModTeam@reddit

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boringhangover@reddit

Where's Luigi when you need him?

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Dallas-ModTeam@reddit

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Send a message the moderators if you have any questions. Thanks!

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opheliapickles@reddit

I don’t like to admit this but I work in health insurance. The Texas Department of Insurance and CMS have requirements around the number of providers per specialty and insurance carrier must maintain within X amount of miles from their members. I can’t imagine a hit like this wouldn’t lead to an inadequate network. In Dallas Baylor can make up for the loss, but THR is the main player in Tarrant County. I’m really surprised BCBS let this happen at all.

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LawPlasticSurgery@reddit

Are the penalties for an inadequate network great enough to outweigh a cheaper contract for them for the next 3-5 years?

We’ve been dealing with a very specialized area with one company, and they are hesitant to give us a sustainable rate, even though wait time is over 2 months for what we see/do.

May have to resort to a TDI complaint, though really we need to join up with a bigger group / get swallowed by a hospital system just to survive.

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gizmo1024@reddit

They went through this with Baylor last year.

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Gmajj@reddit

I had Aetna. I’m old. I have cancer. My oncologist is at Medical City, but all my other doctors that I’ve had for years and know my problems are at Presby. Aetna decided to drop Presby, along with all my doctors. Rather than try to replace all my doctors and clinics I’m familiar with, I went with another insurance company. As far as I know, Aetna (it was a Medicare replacement plan) still hasn’t worked things out with Presby. It’s ridiculous, and for all I know I’ll be in this situation again some day. I can’t get on regular Medicare now because I have a preexisting condition. 🫤

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Duo007@reddit

I do have a question for you, wny did you replace your Medicare A & B benefits for a Medicare replacement plan?

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Gmajj@reddit

I didn’t know what I was doing, honestly. I had to get on disability before I became old enough to receive Medicare. I talked to someone who suggested a Medicare replacement plan when I got old enough and it sounded good. And it was good until it wasn’t.

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Duo007@reddit

I strongly hate Medicare "disadvantage" plans, they are meant for healthy adults and there's no such thing. Co-pays when you need higher echelon of care are ridiculous and chances are many people are messed up physically and financially to afford the copay 😓.

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Gmajj@reddit

I’ve discovered that, unfortunately.

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Duo007@reddit

Well if you need help trying to find a better Medicare advantage plan I know a person that try to shed some insight on your plan and can compare other to get you what you can get, take care stranger and im sorry this happened to you.

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Gmajj@reddit

Thank you! I just got home from a pet scan. At least my new insurance agreed to pay for that! 🤞

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greyseababy@reddit

What about the people who have specialists at UTSW? I have cystic fibrosis and the next closest specialist is in fucking Tyler. What the fuck am I supposed to do now?

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electricgotswitched@reddit

BCBS does this shit every year with some hospital in the area.

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FrontSolution6863@reddit

Ummm my post-op’s tomorrow…

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sweetfire009@reddit

You are most likely eligible for “continuity of care” benefits (ie you can see your care team at in-network rates) if it’s associated with an active line of treatment.

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FrontSolution6863@reddit

Thank you… working on this as we speak 🙄🙄

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Dawnzarelli@reddit

Also, post ops aren’t usually billable for three months after a surgery unless it’s to treat a complication.

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ToshPLP@reddit

Non-paywalled link you demon.

https://www.dmagazine.com/healthcare-business/2025/04/utsw-thr-officially-out-of-blue-cross-blue-shield-of-texas-network/

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DeepYogurtcloset3235@reddit

Absolute BS. People at my work were informed yesterday (we all have BCBS) and there are multiple people receiving cancer treatment, people with chronic illness, etc seeing specialists at UTSW. In a lot of cases, there are no alternatives to the UTSW doctors - that’s where all the specialists are.

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tebor8@reddit

Does anyone have MyBlue Health HMO? It seems that that plan is unaffected based on the article, as in it’s not listed.

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TeeBrownie@reddit

The greediest vs. the greediest. No matter the outcome, it’s the patients who lose.

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pifumd@reddit

Oh great. I have to find all new doctors i guess.

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Dawnzarelli@reddit

Request a GAP with your insurance for continuity of care.

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CatteNappe@reddit

Not unless you need to see one in the very near future. It's quite possible they will resolve this little dance in the next few months. My next appointment with a provider in that network is in June, and I have high hopes things will be back to normal by then.

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