St. Charles terminates contract with Aetna for Medicare Advantage plan

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Hundreds of Central Oregonians enrolled in Aetna’s Medicare Advantage Plan will lose coverage next week at the region’s only hospital system.

The insurance provider issued a statement to Central Oregon Daily News saying, in part, “Aetna attempted to reach an agreement with St. Charles Health System that is fair and reasonable for Aetna medicare members before the May 14th termination date,” according to the statement. “We made numerous attempts to revolve the matter, however, St. Charles Health System terminated the contract.”

St. Charles’ CFO Jenn Welander said Aetna contract negotiators asked for things beyond what is considered the industry standard.

“We worked really hard for almost nine months and Aetna was unwilling to provide terms that are customary that we see with all of the other payers we contract with, for Medicare Advantage,” Welander said.

The contact termination does not affect non-Medicare Aetna customers.

And, St. Charles said, Aetna Medicare patients may still use St. Charles hospitals and clinics as “Out of Network” providers.

We heard from at least one patient who was forced to reschedule a surgical procedure out of town to ensure it was covered by Aetna Medicare Advantage.

 

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