VIRGINIA — As Sentara and Anthem Blue Cross Blue Shield continue to face questions over their contract negotiations, a health insurance broker in Virginia Beach said he is hearing from concerned customers trying to understand what the dispute could mean for their coverage.
Jason Christensen, a life insurance broker with Tri-State MediHealth Solutions, said the company has received more than 100 additional inquiries about the dispute, including questions from people worried about whether their doctors will remain in network and whether they will need to change insurance plans.
“When we're at events where we educate people with Medicare, I would say eight out of 10 people are asking, ‘What's going on with Medicare with Anthem and Sentara?’” Christensen said.
See previous coverage: 'I would be at a loss': Anthem customers fear higher costs if Sentara commercial plan negotiations fall apart
Christensen said his advice to customers is to stay informed and avoid making decisions based on uncertainty.
“I try to tell them it's like parents fighting over custody. They're gonna work it out. Something's gonna happen,” Christensen said. “At the end of the day, if things do need to change, then we're here for that.”
Sentara and Anthem have been negotiating reimbursement rates since August. Last week, Sentara announced it was ending negotiations with Anthem over coverage for Medicaid, Medicare and Affordable Care Act exchange patients, raising questions about whether the companies will reach an agreement for their remaining commercial plans.
About 215,000 Anthem customers in Hampton Roads could face higher out-of-network costs if the companies fail to reach an agreement.
See previous coverage: Sentara ends negotiations with Anthem for Medicare, Medicaid, ACA patients
Sentara said it had repeatedly received proposals from Anthem for lower reimbursement rates for most of the Medicaid, Medicare and ACA exchange plans involved in the negotiations. Anthem has said it wants to maintain access to Sentara providers and avoid disruptions to patient care.
The companies' current contract remains in effect through Dec. 31, 2026. Customers' coverage is not changing immediately because of the dispute.
Christensen said Tri-State MediHealth Solutions is reviewing customers' existing plans and comparing them with other options in case a switch becomes necessary.
“What we're doing now is we evaluate the plan that they're in, look at comparable plans that have the same benefits, and then we're preparing to switch if that needs to be,” Christensen said.
He said the goal is to help customers find plans that meet their needs, including keeping their doctors in network and ensuring their medications remain covered.
For people concerned about what happens next, Christensen recommended gathering information from their insurance provider and doctor, reviewing any correspondence from their insurer and checking for changes that could affect their coverage.
He said the brokerage is also accepting new clients who need help reviewing their options.
Christensen's biggest warning, however, is to be cautious of unsolicited calls from people claiming to represent an insurance provider or offering a new plan.
“Medicare is not going to call you and tell you anything like that,” Christensen said.
He urged people not to trust promises about their coverage from callers while the negotiations remain unresolved.
“Really, nobody knows anything yet until the first. And so, don't believe any promises that somebody's saying right now,” Christensen said.
For now, Anthem customers can continue seeing their Sentara care providers through at least Dec. 31, while the companies continue working toward a resolution for their remaining commercial plans.
