when Anthem Blue Cross Blue Shield and Hartford HealthCare failed to reach a contract agreement Saturday, tens of thousands of Connecticut patients suddenly faced higher out-of-pocket costs for medical treatment.
Among them was 36-year-old Mark Gostkiewicz of Colchester, who has relied on his Anthem insurance to help with the bills for an ongoing health condition. He goes to Backus Hospital in Norwich, one of the hospitals that Anthem now considers out of network.
“Since last September, I’ve gotten pretty familiar with Backus Hospital. There were three times that I went in because I was having symptoms,” he said. “Now, everything that is close to me is off the map. I can still go there, but I have to pay a lot out of pocket.”
Gostkiewicz, a teacher, is one of an estimated 60,000 customers who are now paying out-of-network costs to use Hartford HealthCare services and medical facilities.
Affected hospitals include Hartford Hospital, the Hospital of Central Connecticut in New Britain, Midstate Medical Center in Meriden, Backus Hospital in Norwich, Windham Hospital in Willimantic and the Institute of Living, a Hartford-based facility that treats mental illness and other health conditions.
With more hospitals and medical providers now out of network, consumers will have to pay higher costs for their treatment.
We’re well off and this is hitting us,” Gostkiewicz said of his family. “It’s crazy to think how many people who can’t plan like us will be affected. I want to say it’ll cost at least 40 percent more for me, and 40 percent is numbers in the thousands.”
Gostkiewicz and his wife have two young children and say they aren’t likely to seek out medical treatment at hospitals farther away from their home. Instead, they’ll pay the higher out-of-network cost.
“If I have those symptoms, I am going to the closest place. It’s got to be addressed right away and if it’s with my kids? You know, minutes count,” Gostkiewicz said.
In a statement Saturday night, Anthem spokeswoman Sarah Yeager said that after months of negotiations, Hartford HealthCare did not accept the insurance company’s contract negotiation offer.
Yeager said Anthem was asking Hartford HealthCare to agree to cost-of-living increases that are comparable to other hospitals in the state.
“HHC is demanding three years of consecutive rate increases that are two to three times the rate of inflation each year,” Yeager said. “That is not acceptable to us and not acceptable or fair to our customers and members.”
Hartford HealthCare spokesman Shawn Mawhiney said their company is expecting it to be a “confusing time” for patients and they hope to help as best they can.
“Patients are going to be asked to fill out what are called ‘continuation of care’ forms, and they send these forms to Anthem. From there, Anthem makes determinations as to whether or not the patients would be able to get the care at the cost in-network or out-of-network,” Mawhiney said Sunday afternoon. “I think the best advice is to go to the website that has been created — hartfordhealthcare.org/anthem — and fill out those forms.”
In a letter to consumers, Hartford HealthCare Executive Vice President David A. Whitehead said they are working with Anthem to reach a fair agreement, but in the meantime bills will be sent directly to consumers.
“While we are out of Anthem’s network, Hartford HealthCare will send a bill directly to you for services you receive. You will be responsible for paying this amount,” he wrote.
Yeager said Anthem will try to ensure a smooth transition for Hartford HealthCare customers who will now be considered out of network, by transitioning them to other comparable in-network providers and hospitals in the area and throughout the state who can meet their needs.
As for Gostkiewicz, he hopes that he’ll be able to use Backus Hospital as an in-network provider soon.
“I am really hoping that in a week, I’ll hear about a deal,” he said.