JACKSONVILLE, Fla. – Florida Blue Medicare patients should expect some changes to their insurance coverage if they utilize Baptist Health.
While no official details have been shared on the new contract agreement between Florida Blue and Baptist Health, patients are starting to report issues as they try to reschedule appointments.
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“People are very excited. They think as basic communications are put out that they believe their primary care is back in network. It’s just it’s not, though, so that’s not being communicated very well,” Bill Green said, a local Medicare insurance agent with Green Insurance.
Green said the new agreement covers specialists and hospital services but excludes primary care for HMO members with a Medicare Advantage plan. He’s been getting calls all Wednesday morning from his clients who are understandably confused.
“I’m not an employee of Florida Blue, I don’t work for them. This is just what we’ve been told. So, the negotiation that came in is for specialists in hospital. However, it does not include primary care,” Green said. “That notification was sent out to affordable Medicare members at least 45 days ago. That’s the requirement. So, while it’s wonderful, they came back to an agreement, if someone wants to maintain seeing their Baptist primary care, if they have a PPO, they can pay the out-of-network, co-pay. Unfortunately, the HMO they just wouldn’t be able to.”
It’s still unclear if non-Medicare HMO members are affected by the new contract agreement between Baptist and Florida Blue.
Viewers have emailed News4JAX reporting issues with their Florida Blue Coverage after Oct 1.
“As of October 1st, Baptist is no longer accepting the ‘my blue’ plan offered through Florida Blue,” one viewer wrote. “[A] Baptist Representative also told me, there’s another Florida Blue they are no longer accepting- ‘Florida Blue Select.’”
“My Baptist doctor just called and said I was not in his plan as Baptist is not taking Florida Blue HMO,” another viewer said in an email.
News4JAX has reached out to both Florida Blue and Baptist Health to confirm which patients can expect coverage changes and are still waiting to hear back.
In the meantime, patients should confirm with any primary care doctors or specialists that their insurance is still accepted to avoid any out-of-pocket costs.
“The advice would be, if you want to maintain your relationship with your Baptist primary care provider, there are some other Medicare plans that do have them in network. That’s just something we’d have to meet with one on one and go over what somebody’s medical needs and prescription needs are,” Green said.
Green recommends Florida Blue Medicare members call the insurance company to get their primary care reassigned. Visits to hospitals and specialists are not affected.