Blue Cross Blue Shield of Texas drops Kelsey-Seybold Clinic from most plans (Houston: health insurance, get credit)

[Spartacus713]

Last October Blue Cross Blue Shield of Texas sent me a letter giddily congratulating me that my PPO plan was NOT being cancelled for 2016. As a result of this rather strange communication, it occurred to me that I had just experienced a very close call and that previously unbeknownst to me, I was probably navigating very close to the proverbial edge.

Yesterday, I received an email from the Kelsey Seybold Clinic here in Houston - my healthcare provider - notifying me that the edge has now been traversed, at least as far as it relates to coverage with them. Here is an article about that from the Houston Business Journal:

Blue Cross drops Kelsey-Seybold Clinic from most plans

"This is very disappointing to Kelsey-Seybold and our patients," Spencer Berthelsen, managing director of Kelsey-Seybold Clinic, said in a statement. "We have made a long and diligent effort to continue our participation with Blue Cross. We deeply appreciate the trust which our patients have placed in us. We pledge to work with them through this transition and hope that they will continue to choose Kelsey-Seybold for their care."

The changes could affect 100,000 patients as 470 doctors at 20 locations go out of network, increasing the costs for health care, according to the Houston Chronicle.

Of course Kelsey Seybold is insisting that BCBS has dismissed them from their network and BCBS is insisting that Kelsey Seybold has dismissed BCBS as an insurance provider. This apparently applies to around 100,000 people in the Houston area, all of who are sure to be relieved to hear the finger pointing, blame-shifting and squabbling between these two organizations in lieu of providing any productive solutions to our current conundrum. {sarcasm}

I talked to them both organizations this morning and that is apparently what their plan of action currently is.

Anyway, I am apparently now in the market either for a new individual health insurance plan, or a new healthcare provider, and maybe both.

Thanks, Barack!

[HookTheBrotherUp]

What is going on here? If you like your doctor, you can keep your doctor. Also, if you like your plan, you can keep your plan. And lastly, your costs will go down on average of $2500!

Seriously though, Texas is fortunate in one regard, Texas knew what BS this scheme was and did not participate in the exchanges. Just imagine the calamity if Texas did... Texas would be stuck with a mess, and we, the taxpayers, would have to pay for it one way, or another. Good call, but the politicians won't get credit for it.

[testmo]

Have you even checked out the exchanges for what you can get? May suck because texas wont allow texas residents the same option for low cost plans available in other states

That being said... Kelsey seybold recently formed its own managed healthcare company Kelsey Care. BCBS my bet is angry they would pay a true competitor provider money while the patient is under their BCBS plan.

But yes if your first thought in life is to blame the US president for the goings on within BCBS texas I can see why you wouldnt bother to look into things

[chris_ut]

Welcome to the crap the rest of us have been stuck with. Obamacare is a travesty that screwed those of us who were buying our own insurance. This year I went to self pay and just pay the stupid fine since its such garbage now. I may pick it up again when I hit my 50s if the system hasn't been overturned or crashed and burned from massive losses by then.

[bohunak]

BCBS cancelled PPO this year. You can't keep the same plan like last year. At least we couldn't. The same went for United customers. I don't know if all of them, probably not, but a lot of them. Our coverage prices are insane, for no good reason. That sucks, big time.

[Prey521]

I have BCBS of Illinois which still covers Kelsey.....but it doesn't look like it will for much longer! UGH! They'd better not cancel before my wife gives birth LOL

[Spartacus713]

Originally Posted by bohunak

BCBS cancelled PPO this year. You can't keep the same plan like last year. At least we couldn't. The same went for United customers. I don't know if all of them, probably not, but a lot of them. Our coverage prices are insane, for no good reason. That sucks, big time.

I still have a grandfathered BCBS PPO, and have not received notice of cancellation, at least not yet. I could well receive that in October, just to add insult to injury.

I think they cancelled quite a few PPO plans last year in Texas and stopped selling new ones, if I understand correctly. But a good number of older PPO plans were grandfathered, apparently including mine.

[Spartacus713]

Originally Posted by Prey521

I have BCBS of Illinois which still covers Kelsey.....but it doesn't look like it will for much longer! UGH! They'd better not cancel before my wife gives birth LOL

If you look on Kelsey's website, they have information about all this. The bad news is that it does not appear that your BCBS coverage will cover Kelsey for much longer. The good news is they have a number of transitional exceptions listed, which includes coverage for child births in progress at the time of the cutoff on October 1, 2016.

[Prey521]

Originally Posted by Spartacus713

If you look on Kelsey's website, they have information about all this. The bad news is that it does not appear that your BCBS coverage will cover Kelsey for much longer. The good news is they have a number of transitional exceptions listed, which includes coverage for child births in progress at the time of the cutoff on October 1, 2016.

I just got off the phone with them, and you're correct......we lose our docs with KS on 10/1 as well! WTH!!! My wife is going to be upset! She loves her doc and the kids doc as well. Now we have to apply for that transitional care until the baby is born. This really sucks!

[scorpsman]

Whew! We just made it. My wife delivered our son on July 6th. Her OB/GYN is from Kelsey and we are on BCBSTX PPO.