UPMC is now out of network

[Al Legheny]

Dear PIT Commuters;


I am not sure who to contact about this issue so I am started with R&I and then I sent it to others . It is currently open enrollment with our benefits. I live in Pittsburgh and for those who end up selecting the Blue Cross & Blue Shield as their insurance. They are going to see a huge cost increase if they use UPMC, which owns almost every hospital in PIT. UPMC will stop accepting accepting this insurance as an in-net work as of July 2012. Therefore all people who have this insurance will be charged and out of net work charges and will also have a higher out of pocket max. This could cost a person in the tune of thousands of dollars per year. They would be forced to only a few in-network choices for their health care. Our company switched from BC&BS of North Carolina to BC&BS Anthem, which UPMC contract with the Highmark or the Anthem expires June 30th 2012 and they are not going to renew these contract.

It has been all over the news and my wife who works at FEDEX got this information and she called about USairway since we use for our insurance. The guy at BC&BS told her that the information she has is correct and it will effect us.
Is there any way to get this information out to our people who are living in PIT so they can make a informed decision with their health care? Please forward it to own ever works on these issues since the open enrollment closes at the end of this month.

Thank You
name removerd for public distribution

 

[nonrev]

No need to start a panic...Tempe is well aware of this and I spoke with the individual who runs the benifits Dept. They will work something out before that happens which means we could be stay with UPMC till the end of the year and get another carrier next year to administer our benifits. My feeling are this will come and go and be no big deal. Mosts of the unions have been told this already and are showing no alarm either. UPMC will never be "out of network" and am I in the know?....YES I AM

 

[SparrowHawk]

Soooo, Was this the Hope & Change you voted for? This is just the beginning of the nightmare known as ObamaCare. It will become easier to die then deal with the bureaucracy.

 

[Phoenix]

Soooo, Was this the Hope & Change you voted for? This is just the beginning of the nightmare known as ObamaCare. It will become easier to die then deal with the bureaucracy.

will become?? Bureaucracy has been like a constant tasering for some time now. For crying out loud, I have to remind my bank that I speak english every time I use the damn ATM. What Fing country am I in? What Fing language are the bills printed in?

P.S. Isn't there a programer somewhere that could add a little bit to our ATM cards that indicates the language we speak... Couldn't the Occupy Walstreet protesters complain about something useful?

Oh, yeah if you want to see a preview of the health care providers that will work the counter via Obama excellence, visit the Grey Hound Bus station or the DMV (Please be patient if you are greeted by a sign that says out for protest, will be back in a few weeks).

 

[USFlyer]

This has nothing to do with healthcare reform. I work in the healthcare industry, and providers-payers are regulary negotiating new contracts, resulting in providers dropping in and out of network. Having worked in provider contracting, I can tell you the BCBS payers are the most difficult to negotiate with. Been happening for years. Employers have no say in this -- it's a contractual relationship between providers and payers, not beneficiaries.

 

[jimntx]

Actually, employers do have a say in it. Here at AA, the company changed the "preferred provider" in Texas from Aetna to Blue Cross-Blue Shield for 2012. For 2011, they changed it from United Healthcare to Aetna. The "preferred provider" is the one who gave AMR the best deal. Of course, our situation may be different from US Airways. AMR is "self-insured." The preferred provider simply handles the paperwork, decides to allow/deny the claim, notifies AMR of how much they owe, and then distributes the money to the doctor/hospital/etc for a fee...a large fee. If you offer a lower fee, you can be the preferred provider next year.

 

[BoeingBoy]

Actually, employers do have a say in it.

Only to the extent of changing "insurance carriers" unless you're talking about health coverage that doesn't make distinctions between in and out of network, which are getting pretty rare and expensive when you can find them. If a doctor or hospital drops out of an insurance company's network, the airline can't make that doctor or hospital stay in the network. All they can do is change insurance carriers to one that does include the provider or work out a separate deal with that care provider or facility.

Jim

 

[Dont call me Shirley]

The "preferred provider" is the one who gave AMR the best deal. Of course, our situation may be different from US Airways. AMR is "self-insured." The preferred provider simply handles the paperwork, decides to allow/deny the claim, notifies AMR of how much they owe, and then distributes the money to the doctor/hospital/etc for a fee...a large fee. If you offer a lower fee, you can be the preferred provider next year.

US Airways, like most major companies, is self-insured.

 

[UPNAWAY]

Soooo, Was this the Hope & Change you voted for?

BTW my premiums went up around 20%, gotta love socialized health care!

 

[SparrowHawk]

This has nothing to do with healthcare reform. I work in the healthcare industry, and providers-payers are regulary negotiating new contracts, resulting in providers dropping in and out of network. Having worked in provider contracting, I can tell you the BCBS payers are the most difficult to negotiate with. Been happening for years. Employers have no say in this -- it's a contractual relationship between providers and payers, not beneficiaries.

I beg to differ. ANY time you have the Government interfering in a free market you have increased cost and decreased service. Insurance companies are busy positioning themselves for the upcoming tsunami of Government regulations and manipulations that will pick winners and losers based on the typical Washington, DC crony capitalism.

As you accurately point out, no where do the beneficiaries factor into the equation.

 

[Jester]

US Airways, like most major companies, is self-insured.

Oh, that's not good... I have seen companies file bankruptcy liquidation, and then tell the former employees that if they have outstanding medical claims, those obligations now their responsibility. Usually, the writing is on the wall, when the healthcare provided begins to call the patient for the 90 days pass due bills, but by then it is too late after possiblity hundreds of thousands of dollars of medical treatment has been received. When that happens, a group of screwed employees need to hire a corporate bankruptcy attorney to petition the court and allow those outstanding medical claims to be given a priority over other creditors and hope the Judge is merciful.

I assumed with all the different plans and options, the insurance was not self-insured through the company.

So Worries Jester.

 

[700UW]

BTW my premiums went up around 20%, gotta love socialized health care!

Another thing you dont know about, the US doesnt have socialized medicine!

Maybe you should work under a CBA and a union where Healthcare costs are negotiated.

 

[SparrowHawk]

Another thing you dont know about, the US doesnt have socialized medicine!

Maybe you should work under a CBA and a union where Healthcare costs are negotiated.

That will work!! Then the extra cost can be shifted to others which raise their premiums and put insurance out of reach of many causing more uninsured that further raise costs due to use of the ER as their primary physician.

Now that's Hope and Change in action. Screw one group so the group that supports you financially and politically (Insurance & Unions) can gain an advantage. That plan would make Jerry Glass blush in embarrassment and shame.

All rise for the President of Chicago, Barack "Change we can Believe in" Obama.

Excuse me I have to go cling to my guns and religion now.

 

[luvn737s]

Insurance companies make legislation irrelevant. If you want to change the public's behavior, change what will be covered under insurance.

A Triple Angus Whopper is to a health insurer, what a card counter is to a Vegas casino. Both cut into profits. Of course beating the House is more fun than a balloon angioplasty.

 

[700UW]

Gee just like no one spoke up when US pillaged the employees to subsidize your fares, out of our wallets and benefits and our pensions!

And if you an employee at will, you work under the fact the company can do what it wants to you.

You reap what you sew.

And I dont know what world you living in, but insurance is all ready out of reach for over 50 million Americans!