Your Questions
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I’m an HMO member and am not sure whether my primary care provider changed during the negotiation. How do I check?
We may have assigned you a new PCP as part of the negotiation. Go to your member account online to see. If we did move you to a new PCP, we will reassign you back to your Memorial Hermann PCP.
If during the negotiation, you chose a new PCP, we will honor your choice and not move you back to your Memorial Hermann PCP. You may change your PCP selection at any time.
To review your PCP online:
- Register for or log in to your member account online or use the BCBSTX App
- Scroll down and select your current provider in the Your Care Team section
- Review the PCP listed
If you want to change your PCP online:
- In the Primary Care Provider For section, select Change PCP
- Use the Search by Provider options and map to find available providers
- Click on a provider to select that provider
- Choose Change PCP
You can also search in-network doctors by visiting bcbstx.com and selecting Find Care, or by visiting your online provider directory.
If you have any questions, or if your preferred PCP is not accepting new patients, call us at the number on your member ID card.
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What if I had claims with Memorial Hermann that were processed as out-of-network?
Our agreement with Memorial Hermann is retroactive to April 1, 2026. This means that any claims processed as out-of-network on or after April 1 will be reprocessed at the in-network level. We ask for your patience while we reprocess the claims.
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I paid Memorial Hermann cash for services after April 1, what should I do?
If you paid out of pocket for services while Memorial Hermann was out of network, Memorial Hermann will file the claims with us so that we can reprocess them as in-network. Memorial Hermann will refund any payments you made over your in-network cost share. Check in with your provider to confirm.
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I have a Blue Cross and Blue Shield plan other than BCBSTX. Am I impacted?
This negotiation may affect Blue Cross and Blue Shield members with plans in other states who access Memorial Hermann. Call the number on your member ID card if you have questions about your coverage.
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Why does BCBSTX negotiate reimbursement rates and terms with health care providers?
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.