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Frequently Asked Questions by SWHP patients

Frequently Asked Questions from Patients with Scott & White Insurance

Insurances Accepted at St. Joseph Regional Health Center

Insuances Accepted at St. Joseph Physician Associates, Rural Clinics and Walk-In Clinics

 

I have Scott & White insurance.  Can I still see my St. Joseph (SJPA) doctor?
Patients with Scott & White Health Plan (SWHP) are not being turned away from St. Joseph physician offices.  However, we are informing patients with the health plan that St. Joseph doctors are out-of-network.  We're asking them to call the health plan for specifics on their coverage, so they don't incur unexpected out-of-pocket fees.  That number is 979-691-3275.

 

What if I need to go to a St. Joseph hospital and have Scott & White insurance?
Between now and April 30, 2012, St. Joseph hospitals are still in-network for people with Scott & White Health Plan.  This includes St. Joseph Regional in Bryan, the St. Joseph College Station ER and St. Joseph hospitals in Caldwell, Madisonville and Navasota.  During this time, patients with the health plan should not see a difference in their hospitalization or emergency room coverage.

On May 1, 2012, St. Joseph hospitals will be out-of-network for patients with Scott & White insurance-with these exceptions:

  • Hospital services that meet specific criteria. SWHP will treat those as in-network for 90 days after the contract expires. Please call the health plan for specifics: 979-691-3275.
  • Pregnancy. Women at least 24 weeks pregnant on May 1, 2012, may deliver at St. Joseph, receive immediate postpartum care and a follow-up check-up within the first six weeks after delivery. This care will be provided at an in-network rate. Again, please call the health plan to verify your coverage: 979-691-3275.
  • Emergency Room care. State law mandates that an HMO cover certain necessary emergency health care services, regardless of whether a hospital has a contract or arrangement with the HMO. To read specifics from the Texas Department of Insurance, follow this link: http://www.tdi.texas.gov/hmo/statemanben.html

 

Where will I go to the hospital after Scott & White Health Plan's contract with St. Joseph ends?
For information on non-emergency hospital care after April 30, 2012, please contact Scott & White Health Plan: 979-691-3275 or swhpques@swmail.sw.org

 

I have a Scott & White doctor, but not Scott & White insurance. My doctor has ordered a test/procedure/admission to a St. Joseph hospital facility. Will my hospital or test be covered? Can that doctor still see me at a St. Joseph hospital?
If you don't have Scott & White Health Plan, your insurance coverage will not be affected. Patients with other plans like Blue Cross, CIGNA and Aetna will received the same benefits as outlined in their plan.

 

Is St. Joseph going to re-negotiate a favorable contract with Scott & White Health Plan?
Negotiations are not in progress and St. Joseph is not considering another Scott & White Health Plan contract.

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