Florida Blue and Cigna changing Medicare Advantage Plans in Lee Health and NCH

Author: Sommer Senne Writer: Sommer Senne
Published: Updated:

Patients who see Lee Health and NCH primary care doctors and have Florida Blue’s and Cigna’s Medicare Advantage plans will have to adjust to what could be a costly change.

A Lee Health Spokesperson told WINK News that in September, Lee Health and Florida Blue agreed that primary care physicians would no longer be in Florida Blue’s Medicare Advantage plan network.

Lee Health hospitals and specialists are still fully covered under the network, and this change affects less than 3,000 patients at Lee Health with Florida Blue.

Starting Jan. 1, NCH patients who are part of the Florida Blue Medicare Advantage plan network will no longer have access to their primary care physicians, affecting around 6,000 patients.

Like Lee Health, NCH hospitals and specialists are still fully covered under the network.

This change affects Florida Blue’s PPO and HMO Medicare Advantage plans.

Florida Blue is not the only health insurance company making this change.

Cigna is also making the change starting Jan. 1.

A Cigna representative spoke with WINK News reporter Sommer Senne, mentioning that the company will discontinue its individual PPO Medicare Advantage plan in Florida while still offering its individual HMO plan.

The spokesperson says impacted customers were notified of their options for the upcoming year, and they are providing support that includes considering a Medicare Advantage HMO plan or a Medicare Supplement plan.

NCH told WINK News that 600 patients with the Cigna PPO Medicare Advantage plan will be affected.

To help those impacted by the change, NCH is hosting an open house for regional insurance brokers and Medicare Advantage members on Nov. 4 at 3 p.m. at the NCH Telford Auditorium in Naples.

WINK News is working to determine how many physicians at NCH and Lee Health will become out-of-network due to these changes.

NCH responded by saying that 35 doctors will now be out-of-network.

We’re also asking Florida Blue and Cigna if patients’ co-pays will increase and by how much if they have to switch plans.

Read the full statement from Florida Blue below:

We value our relationship with Naples Comprehensive Health (NCH). While their specialists, hospitals, and other facilities will remain in our network for our Medicare Advantage members, Florida Blue Medicare and NCH have mutually agreed that NCH’s primary care physicians will exit our Medicare Advantage network beginning January 1, 2025. Members with Florida Blue Medicare Supplement plans can continue seeing their NCH primary care doctor.

Individuals who have Blue Cross Blue Shield Medicare Advantage plans based in other states should contact their home plan to verify their coverage. Some plans may include out-of-network benefits that could allow them to access NCH primary care doctors.

Florida Blue Medicare will continue to offer Medicare Advantage plans in Collier and surrounding counties. In Collier County, Medicare beneficiaries have the option to choose from five Florida Blue Medicare Advantage plans.

NCH and Florida Blue Medicare are working to support those who are impacted through this transition. Members who have questions, concerns, or need help finding a new doctor can call Florida Blue Medicare Member services at 1-800-926- 6565 (TTY: 1-800-955-8770).

Correction: an earlier headline said “Florida Blue and Cigna cancelling Medicare Advantage Plans.”

Copyright ©2024 Fort Myers Broadcasting. All rights reserved.

This material may not be published, broadcast, rewritten, or redistributed without prior written consent.