CINCINNATI — Tens of thousands of Mercy Health patients who use Anthem Blue Cross Blue Shield for their Medicaid insurance are in limbo right now.

That’s because the contract between the hospital system and insurance provider has ended, and patients will only be covered by the insurance until the end of the month.

 What You Need To Know
  •   The contact between Mercy Health and Anthem Medicaid expired July 1  

  •   Mercy Health is still providing service to Anthem customers until July 31, but will continue out-of-network care  

  •   The contract ended because they could not come to a fair agreement  

  •   Anthem said it will help its customers as they navigate this recent change  
 Ashley Garland and her family have been patients at Mercy Health and have used Anthem Blue Cross Blue Shield for nine years now.  

"They've been very easy to work with," said Garland. "The coverage has been great. The doctors that we've experienced have been very knowledgeable, very helpful in our situation."

The insurance coverage is essential to the Garlands, especially for their son Josiah. 

"He's type one diabetic," she said. "We have such a strong connection with our doctors. His medical needs can sometimes be pretty significant."

While Josiah and the Garlands remain covered, Ashley is concerned about what’s coming. That’s because Mercy Health and Anthem could not reach a deal regarding Medicaid coverage.

The contract expired last weekend and the hospital system says Anthem Medicaid patients will only be covered through the end of July. Until then, any care will be billed as being out-of-network.

“If this would happen and directly affect us,” she said. “Who do we go to now? How can we build that relationship starting over from ground one? You know, from the bottom level, that’s a lot to take into consideration and really scary.”

In a statement Anthem said, “While Mercy Health terminated their contract with Anthem Blue Cross and Blue Shield early, our first priority is to help our members transition to alternative in-network care providers to ensure continued access to quality care with the least amount of care disruption possible. However, to avoid care disruption for our members, Anthem and Mercy Health have reached an understanding to allow Anthem Medicaid members to continue care at Mercy Health doctors and hospitals through standard out-of-network reimbursement through July 31.”

Although this ended contract doesn’t directly affect the Garlands, as they’re not Medicaid customers, she said she has a game plan in place in case things change. 

“Search for doctors that are already still in network,” she said. “Just to have a backup plan and how soon that we could get connected if it would come to that.”

Mercy Health also released a statement saying, “We are committed to providing quality, compassionate health care to every person who walks through our doors. To make this transition easier on our patients, and to give them time to change insurance plans to ensure long-term access to the doctors and facilities patients know and trust, Mercy Health will serve Anthem Managed Medicaid patients in Ohio through July 31."

But it’s Garland’s concern that this may ultimately affect all insurance holders, eventually. 

“I think it’s a snowball of problems that may be coming down the pipe, unfortunately,” she said. 

Mercy said all other patients with Anthem Health insurance are not affected at this time but may become affected soon.