Care at Children's Minnesota now more expensive for BlueCross BlueShield patients

BCBS says it has in-network contracts with several other healthcare providers in Minnesota.

The July 5 deadline for a deal to be struck on a new contract for BlueCross BlueShield patients at Children's Hospitals of Minnesota has passed with no agreement in place.

It means that parents with kids covered by BCBS insurance face a hike in prices starting Wednesday, as Children's facilities are now considered out-of-network.

As the Star Tribune explains, these families must now make a decision to either stay with Children's – Minnesota's largest pediatric care provider – and pay the steeper out-of-network rates; or find a new, in-network healthcare provider.

Roughly 66,000 subscribers received care at the health system in the past year alone.

'Emergencies will still be in-network'

BCBS though reminded subscribers that serious and life-threatening medical emergencies will still – and will always – be processed as "in-network." Normal and routine services in a clinic and not the ER will be paid at out-of-network rates.

In statements issued just after midnight, BCBS said it's disappointing that Children's "would choose to walk away" from its network, while Children's said it was also disappointed Blue Cross was "unwilling to find common ground."

BCBS announced last week that it agreed to a three-year extension with another children's care group: Gillette Children's Specialty Healthcare, which has seven hospitals and clinics across the Twin Cities including its St. Paul Campus, plus four more in greater Minnesota as well as outreach clinics.

BCBS patients still have in-network access to the following healthcare providers:

  • University of Minnesota Children's Masonic Hospital
  • Gillette Children's Specialty Healthcare
  • Mayo Clinic Children's Center
  • Sanford Children's Hospitals
  • Shriners Hospitals for Children

Disagreement over Medicaid reimbursements

Children's announced in March that BCBS would no longer be an in-network provider because the insurer demanded an "exceptionally large, double-digit reduction" in payments for Medicaid patients that would "financially cripple" Children's.

In a statement on June 24, BCBS said it had made "every effort" to reach a new agreement with Children's, and made accusations of there being "misinformation" regarding the contract impasse. BCBS also said it had offered Children's a "fair deal" on Medicaid.

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