Thousands of Houston-area patients with Blue Cross Blue Shield of Texas (BCBSTX) insurance may soon need to double-check whether their health plan will cover care at Memorial Hermann facilities, as negotiations continue on a new contract with a looming deadline.
If the two sides can’t reach an agreement by the end of Tuesday, March 31, 2026, Memorial Hermann hospitals, facilities and affiliated providers could become out-of-network for certain BCBSTX plans.
What “out-of-network” could mean for patients
If Memorial Hermann becomes out-of-network, patients could see:
- Higher co-pays
- Higher deductible costs
- Unexpected medical bills, depending on the plan’s rules and benefits
It could also disrupt continuity of care, especially for people who are:
- In the middle of treatment
- Pregnant
- Managing a disability, acute condition, or life-threatening illness
- Scheduled for an upcoming procedure
In those situations, patients may have to determine whether they can keep their current doctor and location of care or move to another provider that remains in-network.
A similar situation unfolded in 2022, when the contract expired at the end of February. Negotiations continued after that deadline, and the organizations later announced a four-year agreement that restored in-network access for patients.
What you can do right now
Patients don’t have to wait until they’re at a doctor’s office to find out what their coverage will be.
Here are immediate steps to take:
- Call the number on the back of your insurance ID card and ask what your options are if Memorial Hermann becomes out-of-network.
- If you’re pregnant or have a disability, acute condition, or life-threatening illness, ask about “continuity of care.”
- You may qualify to keep receiving care at in-network rates for a limited time, but you typically must apply.
- Check your plan’s provider directory to confirm which Memorial Hermann locations and doctors are covered under your specific plan.
- If you have appointments coming up, call your doctor’s office and ask what they recommend if the network status changes.
Memorial Hermann released the following statement regarding the situation:
“Despite nearly eight months of our best efforts to negotiate fair and reasonable terms, we have yet to reach an agreement with Blue Cross Blue Shield of Texas. This comes as little surprise, given Blue Cross Blue Shield’s national and statewide playbook of asking for unreasonable demands while dragging out negotiations to the last minute. This approach ignores the financial realities facing health systems and health care providers today, jeopardizes continuity of care and creates unnecessary anxiety for the patients and families who depend on us for their care. We remain committed to serving the Greater Houston community and urge Blue Cross Blue Shield of Texas to negotiate a good faith proposal that values patients, respects caregivers and preserves their members’ access to care.”
BlueCross BlueShield released the following statement:
“After months of active negotiations, Blue Cross and Blue Shield of Texas and Memorial Hermann Health System could not reach an agreement that reflects our joint commitment to access to affordable, quality health care for our members and patients. We remain committed to pursuing good faith negotiations that ensure we can fairly and prudently cover the cost of care appropriately on behalf of our members.
“We take any disruption in our network of providers very seriously and are working earnestly to ensure our customers, members and their families have access to undisrupted care now and in the future. Members can visit https://www.bcbstx.com/memorialhermann for the most recent updates.
“Members who are being treated for an acute condition or life-threatening illness, a disability, or pregnancy may qualify for continuity-of-care. This means they could still receive care at Memorial Hermann Health System during treatment at in-network rates. Members can find out if they are eligible by calling the number on their member ID card for more information.”