As Brian Nowlin walked out of his yearly physical earlier this month, the staff at his doctor’s office handed him a flyer. Beginning in January, the flyer informed him, his Blue Cross and Blue Shield of Texas insurance plan would no longer be considered in-network.
It was the first he’d heard of it, Nowlin said.
“If I (hadn’t) went for my annual physical, I don’t think they would’ve said anything,” he said.
Nowlin is currently enrolled in the Blue Advantage HMO plan, which he signed up for on the individual Marketplace established under the Affordable Care Act.
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His insurance plan is slated to drop out of the Southwestern Health Resources network in 2026. Southwestern Health Resources includes two major health systems — Texas Health Resources and UT Southwestern — that are powerhouses in Dallas-Fort Worth.
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For patients like Nowlin, the change means a choice between switching insurance plans, or finding new medical providers.
A negotiation from earlier this year
Nowlin’s plan is dropping out of network as part of contract negotiations that took place earlier this year, according to spokespeople for both Blue Cross and Blue Shield of Texas and Southwestern Health Resources.
However, the two entities did not announce that change at the time.
In April, the insurer and the health network hit a significant negotiation hurdle, resulting in a temporary lapse of in-network coverage for thousands of North Texans.
After several days of limbo, the entities came to an agreement. When the insurance company and the health network announced the deal, neither mentioned that the resolution would be short-lived for the Blue Advantage plan.
Southwestern Health Resources’ announcement said the health system “has secured a new three-year agreement with Blue Cross and Blue Shield of Texas,” with no mention of specific coverage plans.
The insurance company’s announcement specifically included the Blue Advantage HMO as one of the plans that had been restored to in-network.
The agreement “includes our ParPlan, Blue Choice PPO, Blue Essentials, Medicaid, Blue Cross Medicare Advantage (PPO), Blue Cross Medicare Advantage (HMO), Blue Advantage HMO and MyBlue Health networks,” the insurance company’s April announcement said.
The insurance company posted a similar statement on its website at the time. Now, though, the website includes an additional caveat.
“In April 2025 we finalized new contracts with Southwestern Health Resources in North Texas,” the insurance company’s website now says.
“However, as part of the resolution, SWHR decided to leave our Blue Advantage HMO network as of Jan. 1, 2026.”
Notification
Both entities told The Dallas Morning News that the impacted patients have been notified of the upcoming coverage change.
Blue Cross and Blue Shield of Texas, through spokesperson Dawn Kahle, said that affected enrollees were notified. Southwestern Health Resources spokesperson Kimberly Walton sent an email statement on behalf of the health network, which also said the affected patients “were given advanced notice of the change.”
Nowlin said that, while he did know about the negotiations earlier this year, he did not know about the upcoming change until his doctor’s office handed him that flyer.
“I did receive a notification back in March or April, that they were in contract negotiations,” he said. “But they never sent anything out letting me know … that they’re only going to be in-network until the end of the year.”
Now, Nowlin is left to sort out whether he should change his medical provider or his insurance.
Southwestern Health Resources’ statement this week noted two options for Marketplace enrollees who want to stay with their medical providers in 2026: MyBlue Health through Blue Cross and Blue Shield of Texas, or plans through Ambetter from Superior Healthplan, excluding the “Value” plan.
Enrollment for Marketplace plans remains open until Jan. 15; selections must be made by Dec. 15 for coverage to begin on Jan. 1.