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Urgent Message for Members of CIGNA  HealthSpring® (Formerly Bravo)

CIGNA HealthSpring® has terminated the provider agreement with Crozer-Keystone Health System (CKHS), effective April 30, 2014. As a result, except in an emergency, CIGNA HealthSpring members will no longer have access to Crozer-Keystone Health System, Delaware County's largest network of providers. The following letter to all CIGNA HealthSpring members addresses the termination of CIGNA HealthSpring's provider agreement with Crozer-Keystone Health System:

Letter to CIGNA-HealthSpring Members (Updated on April 7, 2014, with two additional free information sessions at Community Hospital on April 15 and April 18.)

Frequently Asked Questions (FAQs)

Following are Frequently Asked Questions (FAQs), that include contact numbers for CIGNA HealthSpring members to call to change health plans; a website and numbers for Medicare beneficiaries to contact; a schedule of free information sessions that Crozer-Keystone has scheduled at various locations starting on April 1; and information about alternate health plans available for you.

What is happening?

CIGNA HealthSpring has terminated the provider agreement with Crozer–Keystone Health System (CKHS) effective April 30, 2014.

CIGNA Healthspring is telling me they are in active negotiations with Crozer-Keystone Health System

No. If a CIGNA HealthSpring representative told you that there are active negotiations, this is inaccurate and false. Notwithstanding any statements to the contrary by CIGNA HealthSpring, there are no ongoing negotiations between CIGNA HealthSpring and Crozer-Keystone Health System. CIGNA HealthSpring sent CKHS a notice letter of termination effective April 30, 2014.

I have CIGNA HealthSpring, how does this impact me?

As of April 30, 2014, as a result of CIGNA HealthSpring’s termination, except in an emergency or for services covered under state and contractual continuity of care requirements, or urgent care provisions, CIGNA HealthSpring members will no longer have access to Crozer-Keystone Health System (CKHS), Delaware County's largest network of providers.

Which Crozer-Keystone Health System providers are terminated by CIGNA HealthSpring?

CIGNA HealthSpring’s termination effective April 30, 2014, applies to Crozer-Keystone Health Network physicians and services at Crozer-Chester Medical Center, Delaware County Memorial Hospital, Taylor Hospital, Springfield Hospital, Community Hospital and all of our outpatient locations, including Crozer Brinton Lake facilities; Media Medical Plaza; the Crozer-Keystone Surgery Center at Haverford; and our home health and infusion providers.

While CIGNA HealthSpring has claimed to have terminated the agreement for only the CKHS hospitals, their termination also ends participation of all CKHS ancillary sites and home health providers, and  forces the  CKHS employed physicians out of compliance with the plan’s credentialing requirement to have privileges at a participating hospital. As a result, our employed physician’s participation must also end as of the effective date of termination of other CKHS providers.

Why is this happening?

We did not seek out this termination and have tried our best to have CIGNA HealthSpring reverse it.

We did not terminate Crozer-Keystone Health System’s participation with CIGNA HealthSpring, CIGNA HealthSpring terminated the health system. We did not, as claimed by CIGNA HealthSpring, seek a rate increase and in fact twice offered the plan a rate decrease, which they did not accept. CIGNA HealthSpring terminated our participation when we did not agree to their demand that we accept rates below Medicare rates and significantly below our cost to provide care to their members, as that would be an unsustainable position for any health system.

I am covered by CIGNA HealthSpring. What can I do?

While Medicare enrollee options are strictly limited by federal rules, patients may have the right to change health plans, or try to request permission of the Centers for Medicare & Medicaid Services for permission to do so in order to continue to receive medical care and treatment from the healthcare providers they know and trust.

You may have the right to change health plans, so that you can stay with the healthcare providers you know and trust, and who know you and your family.

You should check with Medicare to see if you qualify for a special enrollment period.  Special enrollment period criteria is available information in the Medicare & You 2014 handbook and available on www.Medicare.gov. If your situation does not qualify you automatically for a special enrollment period, you can try to request permission of the Center for Medicare & Medicaid Services to change health plans to continue to receive medical care and treatment from Crozer-Keystone Health System. The phone number to call the Center for Medicare and Medicaid services is

1-800-633-4227 or 1-800-MEDICARE.

Crozer–Keystone Health System participates with many other high quality health plans. Each of these other plans has a quality ranking from Centers for Medicare and Medicaid Services (CMS) that is equal or better than CIGNA HealthSpring, and many years of experience in health insurance. Subject to federal rules, you may also be eligible to re-enroll under traditional Medicare, if you desire.

What if I do not change my health plan?

If you choose to remain a CIGNA HealthSpring member after April 30, 2014, the plan may not authorize coverage for care by a CKHS provider except in an emergency or for a short time under continuity of care provisions or under urgent care provisions. Patients would need to request authorization of continuity of care from CIGNA HealthSpring if they want to continue their ongoing treatment for a short time with a Crozer-Keystone Health System provider.

Except for an emergency or for services covered under state and contractual continuity of care requirements and authorized by CIGNA HealthSpring, or urgent care provisions, you will need to contact CIGNA HealthSpring and ask them to help you select other doctors and hospitals and ancillary services for your care. If you choose to remain with CIGNA HealthSpring and change healthcare providers, we will work with you to coordinate that transfer. 

What if the Center for Medicare and Medicaid Services (CMS) will not grant me permission for a special open enrollment period to change my health plan?

After April 30, 2014, CIGNA HealthSpring may not authorize coverage for care by a CKHS provider except in an emergency or for a short time under continuity of care provisions. You will need to request authorization of continuity of care from CIGNA HealthSpring if you are in active or ongoing treatment and want to continue to receive this treatment by a Crozer-Keystone Health System Provider. Continuity of Care is for a short period of time and must be authorized by CIGNA HealthSpring. 

Except for an emergency or for services covered under state and contractual continuity of care requirements and authorized by CIGNA HealthSpring, or urgent care provisions, you will need to contact CIGNA HealthSpring and ask them to help you select other doctors and hospitals and ancillary services for your care. If you choose to remain with CIGNA HealthSpring and change healthcare providers, we will work with you to coordinate that transfer.

They may require you to pay a higher out-of-pocket cost, or that follow-up care after an emergency is provided elsewhere, and they may not allow you to receive any elective services from a CKHS provider.

This applies to Crozer-Keystone Health Network physicians and services at Crozer-Chester Medical Center, Delaware County Memorial Hospital, Taylor Hospital, Springfield Hospital, Community Hospital and all of our outpatient locations, including the three Crozer Brinton Lake buildings; Media Medical Plaza; the Crozer-Keystone Surgery Center at Haverford; and our home health and infusion providers.

Can I still use a CKHS provider in an emergency and will it be covered by CIGNA HealthSpring?

In no event would Crozer-Keystone Health System refuse to treat any patient in an emergency. CIGNA HealthSpring provides coverage of services for non-participating providers in an emergency, subject to the provisions described in your subscriber certificate.

I want to know how I can change health plans?

While Medicare enrollee options are strictly limited by federal rules, patients may have the right to change health plans, or try to request permission of the Centers for Medicare & Medicaid Services for permission to do so in order to continue to receive medical care and treatment from the healthcare providers they know and trust. If you want to consider changing health plans, there are many resources available to help you. Here are some of those resources:

Medicare beneficiaries can enroll through the Centers for Medicare and Medicaid Services Online Enrollment Center at http://www.medicare.gov/. Medicare beneficiaries can also call MEDICARE (1-800-633-4227), 24 hours a day/seven days a week. TTY/TDD users should call 1-800-325-0778.

You can contact other plans directly – the phone number and website are provided below.

CKHS has scheduled several free information sessions to provide you with more information. We have invited representatives from several of these other health plans to be there, so that you can learn about their benefit plans and provider networks and decide what is best for you and your family. There is no cost, parking will be free and refreshments will be provided - we hope that you will join us! The dates and times for these sessions are as follows. You do not have to RSVP.

April 7, 2014

5-7 p.m.

Ridley Township Public Library, 100 E. MacDade Blvd., Folsom, PA

April 9, 2014

11 a.m-1 p.m.

Haverford Township Public Library, 1601 Darby Rd., Havertown, PA

April 15, 2014 (NEW!)

5-7 p.m.

Community Hospital, 2600 W. 9th St., Chester, PA 19013, Southeast Conference Room

April 18, 2014 (NEW!)

11 a.m.-1 p.m.

Community Hospital, 2600 W. 9th St., Chester, PA 19013, Southeast Conference Room

Does CKHS participate with other Medicare Advantage health plans and can I change to one of those plans if I want to?

While Medicare enrollee options are strictly limited by federal rules, patients may have the right to change health plans, or try to request permission of the Centers for Medicare & Medicaid Services for permission to do so in order to continue to receive medical care and treatment from the healthcare providers they know and trust.

We participate with many other health plans, each of which has a quality score equal to or better than CIGNA HealthSpring.

Medicare beneficiaries can enroll through the Centers for Medicare and Medicaid Services Online Enrollment Center at http://www.medicare.gov/. Medicare beneficiaries can also call MEDICARE (1-800-633-4227), 24 hours a day/seven days a week. TTY/TDD users should call 1-800-325-0778.

You can contact other plans directly – the phone number and website are provided below.

FOR MEMBERS WITH DUAL ELIGIBILITY (MEDICARE/MEDICAID) OR SPECIAL NEEDS PLANS 

PLAN

TELEPHONE

WEBSITE

Gateway HealthSM  

1-888-905-3415

http://medicareassured.com

Keystone VIP CHOICE  AmeriHealth Caritas

1-855-241-3648

(TTY/TDD 1-855-241-3649)

 

http://www.keystonevipchoice.com

FOR MEMBERS WITH MEDICARE ADVANTAGE HMO/PPO OR STILL UNDER TRADITIONAL MEDICARE 

PLAN

TELEPHONE

WEBSITE

AETNA

1-888-247-1051 (TTY: 711), 8 a.m. to 8 p.m., seven days a week

http://www.aetnamedicare.com/

Advantra operated by Coventry - an Aetna affiliate

1-877-988-3589 (TTY/TDD: 711 telecommunications relay service), 8 a.m. to 8 p.m., seven days a week. 

http://coventry-medicare.coventryhealthcare.com/

Erickson Advantage*

*Available only to persons who reside at Maris Grove.

1-877-517-5276 (TTY: 711)

Hours: 8 a.m.-8 p.m. 7 days a week

https://www.uhcmedicaresolutions.com

Independence Blue Cross (IBC) including Medicare Select, KHPE 65 and PC 65

1-877-393-6733 (TTY/TDD: 1-877-219-5457), 8 a.m. to 8 p.m., seven days a week.

http://www.ibxmedicare.com/

See Our Locations

Crozer-Chester Medical Center
Springfield Hospital
Taylor Hospital
Delaware County Memorial
Community Hospital

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