The Adventist Health Network will no longer accept insurance from the third-largest provider in California.
Friday, Dec. 1, was the last day the 16 Adventist Health hospitals, including four in the Central Valley, accepted insurance from Blue Shield of California, following a failure to negotiate rates, according to a news release. The release stated the hospital system is still open to discussions.
The contract termination will affect not just Blue Shield patients, but also patients with Blue Shield’s Medicare Advantage and Medi-Cal Managed Care plans.
“We are deeply disappointed that after 11 months of negotiations, we were unable to reach an agreement with Blue Shield of California,” the release stated.
What Does This Mean for People With Blue Shield?
Adventist Health operates four hospitals in Fresno, Tulare, and Kings counties: Adventist Health Hanford, Tulare, Selma, and Reedley.
With 1.1 million people enrolled and an 11% market share, Blue Shield was the third-largest large group insurer in California in 2021, according to Kaiser Family Foundation.
For those admitted to an Adventist Health hospital before Dec. 1, their coverage will continue until they are discharged. For emergencies, the news release stated that people should always go to the nearest hospital, regardless of their insurance.
What About Pregnant Women?
Pregnant women or those scheduled to have surgery may be able to receive care under continuity of care service, but specific authorization may be required. People with Blue Shield should call the customer service number on their insurance card and ask about continuity of care service.
Those wondering if they can continue to see their physician should call their healthcare service plan.
Important Healthcare Phone Numbers
Other important numbers are:
The Department of Managed Health Care (protecting HMO consumers): 888-466-2219
California Department of Insurance Consumer Hotline: 800-927-4357