A branch of insurance giant BlueCross BlueShield has split from Vanderbilt University Medical Center, forcing thousands of senior citizens to act quickly or lose medical coverage.
Channel 4 heard from several customers of BlueCross BlueShield’s Medicare Advantage program, who received a series of letters explaining changes to their network.
The letters state that Vanderbilt University Medical Center and its affiliated providers are leaving the network at the end of the year.
Mary Danielson, spokesperson for BlueCross BlueShield of Tennessee, said in all, the company has in excess of 20,000 members in Middle Tennessee. Those in the Medicare Advantage program are mostly retirees, ages 65 and older.
The changes means these customers will need to change doctors or pay higher, out-of-network rates to stay with their existing treatment plans.
Danielson said the insurance company wanted to keep Vanderbilt, but they were unsuccessful negotiating rates.
“Our first obligation is to our members and to do everything we can to keep the cost of their care as affordable as possible.” Danielson said. “And Vanderbilt, quite frankly, is simply too expensive.
“In fact, we offered to pay them the same rate that they accept from the federal government, and they were not in agreement with that,” Danielson added.
In an email to Channel 4, Vanderbilt’s John Howser, assistant vice chancellor of Medical Center News and Communications, confirmed they could not reach an agreement:
We (VUMC) have been communicating with the affected individuals since September to make them aware of this change. Since September, we have sent our Medicare Advantage patients letters, made outbound phone calls, have established an 800 phone hotline to answer questions, have been running large advertisements in The Tennessean for several weeks now, and have established a dedicated website to answer questions. The website and Tennessean ads include a list of the other Medicare Advantage plans that will provide in-network access to VUMC’s hospitals, clinics and physicians for 2016. The website is vanderbiltmatterstome.com.
Medicare Advantage customers have until Dec. 7 to switch plans if they want to remain in-network with Vanderbilt health professionals.
Date: November 30, 2015