GRHS releases more details on 2025 Medicare plans

WEST BURLINGTON – Southeast Iowa Regional Medical Center (SEIRMC) and Henry County Health Center (HCHC) will no longer accept Medicare Advantage plans offered by Aetna, effective October 10, 2024, and Wellpoint (formerly Amerigroup), effective December 31, 2024, for clinic or hospital services. In addition, the new Medicare Advantage plan being offered by Molina for 2025 will not be accepted. All patients, regardless of insurance, will receive emergency care in SEIRMC and HCHC Emergency Departments.
This decision was made after the contract terms Great River Health presented to these carriers were not accepted.  The contract terms were reasonable and accepted by other insurance carriers.  Negotiations to extend the terms of the Aetna contract to the end of the year were unsuccessful.
Patients with these plans have been notified of this upcoming change by Great River Health. Staff are working with patients to navigate receiving continued care and finding an in-network provider.
The news comes on the heels of a new billing structure at the hospital after changing the health system designation to hospital-provided care billing, which charges patients a facility fee in addition to office visit fees.
Patients wishing to receive healthcare services at SEIRMC or HCHC that are covered by their insurance 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. Great River Health will continue to accept current Medicare Advantage plans offered by Humana, United Healthcare, and Wellmark Blue Cross & Blue Shield.
Great River Health offers free, confidential, one-on-one counseling to help make informed decisions about Medicare and other health coverage options through the Senior Health Insurance Information Program (SHIIP). You can request an appointment with a volunteer SHIIP counselor at HCHC by calling 319-385-6774 or in Fort Madison, Keokuk, or West Burlington at 319-768-3342 or requesting an appointment online at https://outlook.office365.com/book/SHIIPBookings@grhs.net/.
These schedules fill up quickly so other options for changing your plan during Annual Open Enrollment include contacting the insurance provider or a local health insurance agent. Clients can also contact the SHIIP office in Des Moines at 1-800-351-4664 or www.shiip.iowa.gov. Patients with questions can call Great River Health Patient Financial Services at 319.768.3625, option 2.