NORTHAMPTON — Blue Cross Blue Shield of Massachusetts and Cooley Dickinson Hospital are notifying patients that insurance coverage will continue, even as some 2,500 Medicare Advantage subscribers in the region learn that their primary care providers will soon no longer be in-network.
A joint statement issued Friday by the insurance company and hospital is designed to allay fears about Cooley Dickinson primary care providers leaving Blue Cross’ Medicare Advantage PPO and HMO networks as of Oct. 1.
“Cooley Dickinson primary care providers remain in Blue Cross’ commercial networks. Mass General Brigham specialty and hospital care will remain in-network for Blue Cross Medicare Advantage and commercial plans, including at Cooley Dickinson Hospital,” the statement reads.
With a number of patients getting letters from Blue Cross about the changes coming this fall, the insurance company and hospital are providing information about the process to keep insurance up to date, even during the open enrollment period that starts Oct. 15.
“If a Blue Cross Medicare Advantage member needs to continue seeing their current primary care provider after Oct. 1, we have established a coordinated 90-day transition period through Dec. 31 to support them,” according to the statement.
This transition allows all Blue Cross Medicare Advantage PPO and HMO members to request continued access to their primary care providers by submitting a continuity of care form directly, or by calling the phone number on the back of their member ID cards to have Blue Cross initiate the process.
There will be no change in cost during this 90-day window. With approved continuity of care, members will continue to see their provider at the in-network cost-sharing rate.
Blue Cross members affected by this change are currently being notified. Mass General Brigham is informing its providers of this change as well, and will also notify affected patients.
“We are committed to ensuring members and patients have the resources they need to navigate this change smoothly,” the statement reads. “We encourage patients to explore options that best meet their health care needs during the upcoming Medicare Advantage Open Enrollment period.”
Patients who want to keep their primary care doctor will need to select a new plan with another company to take effect Jan. 1. Those that want to stay on Medicare Advantage would need to find a primary care doctor who accepts the insurance.
State Sen. Jo Comerford, D-Northampton, spoke to hospital leaders about the situation. She said the guarantee of continuity of care with no additional costs — maintaining regular copays and cost-sharing as if there had been no change — is good news.
“I don’t think the intention was to not cover people,” Comerford said.
However, she noted that the correspondence could have been improved. “We hope to see more communication that is more clear and understandable,” Comerford said.
The official notification that Mass General Brigham would be terminating its contract with Blue Cross was made to the insurance company on Jan. 20.
