Aetna Health Negotiations
As Adventist Health continues to meet the health and well-being needs in the communities we serve, we are evaluating our payer contracts to ensure fair and equitable rates for our services. During this time, we want to reach out to our valued patients, community partners, trusted employers, and our communities to let them know our current contract with Aetna Health is not sustainable, and we need to renegotiate our terms. We are making every effort to negotiate in good faith, but our current contract between Adventist Health hospitals in California and Aetna will terminate on the following dates:
12:01 a.m. May 1, 2023, at Adventist Health Delano, Adventist Health Tulare, Adventist Health Hanford, Adventist Health Reedley, and Adventist Health Selma, Adventist Health Lodi Memorial, Adventist Health Sonora, Adventist Health and Rideout, Adventist Health Clear Lake, Adventist Health Ukiah Valley, and Adventist Health Howard Memorial hospitals.
12:01 a.m. July 1, 2023, at Adventist Health White Memorial.
12:01 a.m. November 1, 2023, at Adventist Health Glendale, Adventist Health Simi Valley, Adventist Health Bakersfield, and Adventist Health Tehachapi Valley.
We are deeply disappointed that after four months of negotiations, we were unable to reach an agreement with Aetna. We cannot afford to continue caring for Aetna Health members without a substantial increase in payments. We have offered Aetna Health fair agreements, yet they refuse to work with us in a meaningful way.
Aetna Health has earned record profits and yet they continue to refuse to offer even a cost-of-living increase to Adventist Health to keep our facilities open. Without an adequate cost increase we can’t continue to care for their patients at the rates they are paying us.
At Adventist Health, our first concern is always our patients. Adventist Health continues to negotiate with Aetna Health. We will update you should the current situation change.
If you have questions, please do not hesitate to contact the Adventist Health Aetna Negotiation information line at 855-479-5196.
FAQs for patients
The following is a list of frequently asked questions regarding the termination of Aetna PPO/HMO, should patients have questions.
Q: What’s happening?
A: Adventist Health’s contract with Aetna Health PPO/HMO may terminate on the following dates in our hospital communities:
- 12:01 a.m. May 1, 2023: Adventist Health Delano, Adventist Health Tulare, Adventist Health Hanford, Adventist Health Reedley, Adventist Health Selma, Adventist Health Lodi Memorial, Adventist Health Sonora, Adventist Health and Rideout, Adventist Health Clear Lake, Adventist Health Ukiah Valley, and Adventist Health Howard Memorial hospital communities.
- 12:01 a.m. July 1, 2023: Adventist Health White Memorial hospital community.
- 12:01 a.m. November 1, 2023: Adventist Health Glendale, Adventist Health Simi Valley, Adventist Health Bakersfield, and Adventist Health Tehachapi Valley hospital communities.
This may affect Aetna Health commercially insured patients who access care with Adventist Health hospitals and physicians.
Q: Why is this happening?
A: After months of negotiating, Adventist Health and Aetna Health were unable to reach terms on a new agreement.
Q: I am very concerned about this, what can I do?
A: If you receive healthcare coverage from your employer, your employer needs to know your concerns. Speak to your human resources department about your concerns.
Q: What does this mean if I am in the hospital on or after 12:01 a.m. on the termination date?
A: You will be covered by Aetna Health until you are discharged from the Adventist Health hospital. However, Aetna Health may elect to transfer you to another contracted hospital. Aetna Health may only transfer a patient if the transfer can be safely performed. You will need to confirm the details of your insurance benefit by calling your health plan customer service number on your insurance card. You can also use this number to ask your health plan if you are eligible to complete your current episode of care at the Adventist Health hospital as a continuity of care service.
Q: What if I have to go to the Emergency Department? Can I use my Aetna Health insurance?
A: You can always come to an Adventist Health hospital for medical emergencies. However, you should ALWAYS go to the nearest hospital in an emergency, regardless of your insurance coverage or ability to pay.
Q: What if I’m scheduled to deliver a baby or have a surgical or outpatient procedure, or receiving care for a chronic or terminal illness (such as cancer)?
A: Some members may be able to receive care for a period of time as a continuity of care service. You must receive specific authorization from Aetna Health for a continuity of care service. You should call the customer service number on your insurance card and ask about continuity of care service.
Q: I want to continue using ,y local Adventist Health facility, what can I do?
A: You should contact your health plan’s customer service number to ask about your benefits and out-of-network options for care.
Q: Can I still see my physician at the clinic?
A: You should contact Aetna Health to find out if there is a change in patient responsibility as part of Aetna’s out-of-network status. We realize how important continuity of care is for you with the care team who knows you best.
Q: Will Adventist Health re-establish a contract with Aetna Health?
A: Adventist Health remains open to discussions. We will provide updates should the current situation change. All the latest information will be shared on this page.
Q: I am an Aetna Health member, who should I contact if I have more questions?
A: Please contact your health plan’s customer service number on your health plan insurance ID card. This will give you the most accurate and up-to-date information regarding your benefits and network. You may also contact the Department of Managed Health Care, which protects HMO consumers, at its toll-free number, voice 888-466-2219 or TDD 877-688-9891; or the California Department of Insurance Consumer Hotline at voice 800-927-4357 or TDD 800-482-4833.