GRHS nixing two Medicare Advantage carriers

AETNA AND WELLPOINT

This decision was made after contract terms Great River Health presented to these two carriers were not accepted.  The contract terms were reasonable and accepted by other insurance carriers.  We will continue to provide emergency care for all patients in our Emergency Departments regardless of their insurance.”

GRHS Spokesperson

BURLINGTON – Great River Health System has announced that they are no longer accepting two forms of Medicare Advantage plans.
Information on the change came Monday morning, a week after the health system put out a release about their change in hospital designation which created a new, two-tiered billing structure.
The hospital system, including SEI Regional Medical Center and Henry County Health Center, will no longer be accepting Medicare Advantage plans offered by Aetna and Wellpoint. Wellpoint is formerly AmeriGroup.
The Aetna plan's coverage will no longer be accepted for clinic or hospital services starting on Oct. 10 of this year. The Wellpoint plan will stop at the end of the year.
A hospital spokesperson said the participants in both plans have been notified by letter of the change.
“We are also contacting scheduled patients on an individual basis to help them understand their options, including finding an in-network provider,” the spokesperson said.
“This decision was made after contract terms Great River Health presented to these two carriers were not accepted.  The contract terms were reasonable and accepted by other insurance carriers.  We will continue to provide emergency care for all patients in our Emergency Departments regardless of their insurance.”
Hospital officials said they attempted to push the Aetna date back to the end of the year, but the carrier would not agree to the extension.  That cancellation affects approximately 1,300 patients. 
Patients currently using Wellpoint have also been sent letters with information about the discontinuation of coverage. That affects approximately 300 patients, according to hospital data.
If patients wish to continue receiving healthcare services at SEIRMC or HCHC that are covered by their insurance, they must enroll in an accepted plan during Medicare Open Enrollment which runs from October 15-December 7, 2024, with a plan effective date of January 1, 2025.
The health system will continue to accept current Medicare Advantage plans offered by Humana, United Healthcare, and Wellmark Blue Cross & Blue Shield.