COUNCIL BLUFFS, Iowa (KMTV) — Aetna Medicare Advantage patients who see healthcare providers at CHI will either have to pay out-of-network prices or switch providers if the two companies don't agree on a new contract. The last contract expired on Oct. 1 and the organizations say they're actively negotiating a new one.
- Nancy Jones and her husband are Council Bluffs retirees who have Aetna Medicare Advantage plans. When they turned 65 it seemed like the right choice, but now Nancy isn't so sure.
- Jones likes the doctor she has through CHI and doesn't want to switch to a new one.
- As of our deadline, an Aetna spokesman said the company would send an updated statement about the contract negotiations.
- CHI Health Partners issued the following statement: "CHI Health Partners has been 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 Medicare Advantage plans. Patients with questions should contact Aetna or they may contact our call center at (866) 726 - 8362. Up-to-date information is also available at CHIhealthPartners.org/Aetna."
BROADCAST TRANSCRIPT:
Council Bluffs has two hospitals. CHI Mercy over here. Methodist Jennie Edmundson over here. They serve a considerable number of southwest Iowans and Nebraska neighbors. I'm neighborhood reporter Katrina Markel. I'm here because, for neighbors with Aetna Medicare Advantage, they currently can't see their CHI providers without paying big bucks out of pocket.
"So, I'm just trying to find out, are they in network or are they out of network?" said Nancy Jones on the phone with Aetna.
As of Oct. 1, CHI providers are out of network for Aetna Medicare Advantage patients in Iowa and Nebraska. The organizations are negotiating a NEW contract but the old one expired.
Patients like Council Bluffs neighbor, Nancy Jones, could pay as much as 40% for out-of-network care.
"My husband has said, 'So, let's just switch doctors.' And I said, well that's fine if you want to do that, but I really like him and I would like to stay with him,” she said.
When the Joneses turned 65, they had a choice between Medicare Advantage and traditional Medicare. Like more than half of seniors, they chose an Advantage plan.
Now, contract negotiations may force them to either find new doctors or pay a lot more out of pocket. Nancy worries some neighbors will just give up on medical visits altogether.
"Well, that's not what we worked all those years for,” Jones said. “We worked for our Medicare to help and take care of our health in later years."
CHI Health Partners says it continues to negotiate with Aetna for "fair and appropriate reimbursement rates."
Last week, I interviewed Kristen Blum, the new president of Mercy Hospital. In a wide-ranging interview, I asked about the ongoing dispute.
"We never want there to be barriers, so right now is a challenging time, I think, for our staff, our providers and our patients," she said.
CHI encourages patients to reach out to Aetna or the CHI call center with questions: (866) 726-8362
"So, I guess we'll remain hopeful and we'll see what happens," Jones said.
A spokesman for Aetna responded to me on Tuesday afternoon and said the company is working on an updated statement.
In Council Bluffs, I'm your southwest Iowa neighborhood reporter, Katrina Markel.
