A Change in Health Insurance for Bon Secours Patients

(123rf.com photo)

Hundreds of Bon Secours St. Francis Health System
patients who have Cigna Medicare Advantage plans will have to find other health
insurance if they want to use the hospital’s services
in-network.   

In a statement, Bon Secours said that Cigna Medicare
Advantage was sold to another entity that the hospital doesn’t partner with, so
its hospitals and physician practices in Greenville, South Carolina, will no
longer participate in that plan effective Jan. 1, 2025. 

“We are committed to making this a seamless transition
and have sent letters to impacted patients, enabling them to choose a new,
in-network plan during annual enrollment so they do not experience any
disruptions in care,” Bon Secours said in the statement. “Bon Secours
promises to continue doing our part and work hard to provide care for the
communities we serve.” 

Cigna also issued a statement about the situation.

“We have negotiated in good faith with Bon Secours, but
unfortunately Bon Secours is choosing to leave our network on Jan. 1, 2025,
unless we agree to significant rate increases, which will raise health care
expenses for people who are already dealing with inflation and rising costs of
care,” the statement read. 

“We will continue to offer access to quality care for our
customers in the region,” it continued, “and will work closely with them on
care transition plans where needed.”

In response to Cigna’s comments about contract
negotiations, Bon Secours issued a statement.

“Our top priority at Bon Secours is and will always be
the health and well-being of our patients,” it read. “We informed Cigna of
this decision in June and since then have committed to making this a seamless
transition for impacted patients. We encourage patients to make decisions
during this year’s enrollment period that are best for their care. Bon
Secours continues to be in network with most Medicare plans and is committed to
providing the highest quality and compassionate care for the communities we serve.”

Medicare’s annual open-enrollment period ends Dec. 7, and
patients who want to switch from Cigna Medicare Advantage need to find another
insurer by then. 

In a letter to about 500 affected patients, Bon Secours
said they could learn more about in-network insurers at bonsecours.com/patient-resources/insurance-information.   

Cigna said customers can call the number on the back of
their insurance cards to be connected with other in-network providers in their
area.

Experts say such provider-insurer contract disputes are
not uncommon, though it’s hard to know how often they occur because they aren’t
tracked and because details are not disclosed. But most end up getting resolved
eventually, they say.

One such dispute involved Prisma Health and
UnitedHealthcare.

Late last year, they failed to reach an agreement on a
contract, which left thousands of patients out-of-network for most health
services as of Jan. 1, 2024.

Prisma, the largest health care system in South Carolina
with more than 1.5 million patients across the state, and UnitedHealthcare,
with some 58,000 members using Prisma providers, had been negotiating for
months when they came to the impasse.

UnitedHealthcare said Prisma demanded “outlandish price
hikes” that would have driven up costs while Prisma said the insurer refused to
enter an agreement that reimbursed “for the cost increases we have and
continue to absorb for their health plan members.”

But in July, the two entities announced they had reached
a new multi-year contract without disclosing the details.

Meanwhile, The Cigna Group in January announced that
Health Care Service Corporation would acquire Cigna’s Medicare Advantage, Cigna
Supplemental Benefits, Medicare Part D, and CareAllies businesses for more than
$3 billion. 

Nationally, Cigna’s Medicare plans serve about 3.6
million people, with nearly 600,000 in Medicare Advantage plans, more than
450,000 on Medicare Supplement, and 2.5 million with Medicare Part D, the
companies said in a release.

Health Care Service Corporation said it is the country’s
largest customer-owned health insurer, serving more than 22 million people
nationwide. 

“The agreement will enable The Cigna Group to drive
meaningful value for all our stakeholders, providing an enhanced ability to
accelerate investment and growth in our services platform, while further
deepening our commitment to our existing health benefits platform. In
tandem, the transaction will position our Medicare businesses … for additional
growth as they continue to serve the needs of their customers as part of
HCSC,” David M. Cordani, CEO of The Cigna Group, said in the
release. 

“This acquisition accelerates our growth in an important
market segment,” added Dr. Opella Ernest, President of HCSC Markets.