Highmark BC/BS .... kinda scary if it happens...

[slm2007 7]

Anyone from Western PA that has Highmark BC/BS insurance....don't know if you are aware of the heated debate between UPMC and Highmark but apparently, the contract is about to expire (JUne 2012...). This means to us, any UPMC doctor, surgeon, hospital will become OUT OF NETWORK! I think this probably covers every doctor my family uses. If this happens, I personally will have a $4,000 deductible for out-of-network expenses! I will have to find a new "fill" doctor, a new pediatrician for my son, a new family doctor and new ob/gyn. Any specialist will be extremely limited and we won't be able to go to any UPMC hospital unless we are willing and able to pay the deductible pursuant to our plan. Maybe this is something everyone who has this insurance should be inquiring about. I really can't imagine this being allowed to happen...Highmark will have to come up with something and UPMC really can't be that unfair to the thousands and thousands who are covered by Highmark....this is really scary if it does happen.

[spoiltmom 44]

Wow! Hopefully they will come to an agreement soon. Can you imagine how much money that healthcare system will lose by not being in network? I used to do medical billing, and the scary thing about trying to go out of network is, most of the time patients don't have the money to see you when you are out of network so they find a new doctor instead. The doctor I worked for was out of the Blue Cross/Blue Shield network for a while and he really suffered financially.

[slm2007 7]

Wow! Hopefully they will come to an agreement soon. Can you imagine how much money that healthcare system will lose by not being in network? I used to do medical billing, and the scary thing about trying to go out of network is, most of the time patients don't have the money to see you when you are out of network so they find a new doctor instead. The doctor I worked for was out of the Blue Cross/Blue Shield network for a while and he really suffered financially.

I know isn't it crazy.....Imagine of the 100,000 people that use the UPMC facilities (probably way more than that) but even if half of them find other doctors to go to because of insurance...that is a huge financial hit to the UPMC doctors/system. I know I'll find other doctors, hospitals etc., if they no longer accept my BC/BS. We'll see what happens. The only thing that really upsets me cuz I can adjust to anything is that Children's Hospital is a UPMC hospital and I won't be able to take my son there as "in network" - granted if it is a true Children's Hospital situation, money isn't an issue and he'll be there but for the every day ER issues, I'll go to a different hospital if it is necessary. I can't imagine them wanting to lose more than half of their "clients" who use these hospitals/doctors. Time will tell.

[jen120 23]

I work at a hospital and insurance contract issues happen all the time. Most get resolved without any issues or problems in coverage. Both the hospital and insurance company use the media to their advantage in the contract negotiations. You most likely wont have any issues unless communication completely breaks down. Good Luck!

[nurse535 30]

That's a terrible situation. I hope they're able to come to an agreement so your medical expenses don't drastically increase!

[slm2007 7]

I work at a hospital and insurance contract issues happen all the time. Most get resolved without any issues or problems in coverage. Both the hospital and insurance company use the media to their advantage in the contract negotiations. You most likely wont have any issues unless communication completely breaks down. Good Luck!

Thanks, that makes me feel a little better

I just can't imagine a huge organization like Univerity of Pittsburgh Medical Center isolating thousands of potential "users." Putting Highmark BC/BS insured people in the Out-Of-Network category cannot be something they are putting in the "Pro" column????

Thanks again....