Logan Reid
As of October 1, 2024, Baptist Health Jacksonville and Florida Blue reached an agreement that allows Florida Blue members to continue receiving care at in-network rates without disruption. However, this agreement excluded Baptist Health from the list of in-network providers for myBlue members, who will need to switch to a different Florida Blue plan to continue receiving care at Baptist Health facilities. While emergency care is still covered at the in-network cost share, myBlue members are encouraged to transition to other in-network providers. This change has caused confusion and frustration among those affected, who now face the challenge of understanding their options for medical care and prescription services.
| Characteristics | Values |
|---|---|
| Baptist Health's stance | Baptist Health requested to no longer participate in the myBlue network |
| Florida Blue's stance | Florida Blue agreed to a 30-day transition period for myBlue members with existing appointments, procedures, or medical imaging |
| Impact | myBlue members will no longer have Baptist Health as an in-network provider option |
| Alternative options | myBlue members can switch to a different Florida Blue plan that includes Baptist Health, with an increase in cost |
| Unaffected groups | Members who receive insurance directly through their employer, Members with Florida Blue Medicare, HMO, and PPO plans |
| Continuity of Care | Eligible members can receive care at the in-network cost share for up to six months or until March 29, 2025 |
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What You'll Learn
- Baptist Health no longer accepts myBlue plans
- Baptist Health remains in-network for emergency care
- Baptist Health requested to leave the myBlue network
- Florida Blue members can switch to a plan that includes Baptist Health
- Baptist Health specialists and facilities remain in-network for Medicare Advantage members
Baptist Health no longer accepts myBlue plans
Baptist Health and Florida Blue reached a new multi-year agreement on October 1, 2024. While the agreement ensures that thousands of Florida Blue members will continue to receive care at Baptist Health facilities, it does not include the myBlue plan. Baptist Health requested to no longer participate in the myBlue network, a lower-cost HMO product.
As a result of the new agreement, myBlue members will no longer have Baptist Health hospitals and physicians in their network and will experience changes to their coverage. Baptist Health will continue to see and treat myBlue members without interruption and at the in-network cost share through October 31, 2024. Florida Blue will also provide a 30-day transition period for myBlue members with existing appointments, procedures, or medical imaging scheduled at a Baptist Health facility through October 31.
For myBlue members who are in active treatment for serious and complex cases with Baptist Health providers and who maintain coverage, Florida Blue offers Continuity of Care. This allows eligible members to receive care at the in-network cost share for up to six months, or until March 29, 2025.
During the upcoming open enrollment period (November 1 to December 15, 2024), myBlue members can switch to a different Florida Blue plan that includes Baptist Health, although this may involve an increase in cost. Members who receive their insurance directly through their employer are not in a myBlue plan and are not impacted by the changes.
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Baptist Health remains in-network for emergency care
As of October 1, 2024, Baptist Health Jacksonville and Florida Blue reached an agreement that allows Florida Blue members to continue receiving care at in-network rates without disruption. However, this agreement does not include myBlue members, who will no longer have Baptist Health as an in-network provider option.
Baptist Health has stated that while Baptist Primary Care will no longer be in-network for Medicare Advantage plans, all emergency, hospital, outpatient, and specialty physician services remain in-network for those plans. This means that Baptist Health remains in-network for emergency care.
For myBlue members, emergency care is still covered at the in-network cost share. Anyone experiencing an emergency should go to the closest ER. Additionally, myBlue members who are in active treatment for serious and complex cases with Baptist Health providers can continue to see their Baptist Health care team through Continuity of Care, which entitles eligible members to receive care at the in-network cost share for up to six months, or until March 29, 2025.
Florida Blue is working to transition myBlue members to other in-network providers in Northeast Florida. Members who are unsure if they have a myBlue plan should check their member ID card. It will clearly state "myBlue" at the top. For further assistance, members can call the number on the back of their member ID card.
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Baptist Health requested to leave the myBlue network
Baptist Health hospitals in Duval and Nassau counties, as well as Baptist Health's physician network, have been a part of Florida Blue's network for years. However, they would have been dropped if a deal was not made. The main issue in the negotiations was how much Florida Blue would reimburse Baptist Health for health care services. Baptist Health stated that it had been underpaid for years compared to similar healthcare systems in Tampa and Orlando, and it wanted to close this gap with the new five-year agreement.
As a result of the new contract, myBlue members will no longer receive in-network coverage for Baptist Health facilities and providers, except for critical and emergency health care services. Baptist Health primary care providers will also no longer be in-network for Medicare Advantage plans, although all emergency, hospital, and specialty physician services remain in-network for these plans.
Florida Blue has stated that they are working to help myBlue members transition to other quality in-network myBlue providers across Northeast Florida. Members can also choose to switch to a different Florida Blue plan that includes Baptist Health, although this may come with an increase in cost. For now, myBlue members can continue to receive care at Baptist Health at in-network cost-sharing rates through Continuity of Care, which entitles eligible members to receive care at the in-network cost share for up to six months or until March 29, 2025.
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Florida Blue members can switch to a plan that includes Baptist Health
Florida Blue and Baptist Health have a new agreement that has resulted in changes to the coverage for some members. The new agreement covers specialists and hospital services but excludes primary care for HMO members with a Medicare Advantage plan.
Florida Blue members with a myBlue plan will no longer receive in-network coverage for Baptist Health facilities and providers, except for critical and emergency health care services. This change took effect on October 1, 2024.
Medicare Advantage HMO and PPO members will also no longer receive in-network coverage for Baptist Health primary care providers. However, they can continue to receive services from Baptist Health specialists and facilities at the in-network cost share.
Florida Blue members who receive insurance directly through their employer are not impacted by these changes, as they are not in a myBlue plan.
For Florida Blue members who wish to continue receiving care at Baptist Health, there is an option to switch to a different Florida Blue plan that includes Baptist Health. This option comes with an increase in cost. The upcoming open enrollment period for switching plans is from November 1 to December 15, 2024. During this period, members can select a new plan that includes Baptist Health and ensure it takes effect starting January 1, 2025.
It is important for members to carefully consider their options and review the details of different plans before making any changes to their insurance coverage. They can also seek assistance from the federally funded Navigator program, which provides information about various insurance alternatives.
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Baptist Health specialists and facilities remain in-network for Medicare Advantage members
Baptist Health and Florida Blue reached an agreement in October 2024, which resulted in changes to the coverage for some members.
Medicare Advantage members will experience changes to their in-network coverage for primary care services. However, Baptist Health specialists and facilities remain in-network for Medicare Advantage members. Baptist Health confirmed that while Baptist Primary Care will no longer be in-network for the Medicare Advantage plans, all emergency, hospital, outpatient, and specialty physician services remain in-network.
Florida Blue is matching members of those plans with other primary care providers who remain in-network for Medicare Advantage. Baptist Health hospitals in Duval and Nassau counties, along with Baptist Health's physician network, have been a part of Florida Blue's network for years.
Baptist Health specialists and facilities continue to participate in the Medicare Advantage PPO and HMO plans, and members can continue to receive services from these specialists and facilities at in-network rates.
It is important to note that Florida Blue members who receive insurance directly through their employer are not impacted by these changes and do not have a myBlue health plan.
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Frequently asked questions
As of October 1, 2024, Baptist Health Jacksonville is no longer accepting the 'myBlue' plan offered through Florida Blue. Baptist Health has also stopped participating in the Florida Blue Select plan.
Florida Blue Select members will need to find an alternative insurance provider or switch to a different Florida Blue plan that includes Baptist Health, with an increase in cost.
Baptist Hospital participates in a wide network of health insurance plans and products. This includes Blue Cross and Blue Shield plans such as Federal, State, PPO, Indemnity, Simply Blue, Blue Choice, Blue Care HMO, and Blue Options PPO. Baptist Health's website also provides a tool to find a doctor and view the insurance plans accepted.
Florida Blue Select members who wish to continue receiving care at Baptist Hospital can consider switching to a different insurance plan through special enrollment, which will take effect on November 1. They can also choose to transition to other in-network myBlue providers across Northeast Florida.
Yes, Florida Blue Select members who are in active treatment for serious and complex cases can continue to receive care at Baptist Health through Continuity of Care. This protection covers patients who are pregnant, undergoing treatment for complex conditions, or in post-operative care.
