If a deal is not reached, Monday will be the last day Aetna Medicare Advantage plans will cover CHI Health Partners providers. The same would be true for all Aetna commercial plans if a deal is not reached by Nov. 27.CHI and Aetna, the CVS Health-owned insurance company, each point fingers at the other. Both say they continue to work for a resolution.Aetna told KETV: “CHI Health Partners continues to demand unreasonable price increases that would raise health care costs significantly for members and plan sponsors.”CHI told KETV: “CHI Health Partners has been intently negotiating in good faith with Aetna to renew our contracts to offer fair and appropriate reimbursement rates for the care our hospitals and physicians provide.”Ed Hoeser of Omaha opted into a Medicare Advantage plan with Aetna. Now, for the last three months of the year, it appears he’ll lose in-network access to his psychiatrist, counselor, specialist, and primary providers.He says that will impact his mental health care, which has been critical since his 29-year-old son Jon died last year.In December, Ed’s son Jon died of a seizure believed to be caused by a head injury suffered while serving in the Army. “I’m grateful I had the 29 years with him, but he’s gone,” Hoeser said, “and all we can do is remember his good standings. He loved this country.”Hoeser received notices from Aetna that he’ll lose in-network access to his CHI providers on Oct. 1, which caused tough decisions. “Why should I go have to explain everything that’s happened in my life to a new psychiatrist?” Hoeser said. So, he’s chosen to pay extra to see his psychiatrist so he can have uninterrupted access to his medications. He’ll also avoid seeing his primary care or specialist until he can get a new plan. “I just don’t understand why companies can’t negotiate like responsible adults,” Hoeser said. “They’re supposed to be there for the patients and they’re not. They’re failing.”Hoeser wishes the change would’ve happened on Jan. 1. That way, notice would’ve allowed him to enroll in a new Medicare plan. But that’s not an option.”It’s a blame game and their tactics are going to hurt people,” Hoeser said. “We need more counselors, mental health professionals in this nation, and I think the insurance companies are making it more difficult than it should be.”In May, North Platte-based Great Plains Health announced they would end all Medicare Advantage contracts in 2025.According to a Nebraska Hospital Association survey last year, 9 in 10 hospitals in the state say Medicare Advantage Plans negatively impact their care. Aetna statementAs of October 1, CHI Health Partners is no longer in network for Aetna Medicare Advantage plans, although our contract renewal discussions continue. We were not able to reach an agreement because CHI Health Partners continues to demand unreasonable price increases that would raise health care costs significantly for members and plan sponsors. For our Commercial health plans, CHI Health Partners remains in network through November 27. We are committed to supporting our members through this process. We will continue to work towards an agreement that is fair for our members and brings CHI Health Partners back into our networks. CHI Health statementCHI Health Partners has been intently negotiating in good faith with Aetna to renew our contracts to offer fair and appropriate reimbursement rates for the care our hospitals and physicians provide. We are striving to minimize any disruption in care within our means to the thousands of patients with Aetna commercial and Medicare Advantage plans in Nebraska.Unfortunately, if a deal is not reached, CHI Health hospitals and physicians will no longer be participating providers in Aetna Medicare Advantage plans and, as such, will be out-of-network after September 30, 2024.We understand this situation may cause concern for patients. Patients with questions should contact Aetna or they may contact our call center at (877) 726 – 8362. Up-to-date information is also available at CHIhealthPartners.org/Aetna.We are committed to doing our part to prevent any disruption to our patients’ access to CHI Health physicians and facilities. We will continue to work very hard to reach an agreement that keeps CHI Health Partners in the Aetna network.
If a deal is not reached, Monday will be the last day Aetna Medicare Advantage plans will cover CHI Health Partners providers.
The same would be true for all Aetna commercial plans if a deal is not reached by Nov. 27.
CHI and Aetna, the CVS Health-owned insurance company, each point fingers at the other. Both say they continue to work for a resolution.
Aetna told KETV: “CHI Health Partners continues to demand unreasonable price increases that would raise health care costs significantly for members and plan sponsors.”
CHI told KETV: “CHI Health Partners has been intently negotiating in good faith with Aetna to renew our contracts to offer fair and appropriate reimbursement rates for the care our hospitals and physicians provide.”
Ed Hoeser of Omaha opted into a Medicare Advantage plan with Aetna. Now, for the last three months of the year, it appears he’ll lose in-network access to his psychiatrist, counselor, specialist, and primary providers.
He says that will impact his mental health care, which has been critical since his 29-year-old son Jon died last year.
In December, Ed’s son Jon died of a seizure believed to be caused by a head injury suffered while serving in the Army.
“I’m grateful I had the 29 years with him, but he’s gone,” Hoeser said, “and all we can do is remember his good standings. He loved this country.”
Hoeser received notices from Aetna that he’ll lose in-network access to his CHI providers on Oct. 1, which caused tough decisions.
“Why should I go have to explain everything that’s happened in my life to a new psychiatrist?” Hoeser said.
So, he’s chosen to pay extra to see his psychiatrist so he can have uninterrupted access to his medications. He’ll also avoid seeing his primary care or specialist until he can get a new plan.
“I just don’t understand why companies can’t negotiate like responsible adults,” Hoeser said. “They’re supposed to be there for the patients and they’re not. They’re failing.”
Hoeser wishes the change would’ve happened on Jan. 1. That way, notice would’ve allowed him to enroll in a new Medicare plan. But that’s not an option.
“It’s a blame game and their tactics are going to hurt people,” Hoeser said. “We need more counselors, mental health professionals in this nation, and I think the insurance companies are making it more difficult than it should be.”
In May, North Platte-based Great Plains Health announced they would end all Medicare Advantage contracts in 2025.
According to a Nebraska Hospital Association survey last year, 9 in 10 hospitals in the state say Medicare Advantage Plans negatively impact their care.
Aetna statement
As of October 1, CHI Health Partners is no longer in network for Aetna Medicare Advantage plans, although our contract renewal discussions continue. We were not able to reach an agreement because CHI Health Partners continues to demand unreasonable price increases that would raise health care costs significantly for members and plan sponsors. For our Commercial health plans, CHI Health Partners remains in network through November 27.
We are committed to supporting our members through this process. We will continue to work towards an agreement that is fair for our members and brings CHI Health Partners back into our networks.
CHI Health statement
CHI Health Partners has been intently negotiating in good faith with Aetna to renew our contracts to offer fair and appropriate reimbursement rates for the care our hospitals and physicians provide. We are striving to minimize any disruption in care within our means to the thousands of patients with Aetna commercial and Medicare Advantage plans in Nebraska.
Unfortunately, if a deal is not reached, CHI Health hospitals and physicians will no longer be participating providers in Aetna Medicare Advantage plans and, as such, will be out-of-network after September 30, 2024.
We understand this situation may cause concern for patients. Patients with questions should contact Aetna or they may contact our call center at (877) 726 – 8362. Up-to-date information is also available at CHIhealthPartners.org/Aetna.
We are committed to doing our part to prevent any disruption to our patients’ access to CHI Health physicians and facilities. We will continue to work very hard to reach an agreement that keeps CHI Health Partners in the Aetna network.
