Presence Covenant Medical Center in Urbana and Presence United Samaritans Medical Center in Danville have left BCBSIL networks
As anticipated, as of Feb. 1, 2018, the hospitals formerly known as Presence Covenant Medical Center in Urbana and Presence United Samaritans Medical Center in Danville have left Blue Cross and Blue Shield of Illinois (BCBSIL) networks. This impacts all BCBSIL members who seek care at those hospitals – including HMO, PPO, Medicare Advantage, Medicare Select and Medicaid members.
This network change is a result of the hospitals being purchased by OSF. OSF chose not to keep the existing network participation contracts in place and rejected BCBSIL’s offers to extend those contracts so our members would not be immediately impacted. OSF then requested new contract terms that would significantly increase costs for our customers and we were not able to come to an agreement.
We understand this situation may be confusing for employers and members. BCBSIL is continuing talks with OSF that will benefit our customers and members.
Key points below:
- OSF HealthCare (OSF) took ownership of the former Presence Covenant Medical Center in Urbana and Presence United Samaritans Medical Center in Danville on Feb. 1, 2018, and the hospitals left all BCBSIL networks.
- This network change impacts all BCBSIL members who use those hospitals, including HMO, PPO, Medicare Advantage, Medicare Select and Medicaid members.
- This network change happened because OSF chose not to keep the existing contracts in place for the two Presence hospitals. OSF rejected offers to extend current rates so our members would not be in the middle while we continue to negotiate.
- OSF instead proposed new terms that would significantly increase costs for our customers.
- BCBSIL continued to negotiate, but was not able to reach terms with OSF that were in the best interests of our employer customers and members
- Participation of other OSF and Presence hospitals in BCBSIL networks remain unaffected.
- BCBSIL members will still be able to see their current doctors, in accordance with their benefits.
- Pharmacy and prescription benefits are not impacted.
If members choose to continue seeking care at the new OSF hospitals in Danville and Urbana, claims will be processed at the out of-network benefit level, which may result in higher out-of-pocket costs to members. Medicare Select members who continue to seek care at these hospitals will be responsible for the Medicare Part A deductible. If there is a special circumstance, such as the member is in an ongoing course of treatment for cancer, or the second or third trimester of pregnancy, a continuation of care plan can be requested. Members may still receive an in-network level of benefits for a limited period of time.
BCBSIL is prepared to help guide members through this transition with minimal impact. If you are a member who receives care at those hospitals, you can visit the Provider Finder® to locate an in-network hospital. You may also call either the member services number on the back of your ID card or 877-246-9957. We’ll help guide you through your options.
- Members who believe they have a life-threatening health issue should call 911 or go to the nearest hospital emergency room
- BCBSIL is continuing to engage in discussions with OSF with the goal of reaching agreements that continue to benefit our customers and members.