Blue Cross Blue Shield of Michigan says roughly 250,000 patients could face major changes to their coverage if a new contract with the University of Michigan Health is not reached by June 30.
The state’s largest nonprofit health insurer is telling patients to seek new doctors, adding that about 48,000 patients with “certain serious, life-threatening conditions” will continue to get in-network rates at Michigan Medicine centers through Sept. 29, even if the two sides don’t reach an agreement.
A partial list of those conditions that could stay covered through Sept. 29 includes:
- Cancer
- Organ transplants
- Pregnancies
- Diabetes
- Autoimmune disorders
- Alzheimer’s disease
“Michigan Medicine could have stayed in network with us past the negotiation deadline, past July 1, at rates higher than they get paid today,” Meghan O’Brien, BCBSM’s Director of Corporate Affairs, said. “They unfortunately decided to send us a termination notice. So, we’re working diligently to try to reach an agreement by June 30.”
On Wednesday, Michigan Medicine announced plans to terminate its in-network status with Blue Cross as of July 1 if a new contract is not reached.
This would only affect facilities and providers in southeast Michigan.
Blue Cross is sending letters to patients who pre-qualify for extended coverage.
“We’ve shared multiple proposals with Blue Cross since March 1, and we have adjusted these proposals on our end with the hopes of getting closer,” Julie Ishak, Chief Nurse and Operations Executive for Michigan Medicine, said. “Unfortunately, we have not seen those similar adjustments to scale from Blue Cross.”
“The fact is we have been negotiating this contract in good faith for more than a year,” she said. “And we are looking for a high-value partnership with Blue Cross.”
The dispute has left patients and families stuck in limbo over what to do next.
Changing doctors is not as simple as it sounds when people have specific needs.
Samir and Courtney Abdel-Hak simply want answers.
Their son Amir, who turns 2 next weekend and looks like your typical, adventurous toddler, was diagnosed with Type 1 diabetes last November.
They are insured through Blue Cross Blue Shield and credit the doctors at C.S. Mott Children’s Hospital with saving his life.
“I go to Mott, and luckily, everything there is a one-stop shop,” Courtney said. “He has his psychologist, he has a nutritionist, a dietitian, he has his endocrinologist, and the nurses that work side by side with their endocrinologist, and they take care of everything for him.”
“He’s gained his weight back,” Samir added. “He’s started speaking more clearly, learned new words, and is developing a lot more appropriately. He’s right back on track.”
Amir and his 7-month-old brother, Sonny, are among the thousands of patients who could be affected if Blue Cross and Michigan Medicine do not reach a new contract by June 30
“I’d like to see a negotiation, to see the patients being put first,” Courtney said. “Please stop looking at us like we’re a number and look at us like we’re a family.
“We’re patients,” she said. “That’s a little boy. He’s relying on that to stay alive.”
Both sides continue to negotiate and still hope to reach an agreement on a new contract.
Both sides understand the limbo in which people like Courtney and Samir find themselves.
“I commit to that mother and to all mothers and all patients that we are going to keep asking those questions,” Ishak said. “We’re going to keep coming to the table in good faith effort so that we can continue to take care of these kids and adults alike.”