If you or a covered dependent need inpatient or outpatient hospital care, you can save money by using Houston Methodist Hospital or its community hospitals. Houston Methodist Hospital has agreed to not collect deductibles and co-insurance from eligible participants enrolled in the Texas Annual Conference of the United Methodist Church (TAC) Standard PPO plan. This could mean substantial savings if you or your dependents need hospital care. This non-collection (write-off) of deductibles and co-insurance only applies to hospital facility charges (not doctor charges) which are covered under the TAC Standard PPO plan. Participants in the High Deductible PPO plan are not eligible for this benefit.
Who is eligible?
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Active clergy and lay employees of the TAC Fiscal Office and their eligible dependents (including spouses, children and surviving spouses) enrolled in the TAC Standard PPO plan.
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You are NOT eligible if:
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You are enrolled in the High Deductible PPO plan;
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Medicare is your primary coverage;
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You serve on The Methodist Hospital board.
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What services are covered?
Houston Methodist hospital facility charges for benefits covered under the TAC Standard PPO plan. Clergy are eligible for private room, space-available upgrades.
What services are not covered?
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Services or supplies listed as exclusions in the standard PPO plan document (for example, elective cosmetic surgery and experimental procedures) are not eligible for this benefit.
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Your hospital bill is separate from your doctor bills. The write-off does not apply to doctor bills. You will still owe deductibles and co-insurance amounts for any physician charges associated with your care at a Houston Methodist Hospital (including but not limited to surgeons, anesthesiologists, radiologists, and pathologists).
If you live in the Houston area
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The Houston Methodist Hospital system is renowned for its high quality of care, its internationally recognized research and its caring, spiritual environment.
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Eligible facilities include Texas Medical Center - Fannin, Willowbrook, Sugar Land, San Jacinto (Baytown), Clear Lake (previously St. John), Katy - West Houston, Katy - St. Catherine, The Woodlands, and Houston Methodist Continuing Care Hospital.
Starting 1/1/2024:
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The Houston Methodist Hospital Deductible & Coinsurance Write-off (Non-collection Agreement) will continue; however, deductible and co-insurance amounts waived at Houston Methodist (and related facilities) will not be applied toward your deductible and out-of-pocket maximums should you visit other facilities subsequently.
How to use this benefit
1. When you or your dependents need services from a Houston Methodist Hospital and are pre-registering:
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Explain that the Texas Annual Conference of the United Methodist Church has a non-collection agreement with Houston Methodist hospitals for participants in the TAC Standard PPO plan whereby you and your enrolled dependents do not owe any deductible or co-insurance amounts to the hospital for inpatient or outpatient hospital facility charges.
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You should not pay any pre-registration fees to the hospital for hospital facility charges for benefits covered under the standard PPO plan (the write-off does not apply to services that are not covered under the Standard PPO plan or if you are enrolled in the High Deductible PPO plan).
2. Review your explanation of benefits (EOB) from UMR
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After receiving services from a Houston Methodist Hospital, review your explanation of benefits (EOB) that you receive from UMR. Be sure that the provider shown on the EOB is a Houston Methodist Hospital. The EOB will correctly indicate any patient responsibility amounts (deductibles or co-insurance) that you would normally have to pay to the hospital.
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Even though you don’t have to pay any amounts covered by the non-collection agreement to the hospital, you will still receive credit towards meeting your deductible or out-of-pocket maximums as if you had paid them – a double blessing!
3. Review your statements from the hospital
If you receive a statement from a Houston Methodist Hospital after UMR has paid the hospital bill which shows that there is a balance you still owe to the hospital:
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Review the statement to see if the services are for Houston Methodist Hospital facility charges for a benefit covered under the Standard PPO plan.
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If so, call the hospital billing department number found on the statement, explain about the write-off you (or your dependents) receive as a participant in the TAC Standard PPO plan, and ask the billing department to apply the write-off and send you a corrected statement showing a $0 balance owed.
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You may need to call a second time if you receive another statement showing that you still owe a balance to the hospital, but politely persist until the matter is resolved.
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If you receive a hospital statement showing that you owe a balance to the hospital, do not assume that eventually the hospital will correctly apply the write-off and that you do not need to take any action. You must take the initiative in contacting the hospital to resolve the billing error since you do not want the outstanding charges to be sent to a collection agency.
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If the services are for benefits not covered under the TAC Standard PPO plan, you will need to pay your patient responsibility balance owed to the hospital.
4. Pay any doctor charges you owe
Remember that the write-off only applies to inpatient or outpatient Houston Methodist hospital facility charges – not to doctor charges. You will still owe any deductible and co-insurance amounts to physicians even if they are affiliated with the hospital and have “Methodist” as part of their name, such as “Methodist Surgical Associates” or “Methodist Radiology Associates.” Even though these providers are affiliated with the hospital, “Associates” always refers to a group of physicians, so a statement from a group of “Associates” would be a doctor bill, not a hospital bill, and you would need to pay any patient responsibility amounts owed to the doctor.