Naples, FL, October 24, 2024 — Beginning January 1, 2025, Florida Blue will eliminate access to NCH primary care providers for approximately 6,000 Medicare Advantage plan members in Southwest Florida. This change follows the recent conclusion of negotiations between NCH and Florida Blue, which resulted in a new reimbursement agreement. While the agreement ensures that NCH remains in-network for all other Florida Blue members, it will not include coverage for Medicare Advantage participants seeking primary care services.
In addition to Florida Blue, Cigna has announced that it will also discontinue coverage for primary care providers in Florida through its Medicare Advantage plan, reflecting a growing trend among insurance payers to scale back coverage accessed through Medicare Advantage.
“We understand the concern this will cause for some residents who rely on NCH primary care physicians through a Florida Blue or Cigna Medicare Advantage plan,” said Matthew Stacell, Chief Performance Improvement Officer for NCH. “We are committed to assisting those impacted by the elimination of primary care coverage to understand their options and to find affordable coverage that keeps their trusted NCH doctor in network.”
To help those impacted by this change, NCH will be hosting an open house for regional insurance brokers and Medicare Advantage members on:
November 4 at 3PM
NCH Telford Auditorium, 350 7th St. N, Naples
The event will be an opportunity for current Medicare or Medicare Advantage plan members, people approaching age 65 and caregivers to learn about the variety of care options, including plans that continue to include NCH primary care providers and specialists in network. Following an informational presentation from NCH leaders about traditional Medicare, Medicare Advantage and supplemental plans, attendees will have the opportunity to talk directly with regional health insurances brokers to ask questions about plans tailored to their specific needs. Light refreshments will be served.
The elimination of primary care coverage for NCH primary care providers in Medicare Advantage plans by Cigna and Florida Blue does not impact members who have other health insurance products with these carriers.
About NCH
NCH (Naples Comprehensive Health) is an Advanced Community Healthcare System™ serving Southwest Florida with premier routine, critical, and specialty care. NCH, a locally governed non-profit, is recognized as one of Healthgrades America’s Top 100 Hospitals which puts it in the top 2% in the nation for clinical excellence, in addition to being named a Top 50 Hospital for Surgical Care. The system is more than just two hospitals (referred to as the NCH Baker Hospital and NCH North Hospital) with a total of 713 beds – NCH is an alliance of over 750 physicians and medical facilities in dozens of locations throughout Southwest Florida and is the region’s only Joint Commission accredited Comprehensive Stroke Center. NCH cardiac care is ranked top-3 in the state by Healthgrades. NCH collaborates with the Hospital for Special Surgery for orthopedics, Nicklaus Children’s Hospital for pediatrics, and ProScan Imaging for radiology services, ensuring top-tier medical care is available in Southwest Florida. With the largest provider network, urgent/immediate care centers, diagnostic facilities, and two hospitals, NCH is always advancing the quality of care near you. For more information, visit www.NCHmd.org.