(IRVING, Texas) – CHRISTUS Health, an international not-for-profit health system, announced today that after months of actively negotiating with the health insurance company Aetna, an agreement has been reached for CHRISTUS hospitals and ambulatory surgery centers in south and southeast Texas to return in-network for Aetna commercial and Medicare networks.
CHRISTUS Health is a health care delivery system offering award-winning, high-quality and exceptional care for our patients,
said Randy Safady, executive vice president and chief financial officer. We have a long-standing commitment to the communities we serve and are pleased to reach terms with Aetna that will allow us to continue to prioritize the health and well-being of patients and the community by offering compassionate, uninterrupted care to everyone.
Since the contract termination on July 1, 2023, thousands of Aetna patients have been left without in-network access to CHRISTUS Health’s hospitals and ambulatory surgery centers in CHRISTUS Health Southeast Texas, CHRISTUS Santa Rosa and CHRISTUS Spohn Health Care ministries.
We are delighted to have finalized an agreement with Aetna that ensures its members in the CHRISTUS Santa Rosa, Southeast Texas and Spohn communities will have access to the high-quality treatments and advanced specialty services CHRISTUS Health provides,
said Adele Paulett, vice president and chief managed care officer. While we know this was a difficult time for our patients and providers, we are looking forward to a positive relationship with Aetna and we are thankful to have a resolution that allows us to continue to care for our neighbors and friends close to home.
CHRISTUS Health’s in-network status will be restored as of March 1, 2024. Aetna members are encouraged to call the number on the back of their insurance card if they have any questions regarding CHRISTUS Health’s in-network status.
Termination Effective July 1, 2023
CHRISTUS Health is pleased to announce we have finalized a direct agreement with Corpus Christi ISD retroactive to September 1, 2023! The agreement allows CHRISTUS Health to continue to provide in-network services for employees and their family members.
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We continue to work with additional local employers who realize the importance of having CHRISTUS Health in their networks to finalize direct agreements. We will provide updates as soon as additional agreements are finalized.
CHRISTUS Health is pleased to announce we have finalized a direct agreement with Texas School Health Benefit Plans retroactive to July 1, 2023! The agreement allows CHRISTUS Health to continue to provide in-network services for employees and their family members who have elected the Aetna Signature network option.
These school districts* are included in the agreement:
*Additional school districts are covered by the agreement but are in geographic areas that were not directly impacted by the Aetna termination.
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We continue to work with additional local employers who realize the importance of having CHRISTUS Health in their networks to finalize direct agreements. We will provide updates as soon as additional agreements are finalized.
CHRISTUS Health Southeast Texas, Spohn, and Santa Rosa hospitals and ambulatory surgery centers have been unable to reach an agreement with Aetna and as a result, most Commercial and Medicare customers no longer have in-network coverage at the above CHRISTUS Health locations effective July 1st. Please see FAQ section below for the Commercial and Medicare products not impacted by the contract termination.
We have been in negotiations with Aetna for months to secure a reimbursement rate that is fair and reasonable for the services we provide. Unfortunately, Aetna remains unwilling to offer adequate reimbursement for vital health care services. Although we are pursuing an increase in reimbursement; we will continue to be the most economical choice for our patients. Although Aetna’s responses have been unfavorable thus far, and despite the termination of our agreement, we will continue to negotiate with Aetna in hopes of finalizing an agreement. Negotiated increases will support our viability and allow CHRISTUS Health to continue offering our not-for-profit Mission to serve the needs of our community. CHRISTUS Health has always been there for the patients and communities we serve, and that will never change, and our commitment remains unwavering. The termination will leave thousands of individuals without in-network access to CHRISTUS Health’s hospitals and ambulatory surgery centers after July 1, 2023.
We recognize that patients expect health care services that are high quality and high value. CHRISTUS Health is working hard to keep health care costs affordable for you while continuing to provide high-quality and safe service to our patients and their families. Although Aetna hasn’t provided a dedicated phone number for its members to call with questions regarding the termination, we encourage you to call the Aetna customer service number located on your insurance card to let them know how important it is for CHRISTUS hospitals and ambulatory surgery centers to go back “in-network” so that you have access to the full provider network and benefits you pay for as an Aetna member.
The termination will not interrupt access to your trusted CHRISTUS Trinity Clinic physician. The physicians will remain in-network with Aetna. Additionally, the Aetna Better Health (Medicaid) contract will remain active for all CHRISTUS Health entities. The termination will only impact the facilities listed below.
We will continue to be available to serve you, your family, and neighbors any time you need us. Our emergency departments will always be available, even while we are out of network with Aetna, and we will do all we can to ensure that you get the affordable, quality care you need and deserve.
Please note, we are committed to working with Aetna, even on an out-of-network basis, in order to ensure their members continue to have access to the high-quality care we provide at CHRISTUS Health. Aetna has transition-of-care policies that may allow patients with certain medical conditions (pregnancy, terminal illness, life-threatening conditions, chronic conditions, etc.) to continue their treatment at in-network benefit levels for a defined period of time. To initiate a request for transition-of-care, a physician or Aetna Healthcare patient must submit a Transition of Care form. You can access the form below or by calling the precertification department number on the back of your Aetna identification card.
Aetna Transition of Coverage Request Form
We will continue to post important updates here, so please continue to check our website. Now more than ever, our communities need a trusted health care partner. CHRISTUS Health is truly honored to serve you for all your health care needs. We thank you for putting your trust in us.
The Aetna NAP (Network Access Plan), an Aetna Commercial plan, was not impacted by the July 1, 2023, contract termination. If your identification card includes the NAP logo similar to what is shown below, you can continue to access CHRISTUS Health on an in-network basis for all your health care needs.
If your identification card does not include the NAP logo, CHRISTUS Health is out-of-network effective July 1, 2023.
The following Aetna Medicare Advantage plan(s) was not impacted by the July 1, 2023 contract termination:
Medicare ESA (Extended Service Area), an Aetna Medicare Advantage plan, was not impacted by the July 1, 2023, contract termination. If your identification card includes the Medicare ESA logo similar to what is shown below, you can continue to access CHRISTUS Health on an in-network basis for all your health care needs.
If your identification card does not include the ESA logo, CHRISTUS Health is out-of-network effective July 1, 2023.
Yes, if you have traditional Medicare plus an Aetna Supplement plan, CHRISTUS Health remains in-network with this product. If your identification card is similar to what is shown below, you can continue to access CHRISTUS Health on an in-network basis for all your health care needs.
CHRISTUS Health Southeast Texas:
CHRISTUS Santa Rosa Health Care System:
CHRISTUS Spohn Health System:
At CHRISTUS Health, we know it is important for you to keep the hospitals and providers you know and trust. You will continue to receive the same high-quality and compassionate care on July 1st that we provided on June 30th, whether we’re in or out of network. We encourage you to review your benefits to ensure you can continue to seek care at a non-network provider under your benefit plan provisions.
Because we are out of network with Aetna, our patients with Aetna insurance could experience disruption to in-network coverage from trusted providers, which means you may be required to pay more for the health care you need. To understand your specific benefits, we encourage you to call Aetna Healthcare customer service at the number listed on the back of your insurance identification card. In addition, we encourage you to call Aetna today to let them know you want to keep CHRISTUS in your network and let your employer or agent know that CHRISTUS is your preferred choice for health care.
Yes, Aetna has a “transition of care” coverage program, which is considered when a member has special circumstances such as:
According to Aetna, this coverage is only applicable to the requested doctor. If you need more information about your specific situation, or how the Aetna transition process works, please refer to the back of your insurance identification card to reach an Aetna Healthcare representative.
Reach out to Aetna. Although Aetna won’t provide a dedicated phone number for its members to call with questions regarding the termination, you can dial the number on the back of your Aetna ID card. We encourage you to explain the importance of maintaining your in-network access to the CHRISTUS Health facilities you have come to know and trust.
Talk to your employer. Contact your Human Resource Department and let them know the importance of maintaining your in-network access to the CHRISTUS Health facilities you know and trust. Ask your employer to call Aetna Healthcare and say they need CHRISTUS Health in their network.
