‘We’re a little upset:’ Jacksonville residents affected by health insurance changes
As we approach the end of the year, some health insurance companies are making changes, and it’s affecting patients here in Jacksonville. We learned Aetna might be dropping certain medical practices associated with TopLine MD Alliance group.
Action News Jax was made aware of a letter that was emailed out to some patients who have Aetna insurance. It’s serving as a 30-day notice for members to find a new provider.
Cory McCarter uses is covered by Aetna and he says he is worried about what could happen to his children’s doctor.
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“We’re a little upset,” McCarter said. “We have three babies. And so, it’s a lot of added stress to our family to try and find a new pediatrician when we have one that we love already.”
On November, 1st, McCarter, along with all the other Aetna members who have providers with TopLine MD Alliance received the notice.
Its states in part, “Our practice will no longer be participating in their network as of November 30th, 2023.”
The email also states they haven’t been able to “secure a renewal” agreement. And since it’s set to expire at the end of the month, per Florida law – the provider has to inform patients of the potential termination 30 days prior.“We’re a little upset,” McCarter said. “We have three babies. And so, it’s a lot of added stress to our family to try and find a new pediatrician when we have one that we love already.”
On November, 1st, McCarter, along with all the other Aetna members who have providers with TopLine MD Alliance received the notice.
Its states in part, “Our practice will no longer be participating in their network as of November 30th, 2023.”
The email also states they haven’t been able to “secure a renewal” agreement. And since it’s set to expire at the end of the month, per Florida law – the provider has to inform patients of the potential termination 30 days prior.
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McCarter says this isn’t enough time to find a new doctor.
“With three babies, we don’t really have time because we’ve constantly got new appointments coming up that we have to have scheduled,” McCarter said.
Mccarter’s three children are seen by a doctor from Carithers Pediatric Group. Carithers is one of seven practices in Jacksonville with TopLine MD Alliance. Most of the practices are OBGYNs.
When Action News Jax reached out to Aetna for a statement, a spokesperson said the company is working to reach an agreement before the current one expires. They said, “We are hopeful that our current negotiations will result in a fair agreement that keeps TopLine MD Alliance in our network and serves the needs of Florida members and employers.”
McCarter says he can’t afford to wait until the last minute to find out if his kids will have a doctor or not.
“I mean, that would be my other option to pay the out-of-network costs,” McCarter said. “But with three kids and my wife’s a stay-at-home mom, that’s not really an option for us. So, we’re going to have to stay in network.”
For now, members have until the end of the month to find a new doctor, or wait to learn if their provider will remain with the Aetna.
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FULL AETNA STATEMENT:
TopLine MD Alliance is a valued partner in our efforts to provide our members with access to affordable, quality, convenient care that helps them achieve better health. We are hopeful that our current negotiations will result in a fair agreement that keeps TopLine MD Alliance in our network and serves the needs of Florida members and employers. Our goal is to work with TopLine MD Alliance to reach a new agreement before the current agreement expires.
FULL NOTICE LETTER:
Dear Valued Patient,
I hope this message finds you well. As a member of Aetna, you may have received a letter from them stating our practice will no longer be participating in their network as of November 30th, 2023. For the past few months, we have been working with Aetna to continue our relationship and renew our agreement, which is set to expire November 30th. Unfortunately, we have not been able to secure a renewal, and pursuant to Florida law, Aetna may be required to inform you of the potential termination 30 days prior.
We realize how frustrating this situation is and have been working very hard toward a resolution, so you don’t lose coverage during this crucial time. We ask for your support during these discussions and encourage you to voice your concerns to Aetna by calling their Member Services line at 1-800-872-3862 or by posting or tweeting a message on their Facebook or Twitter page.
In the event that we are not able to come to a resolution, some patients may be eligible to receive a continuity of care authorization from Aetna. This includes patients who are receiving any active course of treatment for a condition or have initiated a course of prenatal care. More information about continuity of care, as well as important details regarding the status of this negotiation can be found in our Frequently Asked Questions (FAQ) page at www.toplinemd.com/Aetna-FAQ.
As members of the TopLine MD Alliance, a collective group of practices, providers and specialty centers that help patients navigate the healthcare system, our priority is to provide you with top-of-the-line care from people you can trust, while making your experience simple and convenient. Because our relationship with you is important to us, we stand committed to continue providing the highest quality and personalized health care that you have come to know. We will continue to keep you informed of any new developments. Please contact our office at 9042419775 should you have any questions.
Sincerely,
Beaches OB/GYN LLC
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