Memorial Health, BCBS reach new coverage agreement

Memorial Health, BCBS reach new coverage agreement
Blue Cross Blue Shield contract set to expire with Memorial Health

SAVANNAH, GA (WTOC) - UPDATE: Memorial Health and Blue Cross & Blue Shield of Georgia have reached a new agreement.

On Wednesday, Oct. 3, Memorial Health stated that patients participating in their insurance programs can continue to receive in-network coverage at their hospitals, physician practices and outpatient facilities.

The new agreement is backdated to Oct. 1, meaning that BCBS members will experience no gap in their coverage.

-------------------------------------------------------------------------------------------------------------------------------------------------------------------------

As of October 1, Hospital Corporation of America is no longer included in Blue Cross Blue Shield of Georgia’s network.

Sept. 30 was the deadline for HCA and Blue Cross Blue Shield of Georgia to reach a deal following contract negotiations. BCBS is trying to keep costs low because, if HCA raises the price, then BCBS will have to raise premiums.

This is potentially impacting about two million Georgians and the services they may seek at hospitals and medical providers around the state.

There are eight HCA-owned hospitals in Georgia including Memorial Health in Savannah and Doctors Hospital in Augusta. There are also a number of HCA groups in the area that may also be impacted including Dublin Multispecialty, Memorial Family Practice, Savannah Pediatric Care, Savannah Primary Care and Savannah Multispecialty,

Until an agreement is reached, routines exams, on-going conditions and elective surgeries could be considered out-of-network.

HCA no longer included in BCBS network

There are a few services that still may qualify to be continued as in-network including cancer treatments, pregnancy, hospice care and transplant care. Patients will need to contact Blue Cross Blue Shield of Georgia to find out if they are eligible to continue receiving in-network rates.

Below is a statement from Memorial Health regarding the BCBS negotiations:

“Most hospitals and insurers, like Anthem Blue Cross & Blue Shield of GA, renegotiate their contracts every 3 years. This is a routine practice in the health insurance industry. We always try to make sure new contracts are complete prior to the expiration date of the previous contract. However, sometimes it can take a bit longer. In that case, the contract when signed will typically have an effective date that syncs with the prior contract so that patients are not impacted by these delays. In this case, the new contract will be dated 10/1/2018 to ensure our patients do not experience any gap in their ‘in-network’ coverage.”

A Memorial Health spokesperson says that while completing contract paperwork, the hospital will hold the bills so there is no impact to the patient.

Earlier this year when Blue Cross Blue Shield of Georgia and Piedmont Health couldn’t reach an agreement, Georgia Gov. Nathan Deal said he would initiate an executive action, allowing state employees to enroll in a new insurance plan.

For more information, click here.

Copyright 2018 WTOC. All rights reserved.