You may be owed money. Blue Cross Blue Shield of Texas (BCBSTX) has agreed to repay consumers after a Texas Department of Insurance (TDI) review found delays in handling out-of-network emergency claims and incorrect information in consumer notices and marketing materials.
BCBSTX will also pay a $10 million fine.
"Consumers who had higher out-of-pocket costs due to the errors will get refunds," Texas Insurance Commissioner Kent Sullivan said in a statement on TDI's website. "Ensuring the fair treatment of consumers and clear, timely consumer information are priorities for TDI."
The company agreed to begin sending the consumer notices by May 1. Once the notice is received, consumers will have 60 days to seek reimbursement.
Consumers with questions should call the number on their BCBSTX ID cards for member information. Former BCBSTX members who no longer have an ID card can call 972-766-6900.
Consumers seeking restitution will need proof the bill was paid or have an outstanding bill for out-of-network emergency care received between August 1, 2017, and December 31, 2019. Proof of payment can be a credit card receipt or statement, canceled check, receipt from the medical provider, or a similar document.
BCBSTX Consumer Refund & Restitution Information | BCBSTX Enforcement Order
