Thousands of people in Yavapai County feel stuck after an insurance provider and a major hospital network walked away from each other earlier in February.
Blue Cross Blue Shield of Arizona and Yavapai Regional Medical Center could not come to a contract agreement, meaning at least 11,000 members are left with out-of-network care for many services.
“I was scheduled for a bunch of heart tests and I am not going to have them,” said Maggie Greenwood. “I canceled everything cause I’m not going to pay that out-of-network costs until I know what’s going on.”
A spokesperson said through email that the move does not affect all their members and emergency care, even at Yavapai Regional Medical Center, is still covered at in-network rates.
This does not apply to many members in Yavapai County, including those enrolled in:
- BCBSAZ Health Choice (AHCCCS or DSNP)
- Federal Employee Program (FEP) not impacted through the end of 2023
- HMO plans using the Neighborhood Network are not impacted through the end of 2023.
- Senior Security Medicare Supplement
After February 8, if your plan uses one of the following networks, Yavapai Regional Medical Center (YRMC) hospital facilities and their hospital-based physician group will be considered out of network.
- PPO or EPO plans using the Statewide/National PPO Network
- HMO plans using the Statewide HMO Network
- Medicare Supplement plans using the Senior Preferred Medicare Supplement Network
- Plans using the BCBSAZ Workers Compensation Network
BCBSAZ and YRMC seem to point the blame at each other, as both have shared letters to the community from their CEO.
In a letter from BCBSAZ, the CEO wrote, “Across all the Blue Cross Blue Shield of Arizona networks, Yavapai Regional Medical Center is the fourth highest cost hospital in the state, receiving reimbursement rates that are twice the Phoenix hospital average, and three times the Tucson hospital average.”
And, in a letter from YRMC, the CEO wrote, “Our most recent offer made significant concessions and was well below our own inflation. BCBSAZ rejected it without even making a counter-proposal. At this point, they don’t seem committed to reaching an agreement.”
BCBSAZ emphasized that an ER visit for members will still be in-network status.
For those who have Senior Security Medicare Supplement, some may be impacted.
Here's how to check your Member ID:
- If your member ID begins with “R”, “NNJ”, or “NNG”, “HC”, “MZH” this contract termination does not apply to you.
- If your member ID Card starts with “XBS” refer to the product name on your card.
- If your card says Medicare Supplement Senior Security plan this contract termination does not apply to you. If your card says Medicare Supplement Senior Preferred plan, this does apply to you.
- If your member ID begins with any other letter combination, this contract termination may apply to you.
At least 11,600 BCBSAZ members are impacted in Yavapai County.
For more information and FAQ, please click here: https://www.azbluefacts.com/yavapai/faqs
