JACKSONVILLE, Fla. – With days remaining before Baptist Health hospitals and employed providers are scheduled to leave Cigna’s network, patients across Northeast Florida are scrambling to understand their options and determine whether they can keep their doctors.
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Unless the two sides reach a new agreement, Baptist Health facilities and employed providers will become out-of-network for Cigna members on June 24.
While negotiations continue, neither Baptist nor Cigna has announced a breakthrough.
The dispute centers on reimbursement rates and contract terms.
Baptist has said it offered lower rates and wants to keep patients in-network. Cigna argues Baptist already costs about 40% more than other local hospitals and is seeking contract changes that would increase costs for employers and patients.
As patients wait for a resolution, insurance experts say those currently undergoing treatment may have options.
What is continuity of care?
Bill Green, founder of Green Insurance Agency, said patients receiving treatment for serious medical conditions may qualify for continuity of care, which can allow them to continue seeing their current providers at in-network rates for a limited period after a contract ends.
“Continuity of care is usually for bigger things,” Green said. “Cancer is one of the most common. It means you can continue to see your provider for usually at least 90 days, sometimes longer.”
Green said the program is designed to prevent disruptions in treatment for patients with serious medical needs.
“It allows them to maintain the care they’ve been getting without a major shift in the middle of a treatment that could be lifesaving,” he said.
Both Baptist and Cigna are encouraging eligible patients to apply for continuity-of-care coverage now rather than waiting until the deadline passes.
Are Baptist’s costs really higher?
One of the major sticking points in negotiations is cost.
Green said he reviewed claims data from his own clients after hearing the claim.
“I did some research. I pulled some of our own client claims just to see kind of what things cost in different places,” Green said. “Baptist seems to be in line with the others.”
Green said disputes between insurers and health systems are becoming increasingly common as healthcare costs continue to rise.
“Medical costs are going up, just in general,” he said. “Premiums going up should offset some of it. But if you look at the margins for insurance companies, they’re not huge.”
Three things patients should do now
For patients who may be affected by the contract dispute, Green recommends taking action before June 24.
First, patients should consider using telehealth appointments to obtain prescription renewals and address immediate healthcare needs.
“If you can get a telehealth to get renewals or prescriptions, that would be ideal,” Green said.
Second, patients should verify whether their doctors will remain in-network and begin identifying alternative providers if necessary.
“If you need to see a doctor before open enrollment, start looking for a new doctor on your plan,” Green said.
Finally, patients should evaluate their insurance options during the next open enrollment period.
For those covered through employer-sponsored plans, Green recommends asking employers to explore other insurance carriers if provider access becomes a concern.
“If you’re through a group plan, ask your employer to shop somewhere besides Cigna,” he said. “If you’re somewhere else, it’s probably just time to shop during open enrollment.”
What services are still covered?
Even if Baptist Health and Cigna fail to reach an agreement, some services will remain available to Cigna members.
According to Baptist Health, CareSpot Urgent Care centers, Baptist Behavioral Health services and independent physician groups, including Nemours Children’s Health, will not be affected by the dispute.
Emergency care also remains protected under federal law, meaning patients can continue seeking emergency treatment regardless of network status.
As the June 24 deadline approaches, patients receiving ongoing treatment are encouraged to contact Cigna to determine whether they qualify for continuity-of-care coverage and to verify the status of their providers.