CEO explains coverage termination
A few weeks ago ThedaCare announced our termination of our Network Health Plan contract. Since then many people have contacted us with questions.
Our decision also caused some angst for some of you. That was not our intent. ThedaCare is focused on making health care better for consumers, patients, families and communities. We are committed to improving the health of the communities we serve. In that spirit, I want to keep you current on the status of our effort to secure a contract extension with Network Health Plan.
Although Network Health Plan has yet to accept our offer for an extension, ThedaCare leaders have a meeting with their executives this week. An extension would allow Network Health Plan members to continue to see ThedaCare doctors through Dec. 31, 2016 – maintaining their current coverage, unchanged.
We hope Network Health Plan will accept the offer to extend, so patients throughout our 14-county service area can be confident about their coverage for another full year.
We had been in negotiations with Network Health for an extended period of time. We sought reasonable terms that addressed a range of concerns similar to those other insurers have agreed to. Clearly, we could not come to an agreement. That’s why we made the difficult decision to end our participation in Network Health Plan at the end of July. This exit was not a surprise to Network Health Plan.
An extension, however, is a way forward. It would mean current plans that include ThedaCare providers and services would remain in effect for all of 2016. We hope Network will accept the extension. Then, patients could enroll in other plans that include ThedaCare doctors and facilities during the next open enrollment.
If you are a Network Health Plan member who sees ThedaCare doctors, you don’t need to do anything right now. Your health care is covered under your current Network Health plan through the middle of the year. That does not change.
If you are offered insurance through your employer and if Network Health declines the extension, talk to your HR department. Network Health is required to cover your ThedaCare primary care doctor and specialists for a certain length of time.
If you are a Medicare Advantage plan member and if Network Health declines the extension and your coverage ends mid-year, please talk with your insurance agent immediately to learn about your options. For example, from Jan. 1 to Feb. 14, 2016 you can enroll in traditional Medicare, as well as Medicare Part D prescription drug coverage. Next fall, during open enrollment, you can enroll in a new Medicare Advantage plan that allows you to continue receiving high quality of care from ThedaCare.
Dr. Dean Gruner
President and CEO