As a Tuesday deadline approaches, contract negotiations between Anthem Blue Cross Blue Shield and MU Health Care have become intense, but so far no agreement has been reached.
That could leave nearly 100,000 patients who use MU Health Care out of network effective Tuesday.
The change could affect thousands of patients who may face higher out-of-pocket costs or need to find alternative providers for medical services.
That number includes those covered under employer-sponsored plans, Affordable Care Act marketplace plans and HealthLink coverage.
A spokesperson for MU Health Care, the nonprofit health care system, said the system continues to work toward an agreement before the deadline.
“We continue to work in good faith with Anthem,” MU Health Care spokesperson Eric Maze said. “The negotiations continue, and we are hopeful we can come to an agreement prior to our deadline.”
MU Health Care recently announced that it extended its contract with UnitedHealthcare to 2027.
Breaking down the data
Depending on the service, the cost of a visit to the Boone Health Convenient Care ranges from $78 to $236, while a visit to MU Health Care Urgent Care, classified as a Level 1 service, is $310. This amount does not include lab costs or imaging as part of the estimate.
Services that may be less expensive at one hospital can be more costly at another for uninsured patients. In-network versus out-of-network costs and co-payments also differ across insurance plans.
For more information on financial assistance eligibility and available discounts, visit the MU Health Care Financial Assistance Policy and Boone Health Financial Assistance Information.
Exclusive MU Health Care services
Even with a variety of care options across the mid-Missouri region, patients should be aware of the limitations to services that come with the termination of the Anthem contract.
Currently, MU Health Care offers a range of specialized medical services not available elsewhere in the region. These include approximately 30 pediatric sub-specialists, a Maternal Fetal Care Center with a fetal surgery program and advanced cancer treatment through the Bone Marrow Transplant and Cellular Therapy program.
MU Health Care also provides specialized orthopedic services, including pediatric vertebral body tethering for scoliosis, which attracts patients nationally, and robotic joint replacement.
In the field of neurosciences, MU Health Care has the largest neurosurgical program in mid-Missouri, and it offers an epilepsy expertise and monitoring unit.
Its urology department performs kidney transplants, and it is the only provider in the region with specialized intensive care units, including cardiac, medical, neonatal, neurosurgical, pediatric and surgical ICUs. Additional unique services include gene therapy interventions and a comprehensive Air Medical Service with four bases across Missouri.
What to do if you’re out of network
Shanon Fucik, chief nursing officer at MU Health Care, said there is a distinct possibility that the health care system will go out of network. Fucik said patients should begin the process of contacting Anthem to see if they qualify for continuity of benefits.
The conditions included under this level of coverage may include pregnancy, cancer treatment, transplant care and recent surgeries.
MU Health Care also has a continuity of care hub where patients can call 573-771-CARE to learn more about their eligibility and options.
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