UC Health, Blue Shield extend contract deadline, stave off disruption of care
This means the thousands of Californians who get medical care at UC Health through Blue Shield of California — including many in the Bay Area who go to UCSF and One Medical, a UCSF affiliate — have an additional 30 days of breathing room before potentially having to find a different health insurer or pay out-of-network rates for services if UC Health and Blue Shield cannot reach a new contract.
UC Health and Blue Shield have been renegotiating contracts to establish how much Blue Shield will reimburse services provided by UC Health hospitals, clinics and other facilities. One Medical is an affiliate of UCSF Health, one of the six UC Health academic medical centers statewide.
Contract negotiations between health care providers and insurers are routine and often involve disagreements over reimbursement rates. In recent years, the tenor of such negotiations has grown more public and combative, often with each side accusing the other of taking positions that would ultimately harm consumers through higher prices or less accessible medical care.
Late last week, San Francisco City Attorney David Chiu and Supervisor Matt Dorsey waded into the matter, urging Blue Shield to finalize an agreement with UC Health so that the roughly 5,000 city employees and retirees who go to UCSF for medical care will not lose access to critical medical services.
Last year, UC Health and Anthem Blue Cross, another major insurer in California, similarly had a dispute over contract terms that lasted months. The two sides eventually reached a new contract.
In the Bay Area, the outcome of the negotiations between UC and Blue Shield could impact residents insured by Blue Shield who get care at UCSF Medical Center and UCSF Benioff Children's Hospitals in San Francisco and Oakland. It includes people in CalPERS plans, employer plans, Covered California plans and Medicare plans (including Medicare Advantage) offered or administered by Blue Shield.
The negotiations do not affect UCSF Health Community Hospitals at Saint Francis and St. Mary's, which will remain in-network.
Both UC Health and Blue Shield said Monday that they hope to reach a new agreement and avoid interruptions for their patients and members.
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If you have a Medicare Advantage (Part C) or Part D plan at the time of incarceration, you will be disenrolled when you enter custody, as the plan will consider you outside of its coverage area. You can reenroll in Medicare — or enroll for the first time, if you became eligible while incarcerated but missed your initial enrollment period — during a special enrollment period that begins when you're released. You can maintain your Original Medicare coverage while you're incarcerated if you continue paying any required premiums. If you have a Medicare Advantage (Part C) or Part D plan at the time of incarceration, you will be disenrolled when you enter custody, as the plan will consider you outside of its coverage area. You can reenroll in Medicare — or enroll for the first time, if you became eligible while incarcerated but missed your initial enrollment period — during a special enrollment period that begins when you're released. Do inmates get free healthcare in the United States? In the United States, incarcerated individuals have a right to adequate healthcare. However, this care is not always free. There may be fees, such as copayments, associated with different services or medications. In the United States, incarcerated individuals have a right to adequate healthcare. However, this care is not always free. There may be fees, such as copayments, associated with different services or medications. The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.
