July 22, 2014

Dignity Health-Anthem talks leave uncertainty for Merced’s insured

Negotiations involving the parent company of Merced’s only hospital and an insurance provider have left some wondering if they’ll need to travel out of town for hospital visits.

Negotiations involving the parent company of Merced’s only hospital and an insurance provider have left some wondering if they’ll need to travel out of town for hospital visits.

Anthem Blue Cross, which covers hundreds if not thousands of government and school district employees in the area, sent a letter to its insured members that stated the provider was preparing contract terminations as of last week. Dignity Health, the parent company of Mercy Medical Center, and Anthem have extended the deadline a day at a time since then.

Officials from Dignity Health and Anthem told the Sun-Star on Tuesday that the negotiations continue and coverage would not be interrupted while they are ongoing.

Unclear information had left some of the insured scratching their heads while wondering if a trip to the hospital would incur higher out-of-pocket costs, said Sofia Gonzalez of Merced. The 31-year-old said she pays $462 a month to cover her family.

The letter warned that higher fees could come from visiting a facility or doctor outside of those contracted with the provider.

Gonzalez said if she could not visit Merced’s hospital, she would have to make the trip to Turlock’s Emanuel Medical Center, which takes Anthem. As an instructional aide with Merced County Office of Education, she is covered by that insurance provider.

The mother of five said children get into mischief and are bound to get hurt, so she worries about whether an injury would be covered at Mercy Medical. “To drive 25 or 30 minutes to Turlock with a child that is injured is not very convenient for me as a mother,” she said. “That’s my concern.”

Officials reassured members on Tuesday.

Darrel Ng, the public relations director for Anthem, said “it’s a good sign” that talks have not ceased. “As negotiations continue, Anthem members can continue to go to Dignity facilities in network,” he said. “When they show up for service, they should double-check to make sure they are still in network.”

Other officials agreed, saying anyone planning a visit to a physician or medical facility at any time should confirm with their insurance provider to ensure health coverage.

Ng said it is common for contract talks to continue past the scheduled deadline.

Dignity Health released a statement Tuesday that confirmed Anthem’s remarks.

“Anthem members can continue to access Dignity Health services using their in-network benefits, and companies with Anthem plans can reassure employees that they may continue to utilize Dignity Health hospitals, physicians and ambulatory providers,” the release stated.

The Merced County Office of Education has 800 employees who have insurance, said Nathan Quevedo, the public information officer. He stressed that not all of those workers live in close proximity to Mercy Medical and might tend to use hospitals in Madera, Stockton or another city.

The district has also seen past health care negotiations continue beyond the initial deadline, he said.

More than 400 employees for the city of Merced are insured through Anthem. City Manager John Bramble said the uncertainty has led staff to recommend that city employees schedule elective surgeries outside of Merced. He said it’s particularly frustrating in a city the size of Merced, where there is only one hospital.

Dignity Health is the parent company to almost 30 hospitals in the state, and a few health maintenance organization, or HMO, medical groups. 

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