just when you think you chose your plan, your provider drops out of the biggest networks. is it a negotiation tactic (NJ)
Just got an email that my orthopedist is not going to be in network with the plan I just chose. I checked their list and they are dropping the biggest insurers including many blue cross plans, amerihealth and others. For the marketplace that leaves Aetna and something called Ambetter. I had heard that Aetnas network isn’t as large so I chose a Horizon BC/BS plan. This is really annoying because being a new patient at a specialist usually means it’s a while to get an appt.
I’m wondering if they are trying to negotiate better terms with the insurers.
I applied, but have not paid for my plan. Can I switch? Still worried that other providers will pull this, and that this provider may end up leaving Aetna too. They will still see you “out of network” but the marketplace plans have no coverage out of network.
Part of their email: “Effective February 12, 2023, Reconstructive Orthopedics will no longer be a participating provider with all Blue Cross Blue Shield health plans where the plan is the primary insurance, including Horizon New Jersey Health. We will also no longer be a participating provider with Independence Blue Cross, AmeriHealth, and Keystone Health Plan where the plan is the primary insurance. We will continue to accept patients with these health plans with out-of-network benefits who wish to see one of our providers.
Effective November 1, 2023, Reconstructive Orthopedics will no longer be a participating provider with United HealthCare. “