Some Florida Blue policyholders will lose all or some access to Baptist Health providers

JACKSONVILLE, Fla. — Florida Blue confirmed Wednesday evening that some of its policyholders will lose all or some access to Baptist Health, despite the deal reached between the health insurer and the health care provider earlier this week.

myBlue policyholders will lose all access to Baptist Health, while Florida Blue policyholders who participate in the Medicare Advantage network will no longer have their primary care doctor through Baptist Health.

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But Medicare Advantage policyholders will still have access to Baptist Health specialists and facilities at in-network rates.

Action News Jax has heard from Florida Blue customers who said they were told they’d be losing access to Baptist Health, but until now, Florida Blue and Baptist declined to answer our questions.

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Full statement from Florida Blue:

“Florida Blue’s new agreement with Baptist Health Jacksonville enables the great majority of our members to continue receiving care at Baptist Health Jacksonville at in-network rates without disruption. However, Medicare Advantage members will experience changes to their in-network coverage for primary care services, and myBlue members will no longer have Baptist Health Jacksonville as an in-network provider.

“Baptist requested to no longer participate in myBlue, an affordable low-cost HMO product. We are already working to help our myBlue members transition to other quality in-network myBlue providers across Northeast Florida. Alternatively, myBlue members can choose to switch to a different Florida Blue plan that includes Baptist Health as an in-network provider, but that plan will cost more.

“Baptist Health primary care providers no longer participate in our Medicare Advantage PPO and HMO networks. Members for these plans have already been matched to different primary care providers.  Baptist Health specialists and Baptist Health facilities continue to participate in our Medicare Advantage PPO and HMO plans — and our Medicare Advantage PPO and HMO members can continue to receive services from these specialists and facilities at in-network rates.

“For more information, our members can visit our landing page, FloridaBlue.com/Negotiation/BaptistHealthJax, or contact Florida Blue at the number located on the back of their member ID card for support.”

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Full statement from Baptist Health:

“We are thankful for the resolution of our new, long-term contract with Florida Blue, which will be beneficial for our community. We know some people have questions about the details of the transition to the new contract and how it will affect them.

“Most Blue Cross and Blue Shield plans including Federal, State, PPO, Indemnity, Simply Blue, Blue Choice, Blue Care HMO, and Blue Options PPO, will continue to be included in our new contract as well as Florida Blue Medicare, HMO and PPO plans. Both parties agreed to some changes in covered services for Medicare Advantage and myBlue plan members. We want to emphasize that access will continue as follows for these members:

• Medicare Advantage. While all emergency, hospital, outpatient and specialty physician services remain in-network for Medicare Advantage members, Baptist Primary Care will no longer be considered in-network effective October 1. Florida Blue is in the process of reassigning these members to a new PCP and will notify them as soon as possible.
• myBlue. All hospital care for myBlue members aged 17 and under will remain intact with in-network coverage. In addition, for adults 18+, all hospital care that results from an emergency admission, labor and delivery and psychiatric services related to a Baker Act admission will continue to have in-network coverage, as will any transfers from a participating hospital for patients who require a higher level of care not otherwise available.
• Continuity of care coverage is always an option for patients who qualify for this special coverage. For myBlue plan members, this would allow for continued in-network access to all care for a period of six months. The insurance company determines eligibility and approval.

“We want to reassure the community that even in plans for which we are not a “participating provider” we are continuing to provide access in the above ways.

“On behalf of our Board, our more than 15,000 team members and 2,000 physicians, we appreciate our community’s patience as we work through the details of this contract transition.  We also want to express our thanks to the media for helping us get the latest information to our community.

“Thank you.

“More information –

• Baptist has never been a participating provider with Florida Blue Select and this plan was not a part of the negotiation.
• The continued access described for myBlue also applies to Blue Select, as it always has. This is not new.”

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