JACKSONVILLE, Fla. — The deal reached in the 11th hour between Florida Blue and Baptist Health has some changes for a few types of members.
Florida Blue said Wednesday that Medicare Advantage members will experience changes to their in-network coverage for primary care services, and myBlue members will no longer have Baptist Health Jacksonville as an in-network provider.
According to the insurance provider, Baptist Health said it will continue to "see and treat myBlue members without interruption and at in-network cost share through (Oct.) 31, 2024."
Baptist Health requested to no longer participate in myBlue. Florida Blue said it would work to transition myBlue members to other in-network providers in Northeast Florida. Members can also switch to a different Florida Blue plan that includes Baptist Health, with an increase in cost.
Baptist released the following information Wednesday regarding the changes:
"Medicare Advantage. While all emergency, hospital, outpatient and specialty physician services remain in-network for Medicare Advantage members, Baptist Primary Care will no longer be considered in-network effective October 1. Florida Blue is in the process of reassigning these members to a new (Primary Care Physician) and will notify them as soon as possible.
myBlue. All hospital care for myBlue members aged 17 and under will remain intact with in-network coverage. In addition, for adults 18+, all hospital care that results from an emergency admission, labor and delivery and psychiatric services related to a Baker Act admission will continue to have in-network coverage, as will any transfers from a participating hospital for patients who require a higher level of care not otherwise available.
Continuity of care coverage is always an option for patients who qualify for this special coverage. For myBlue plan members, this would allow for continued in-network access to all care for a period of six months. The insurance company determines eligibility and approval."
Florida Blue said the following about the new deal's changes Medicare Advantage PPO and HMO networks:
"Baptist Health primary care providers no longer participate in our Medicare Advantage PPO and HMO networks. Members for these plans have already been matched to different primary care providers. Baptist Health specialists and Baptist Health facilities continue to participate in our Medicare Advantage PPO and HMO plans — and our Medicare Advantage PPO and HMO members can continue to receive services from these specialists and facilities at in-network rates."
A deal was reached Monday night, hours before it would have expired. Baptist Health hospitals in Duval and Nassau counties, along with Baptist Health's physician network have been in Florida Blue's network for years, but they would have been dropped if a deal was not made
The issue in the negotiations was how much Florida Blue would reimburse Baptist Health for health care services, the Florida Times-Union reported. Baptist Health said it had been underpaid for years compared to similar health care systems in Tampa and Orlando and it wanted to close that gap with the new five-year agreement.
Florida Blue and Baptist Health shared the following joint statement on the agreement Monday:
"Baptist Health Jacksonville and Florida Blue reached a new multi-year agreement which ensures that thousands of Florida Blue members will retain their access to the Baptist Health and Wolfson Children's Hospital physicians and facilities.
We are pleased that our new agreement will limit disruption and bring peace of mind to many individuals and families in the Jacksonville community.
We look forward to fulfilling our shared commitment to deliver high-quality, affordable health care as we have done together for more than half a century."
