Phelps Memorial Hospital: Aetna Insurance Acceptance And Coverage

As of January 1, 2025, Phelps Memorial Health Center will no longer be part of the Aetna Medicare Advantage plan. This decision is a result of the challenges faced by rural hospitals in providing care for beneficiaries of Medicare Advantage plans. However, Phelps Hospital, Northwell Health, works with over two dozen insurance carriers and offers financial assistance programs for those in need. Patients are advised to contact their insurance providers directly to confirm coverage details, as plans and carriers vary.

Phelps Memorial Health Center discontinues Aetna Medicare Advantage plan

Phelps Memorial Health Center, based in Holdrege, Nebraska, will no longer be participating in the Aetna Medicare Advantage plan as of January 1, 2025. This decision is a result of the challenges faced by many rural hospitals, including Phelps Memorial, in delivering care to beneficiaries of Medicare Advantage plans.

The Chief Executive Officer of Phelps Memorial, Mark Harrel, emphasized their commitment to providing exceptional and compassionate care to the community. However, Medicare Advantage plans often delay and increase the cost of needed care due to complex administrative requirements. This disruption affects patient access to healthcare services, as some Medicare Advantage plans deny covered services that are medically necessary and impose unreasonable documentation demands.

Phelps Memorial encourages its patients to carefully consider their options during the open enrollment period, which began on October 15, 2024. For assistance in exploring alternative plan options, individuals can contact the South Central Agency on Aging in Kearney, Nebraska.

It is important to note that this change only affects the Aetna Medicare Advantage plan. Phelps Memorial Health Center continues to work with numerous insurance carriers, including BlueCross/BlueShield, Midland's Choice, United Healthcare, Three Rivers Provider Network, ProviDRS Care Network, and Medicare. Patients can refer to the list of accepted plans on the Phelps Memorial website and are advised to contact their insurance company to confirm coverage for specific services.

Additionally, Phelps Memorial offers financial assistance to patients who meet certain criteria. This assistance is available for those who lack insurance, government programs, or regular income. The level of financial assistance is determined by factors such as gross income, net worth, family size, and expected future income.

Billing and insurance procedures at Phelps Memorial Health Center

Phelps Memorial Health Center's Billing and Insurance department is available to help patients understand their billing process and statements. The hospital will submit your claims to your insurance company/companies. However, PMHC cannot assume responsibility for settlement disputes between the insurance company and the insured. Patients are ultimately responsible for payment to the hospital.

Phelps Health provides healthcare at no charge or a reduced charge to those who meet the financial need requirements. Financial assistance is generally for people without other financial resources, such as insurance, government programs, or regular income. It is determined by gross income, net worth, assets, family size, available resources, and expected future income. Financial assistance for medically necessary services is available on a sliding scale of up to 100% of gross charges, and up to a full waiver of copayments after third-party insurance proceeds based on the poverty level.

Phelps Health partners with over two dozen insurance carriers, including BlueCross/BlueShield, Midland's Choice, United Healthcare, Three Rivers Provider Network, ProviDRS Care Network, and Medicare. Note that as of January 1, 2025, Phelps Memorial Health Center will no longer be participating in the Aetna Medicare Advantage plan. This is due to increased challenges many rural hospitals face when providing care for beneficiaries of Medicare Advantage plans.

If you have questions about your insurance coverage or a bill that you have received, you can contact Phelps Memorial Health Center's Billing and Insurance department by phone or email.

Financial assistance at Phelps Hospital

Phelps Memorial Health Center in Holdrege, Nebraska, provides financial assistance to qualifying patients with outstanding bills for medically necessary and emergency care provided at the hospital. To receive financial aid under the Financial Assistance Policy, patients must meet the criteria for being Financially Indigent or Medically Indigent. Financially Indigent patients are those who are uninsured or underinsured with a household income equal to or less than 200% of the Federal Poverty Level. They are eligible for 100% financial assistance on their balance. To qualify as Medically Indigent, patients must be uninsured or underinsured with medical bills that exceed 12% of their household income.

Phelps Health also offers a Financial Assistance Program for those facing financial need. Financial assistance is generally for people who do not have other financial resources available, such as insurance, government programs, or regular income. It is determined by gross income, net worth, assets, family size, available resources, and expected future income. A discount of up to 100% may be offered to uninsured or underinsured patients whose family income is equal to or less than 150% of the Federal Poverty Guidelines. Patients can request a Financial Assistance packet by calling the hospital, picking it up in person, downloading it from the Phelps Health website, or requesting it through the Patient Portal.

Phelps Memorial Health Center accepts several insurance providers, including BlueCross/BlueShield, Midland's Choice, United Healthcare, Three Rivers Provider Network, ProviDRS Care Network, Medicare, and Aetna. However, it is important to note that as of January 1, 2025, Phelps Memorial Health Center will no longer be participating in the Aetna Medicare Advantage plan. This decision is a result of the challenges faced by rural hospitals in providing care for beneficiaries of Medicare Advantage plans, which often involve complex administrative requirements that delay and increase the cost of needed care.

Phelps Hospital's accepted insurance plans

Phelps Hospitals Accepted Insurance Plans

Phelps Hospital works with many insurance carriers and has ongoing contracts with several physicians and groups, including anesthesiology and radiology groups, to provide services to patients. However, it is important to note that not all doctors or services may be covered by your insurance plan, so it is recommended to check with your insurance carrier and the hospital's billing and insurance department to understand your specific coverage.

Phelps Hospital is committed to transparency in its charges and provides information about standard charges for all services. They also offer a financial assistance program to patients in certain counties who meet the financial need requirements, providing healthcare at no charge or at a reduced charge.

Phelps Hospital accepts the following insurance plans:

• BlueCross/BlueShield
• Midland's Choice
• United Healthcare
• Three Rivers Provider Network
• ProviDRS Care Network
• Medicare
• Aetna (until January 1, 2025)

If your insurance carrier is not listed, you can contact your insurance provider to consider options for including Phelps Health as a participating provider.

Finding a hospital that accepts Aetna insurance

As of January 1, 2025, Phelps Memorial Health Center will no longer be participating in the Aetna Medicare Advantage plan. This change is due to the increased challenges faced by rural hospitals in providing care for beneficiaries of Medicare Advantage plans. These plans often delay and increase the cost of needed care because of complex administrative requirements.

If you are looking for a hospital that accepts Aetna insurance, there are a few ways to find one. Firstly, you can visit the Aetna website and use their search tools to find hospitals that accept your specific insurance plan. You can search for hospitals without logging in, but if you choose a plan, you will be able to find doctors, hospitals, and providers that accept that particular plan.

Additionally, you can contact your insurance provider directly and inquire about in-network hospitals that accept your insurance. They can provide you with a list of hospitals that are within your network. It is also worth noting that some insurance companies may have online tools or directories that allow you to search for in-network hospitals by location or specialty.

Lastly, you can also try searching for hospitals in your area online and then verifying their accepted insurance plans. Most hospitals will have a list of accepted insurance plans on their websites, which you can review to determine if Aetna is among them. By using these methods, you should be able to find a hospital that accepts Aetna insurance and best suits your needs.

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