PROVIDENCE OREGON – For months, Providence has been in negotiation with Aetna insurance in Oregon. Negotiating for market-competitive and sustainable reimbursement rates is a priority for Providence to cover the cost of care for our patients with Aetna insurance, and to pay our doctors, nurses and caregivers for the essential services they provide.
IMPORTANT: Caregiver benefits are not affected by these negotiations, regardless of their outcome.
Unfortunately, we have not yet come to an agreement. This means patients who are insured by Aetna (not Providence caregivers) may no longer be in network at most Providence medical and affiliated groups, clinics and hospitals in Oregon if our contract expires on Jan. 1, 2025.
· NOTE: For Aetna patients in southern Oregon, the contract for Providence Medical Group clinics expires on Feb. 17, 2025. However, the contract with Providence Medford Medical Center expires Jan. 1, 2025.
Patients with Aetna insurance can still receive in-network care until Jan. 1 at Providence as we negotiate a new contract. However, Aetna has begun notifying patients that health care services received at Providence hospitals and clinics will be out-of-network after contracts expire.
Please refer to the following for more information:
· FAQs for patients with Aetna insurance (see below)
· FAQs about caregiver and provider benefits through Aetna
We remain committed to reaching an agreement with Aetna and to keeping you informed during the negotiation process.
FAQs for patients with Aetna insurance
IMPORTANT: Caregiver benefits are not affected by these negotiations, regardless of their outcome.
When is the termination date?
If we do not come to an agreement, patients with Aetna insurance (not Providence caregivers) will be out-of-network at most Providence medical and affiliated groups, clinics and hospitals in Oregon beginning Jan. 1, 2025.
· For Aetna patients in southern Oregon, the contract for Providence Medical Group clinics expires on Feb. 17, 2025. However, the contract with Providence Medford Medical Center expires Jan. 1, 2025.
How can we support patients through this change?
Patients can talk to their human resources department, insurance broker, or Aetna directly to express their concerns and to see what options they may have.
What are patients’ options for continuing to see their Providence doctors?
· Most Providence hospitals, clinics and medical groups in Oregon may be out of network for patients with Aetna insurance on Jan. 1, 2025.
· For Aetna patients in southern Oregon, the contract for Providence Medical Group clinics expires on Feb. 17, 2025. However, the contract with Providence Medford Medical Center expires Jan. 1, 2025.
· If employer groups offer an alternate plan that’s contracted with Providence, patients may switch plans during open enrollment.
· If patients have PPO benefits, they may be able to receive services by accessing their out-of-network benefits.
· Patients can call the Aetna customer service number located on the back of their insurance ID card with questions about how their insurance coverage may be affected if our contract expires.
· If a patient wants to get an estimate regarding their out-of-pocket costs, please follow your department’s normal processes.
How can Aetna patients seek continuity of care?
Patients who are pregnant or receiving active treatment for a chronic condition may qualify for extended in-network access, also known as “Continuity of Care” through Aetna. If they think they qualify, patients can call the number on the back of their insurance card.
