Austin, Texas, December 12, 2025
Ascension Texas hospitals and clinics may not be in-network for Blue Cross and Blue Shield of Texas (BCBSTX) members starting January 1, 2026, if a new contract is not reached. The dispute revolves around reimbursement rates and financial terms, leaving many patients potentially facing increased out-of-pocket costs for services. BCBSTX is informing its members about the situation, urging them to stay updated by contacting their insurance providers, while Ascension Texas emphasizes ongoing negotiations to find a resolution.
Ascension Texas Hospitals May Become Out-of-Network for Blue Cross and Blue Shield of Texas Members Starting January 1, 2026
Austin, Texas – Ascension Texas hospitals and clinics may no longer be in-network for patients with Blue Cross and Blue Shield of Texas (BCBSTX) insurance starting January 1, 2026, if a new contract is not finalized by that date. The contract dispute centers on reimbursement rates and financial terms between BCBSTX and Ascension Texas. Without a new agreement, patients with commercial BCBSTX plans, Medicare Advantage plans, and Affordable Care Act exchange plans could face higher out-of-pocket costs for services at Ascension facilities.
BCBSTX has alerted its members in Central Texas about this potential change, urging them to contact the number on their insurance card for detailed information. The insurer has emphasized its commitment to protecting members’ access to quality care at cost-effective rates. Meanwhile, Ascension Texas has stated that negotiations are ongoing and highlighted the importance of good reimbursement rates that reflect the current financial challenges, including inflation and rising costs for medical supplies.
Current Status of Negotiations
The contract between Ascension Texas and Blue Cross and Blue Shield of Texas is set to expire on January 1, 2026. If a new agreement is not reached by that date, Ascension Texas facilities may become out-of-network for BCBSTX members. This situation has created a sense of urgency among patients who rely on these healthcare facilities.
Who Will Be Affected?
Patients with commercial BCBSTX plans, Medicare Advantage plans, and Affordable Care Act exchange plans may be impacted by this change. These individuals could face increased out-of-pocket costs for services rendered at Ascension facilities if the contract expires without a resolution.
Continuity of Care Provision
In the event that Ascension facilities become out-of-network, patients may still be eligible for “continuity of care,” allowing them to access in-network rates temporarily. This provision is designed for individuals receiving treatment for acute or life-threatening conditions, pregnant individuals, and those with disabilities. Members are encouraged to reach out to BCBSTX to determine their eligibility for this provision.
Historical Context
This disagreement isn’t unique to Ascension Texas; it mirrors previous contract disputes between BCBSTX and other Texas health systems. For instance, in April 2025, BCBSTX reached a new agreement with Southwestern Health Resources, after a similar contract dispute. The resolution of such negotiations is often critical not only for patient care but also in maintaining competitive healthcare options in the region.
Calling on Patients to Stay Informed
As negotiations continue, patients are advised to stay informed about the status of their coverage by contacting their insurance provider for the most current information. These discussions reflect broader themes in healthcare, emphasizing the need for transparency and awareness among patients to secure the best care available.
Key Takeaways
- Ascension Texas hospitals may become out-of-network for BCBSTX members starting January 1, 2026, if negotiations fail.
- Patients could face higher out-of-pocket costs without a new contract.
- Continuity of care provisions may aid specific patient groups.
- Staying informed is crucial as negotiations evolve.
Frequently Asked Questions (FAQ)
What is the current status of the contract between Ascension Texas and Blue Cross and Blue Shield of Texas?
The contract between Ascension Texas and Blue Cross and Blue Shield of Texas is set to expire on January 1, 2026. If a new agreement is not reached by that date, Ascension Texas facilities may become out-of-network for BCBSTX members.
Which patients will be affected if Ascension Texas becomes out-of-network?
Patients with commercial BCBSTX plans, Medicare Advantage plans, and Affordable Care Act exchange plans may be affected and could face higher out-of-pocket costs for services at Ascension facilities.
What is “continuity of care,” and who is eligible for it?
“Continuity of care” allows certain patients to access in-network rates temporarily, even if their healthcare provider becomes out-of-network. Eligible individuals include those receiving treatment for acute or life-threatening conditions, pregnant individuals, and those with disabilities. Members should contact BCBSTX to determine their eligibility.
Have there been similar contract disputes in Texas recently?
Yes, similar disputes have occurred. For example, in April 2025, BCBSTX and Southwestern Health Resources reached a new agreement after a contract dispute.
What should patients do to stay informed about their coverage status?
Patients are advised to contact the number on their insurance card for the most current information and to stay informed about the status of their coverage.
Key Features of the Contract Dispute
| Feature | Details |
|---|---|
| Contract Expiration Date | January 1, 2026 |
| Potential Impacted Patients | Those with commercial BCBSTX plans, Medicare Advantage plans, and Affordable Care Act exchange plans |
| Eligible for Continuity of Care | Patients receiving treatment for acute or life-threatening conditions, pregnant individuals, and those with disabilities |
| Previous Similar Disputes | April 2025 dispute between BCBSTX and Southwestern Health Resources |
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