People who rely on Blue Cross Blue Shield of Texas Medicare Advantage plans will have to move to a different plan for 2027.
The current Medicare open enrollment period began less than a week ago, and Texans are seeing fewer options for coverage compared to previous years. The BCBSTX website now features a notice letting Texans know they’ll have to look elsewhere for plans.
In a statement to KERA, BCBSTX said impacted customers were notified by mail before Oct. 2 with a letter that “provides them with their options.” Those customers will have a “special election period” where they can choose another plan.
“Like all carriers, Blue Cross and Blue Shield of Texas evaluates its Medicare products annually by market to determine their ongoing viability,” BCBSTX said. “We remain committed to this market across the United States, prioritizing areas where our clinical partnerships deliver strong value and quality care. In some cases, we need to make adjustments.”
BCBSTX’s website said starting in 2027 it will no longer offer Blue Cross MedicareRx Prescription Drug Plans, Blue Cross Medicare Advantage Plans or Blue Cross Medicare Advantage Dual Care Plus Plans.
Medicare Advantage, sometimes known as “Part C,” plans are run by private insurance companies. Those companies must meet certain federal “network adequacy” guidelines – like ensuring there’s a covered doctor within a certain distance of a customer.
Medicare doesn’t cover 100% of healthcare costs, which makes the additional benefits of Medicare Advantage plans – like vision or dental – seem like a better deal, according to Dan Weissman, host and executive producer of the “An Arm and A Leg” podcast, which explores why healthcare is so expensive. But Weissman said the drawback is that the companies will only cover specific doctors or procedures.
“They’re for-profit companies,” Weissman told KERA’s NTX Now. “That’s what drives decisions like, ‘You’re only going to see these doctors’ or ‘We’re not going to pay for that treatment’ and they can also run the numbers and be like, ‘You know what? This plan we’re offering to people in Dallas County, I don’t think it’s going to be a moneymaker for us. We’re not going to offer it next year.’ Nobody can make them, and that’s what’s happening.”
As healthcare costs rise, researchers at KFF – a health policy research organization – found Medicare Advantage plans are disappearing across the country. Weissman said North Texas is expected to be hit especially hard – with about 28% of Medicare Advantage plans disappearing at the end of the year.
North Texas advocates said there are resources available to help people navigate applying Medicare and looking for an appropriate plan. For example, the United Way of Metropolitan Dallas has healthcare navigators on staff who can help people understand their options.
To find healthcare assister organizations, people can go to healthcare.gov’s Find Local Help tool and type in their zip code.
Abigail Ruhman is KERA’s health reporter. Got a tip? Email Abigail at aruhman@kera.org.
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