Those With Anthem Insurance and Valley Health Hospitals (Virginia) Note This

[NateW]

The Valley Health System and Anthem Blue Cross/Blue Shield have reached an impasse in terms of contract negotiations for the renewal of their 5-year contract, which expires December 31st. This means that if not renewed, all services provided by this Network of about 6 hospitals and various other caregivers in the Shenandoah Valley will be considered to be out of network as far as Anthem is concerned. This affects me, so during open enrollment I switched to CIGNA Connect through the ACA.

See:
https://www.winchesterstar.com/winc...ct covers all of,and services, Nantz has said.

 

[PaunchyPirate]

This has happened in western Pennsylvania between Highmark BCBS and our largest (by far) hospital system named UPMC (Univ. of Pittsburgh Medical Center). Over the years, UPMC bought up the majority of hospitals in Western PA and eventually started leveraging their power for better pricing from BCBS. UPMC also got in the insurance business and started competing directly with BCBS. Then BCBS bought into (or purchased, I don’t recall) the second largest hospital system, Allegheny General Health Network.

So both companies are in both businesses. Lawsuits for years over pricing arrangements. They finally reached an agreement after a near total divorce of not covering each other’s network. But the agreement is riddled with issues for the consumer. Large chunks of the networks are still out of network to many plans from the competitor. You literally have to look at each hospital and determine if it’s in network or not. Even though both are owned by the same company. It is very specific to your specific plan. UPMC health plan ACA exchange plans generally can only go to UPMC hospitals and vice versa.

I really despise hospitals and insurance being part of the same corporate umbrella.

Not at all friendly to the consumer. It’s all about corporate $$$.

 

[DenverGuy42]

Same thing happened with Anthem in Colorado with the UCHealth (University of Colorado Health) network

Unfortunately, there are no private plans - as in zero - that cover the UCHealth network now in Colorado. That means that not only did we have to change our network of providers, but also our insurance company as well for 2021. The only way to be in the UCHealth network is to have an employer plan (or be "self insured")

We went with the next best set of providers/hospitals and then chose a plan (we had all of two to choose from) that covered them.