Aetna & Memorial Health Currently Hung Up on In-Network Provider Contract

By Benjamin Cox on February 7, 2023 at 4:15pm

Illinois State retirees in Central Illinois may lose access to the largest hospital system in the region if negotiations break down before the end of the month.

State retirees began receiving notices at the beginning of this month of a potential provider network change between Aetna and Memorial Health System. Aetna and Memorial Health Systems are currently in ongoing negotiations for the provider contract that is set to expire on April 1st. This negotiation does impact both Memorial affiliate hospitals and their physician groups.

According to the letter sent out, if Aetna and and Memorial have not reached an agreement by March 1st and a retiree is currently utilizing one of Memorial’s hospitals or physicians, you will be notified of the process of changing or selecting a new hospital, physician, or any transition of care needs.

For West Central Illinois retirees, that may mean traveling to Quincy, Jerseyville, or St. Louis to find an in-network doctor, specialist, or clinic.

In a statement released by Memorial Health today, the system says they have been working over the last several months to negotiate a new contract with Aetna, including commercial and Medicare Advantage plans: “We continue to negotiate with Aetna in good faith with the goal to ensure access continues beyond April 1, 2023 to Memorial Health facilities, services, physicians, and providers.”

An attempt to reach Aetna for additional comments has not been returned.

Top officials from the Illinois Department of Central Management Services and Aetna were called into question in November during the start of the previous General Assembly’s lame duck session over cuts to a single plan for state retirees with the company back in November.