Insurance Coverage

All patients should familiarize themselves with the terms of their insurance coverage. Understanding your benefits will help you understand the hospital’s billing procedures and charges. If you have any questions about your charges, please feel free to contact our Business Office Customer Service Department at 1-800-386-1747.

If You Have Health Insurance

We will need a copy of your insurance card and any insurance forms that are required by your employer or the insurance company. Deductibles and co-payments are the responsibility of the patient. You will be asked to assign benefits from the insurance company directly to the hospital. This authorizes your insurance company to pay the hospital directly for services rendered to you. Please contact your insurance company for questions regarding your coverage.

If You Are a Member of the Veteran's Administration

South Texas Health System Edinburg was awarded an inpatient and emergency services contract from the Veterans Administration to treat veterans in our five county area: Hidalgo, Starr, Cameron, Willacy, Zapata and Jim Hogg.

Veterans need to be enrolled in the Veterans Administration in order to be eligible to receive benefits of this contract. If you have any questions regarding your eligibility or your VA benefits, you may contact one of the following:

Phone Numbers to Call for Information on Inpatient Contracts

McAllen Outpatient Clinic: 956-618-7145 then press #

VA Texas Valley Coastal Bend Healthcare System, The VA Health Care Center at Harlingen: 956-366-4500 then press #

If You Are a Member of an HMO or PPO

Your plan may have special requirements, such as prior authorization. It is your responsibility to make sure that you understand these requirements. If your plan’s requirements are not followed, you may be financially responsible for all or part of the services rendered in the hospital.

Deductibles and co-payments are also the responsibility of the patient. Some physician specialists may not participate in your health care plan and their services may not be covered. Please contact your insurance company for questions regarding your coverage.

If You are Covered by Medicare

You should be aware that the Medicare program specifically excludes coverage for certain items and services. Deductibles and co-payments are also the responsibility of the patient. Some medications given in an outpatient setting may not be covered.

If you are covered by Medicare and are a patient of a home health agency, it is extremely important that you notify your home health agency of any outpatient services you have received from South Texas Health System Edinburg, or if you are admitted to the hospital.

If You Are Covered by Medicaid

Medicaid has payment limitations on a number of services and items. Medicaid does not pay for the cost of a private room unless medically necessary.

If You Do Not Have Health Insurance

A representative from the Financial Counseling Office will discuss financial arrangements with you. South Texas Health System Edinburg has representatives available to assist you in applying for Medicare, Medicaid, county assistance and for our Charity Care program. All programs, including Charity Care, have qualifications that must be met. If you do not meet these qualifications, you are still financially responsible for your hospital bill.

Accepted Health Plans

View all of the accepted health plans at South Texas Health System Edinburg. Please realize that some managed care organizations may be added, while others may be removed at any time. Please contact Insurance Verification at 956-388-2223 or 956-388-2228.