Important information for patients with Aetna health insurance

We continue to negotiate for a fair agreement but remain far apart with Aetna, despite our best efforts. Aetna has continued to delay progress and has yet to offer a proposal that meets Holy Cross Health’s needs. If we cannot reach an agreement before January 1, 2025, Aetna may force Holy Cross Health facilities and doctors out-of-network.

Aetna’s current reimbursement does not adequately cover the true cost of care we provide. Yet, Aetna keeps raising premiums and out-of-pocket costs for its members, to boost their profits, which topped $5.6 billion in 2023. We are asking Aetna to put patient health over their wealth. For us, Health Comes First.

We are asking Aetna to do its part to protect the care our patients, Aetna members, deserve. Holy Cross Health is committed to providing high-quality patient care, which depends on fair payment from insurers.

Let Aetna know that your health should come first—not their profits. We're working tirelessly to reach an agreement, but we need Aetna to step up and put patients first. 

We believe Health Comes First

We know how important it is for you and your family to receive care from the trusted doctors, nurses and staff at Holy Cross Health. As a not-for-profit, local care provider, we work tirelessly to care for our patients and communities. We also continue to reduce costs and implement efficiencies to ensure we can continue providing top-quality care to our patients. We are asking health insurers to put patients first just like we do. Without them doing their part, access to care is at risk. Holy Cross Health provides high-quality care in our community while doing our part to make health care affordable – in 2023 alone, we've invested $1,846,857. Unfortunately, Aetna keeps raising premiums and out-of-pocket costs for its members, to boost their profits, which topped $5.6 billion in 2023.  We are asking Aetna to put patient health over their wealth. For us, Health Comes First.

Frequently Asked Questions

You deserve access to high-quality health care

At Holy Cross Health, we believe our community members deserve options for high-quality care, and we are proud to be one of Florida’s most trusted health care providers. That’s why we’re working to protect our ability to serve patients for generations because health comes first.  

If you do not find the answers to your negotiation-related questions on this site, please contact us directly via this website through our contact us page or call our patient line at (954) 837-9080. This website will be updated as our negotiations continue, so please check back for the most up-to-date information.  

Q: I have an Aetna health plan. What does this mean for me

A: For now, nothing changes. You should continue to visit Holy Cross Health facilities and employed physicians as you normally would. If Aetna does not work with us to reach a fair agreement before January 1, 2025, Holy Cross Health will be forced out of network and patients may have to pay more when seeking care with our hospital, clinics and employed providers.  

 

Q: What is happening?  

A: Holy Cross Health is negotiating with Aetna for new agreements that appropriately cover the cost of the care we provide patients with Aetna commercial (including employer-sponsored and ACA marketplace) and Medicare Advantage plans. Our current contract will expire January 1, 2025. Negotiations are a routine part of business, and we are doing our best to reach an agreement to minimize impact to patients. What’s not routine is the significant impact inflation has had on our cost to provide the high-quality care you expect, and we need Aetna to do their part to ensure you have access to our care.

 

Q: Why is this happening?

A: As a trusted local care provider, we work tirelessly to care for our patients and communities. We also continue to reduce costs and implement efficiencies to ensure we can continue providing top-quality care to our patients. However, Aetna's focus appears to be their profits, which topped $5.6 billion in 2023. We cannot maintain access to the care and services patients depend on and need without a fair agreement from Aetna.

 

Q:  When does the contract with Aetna end?

A:  Our current agreements will expire effective January 1, 2025.

 

Q: Which Aetna health plans are affected by the negotiations?

A: The following health plans are impacted:

• Aetna commercial / employer-sponsored plans 
• ACA marketplace plans 
• Medicare Advantage health plans
 

Q: Which providers and facilities are impacted?

A: All Holy Cross Health facilities and employed providers are impacted by these contract negotiations.  

• Holy Cross Hospital
• Holy Cross Urgent Care 
• Holy Cross Medical Group
• Physicians Outpatient Surgery Center  
 

Q: What can I do to protect my in-network access to Holy Cross Health?  

A:  While our negotiations with Aetna continue, you can take these steps to protect your
access to in-network care with Holy Cross Health:   

•  If you are eligible for Medicare Advantage, the Annual Enrollment Period ends on December 7th and you can continue looking for plans through that time, even if you have already made a selection. You also are allowed an additional change during the Open Enrollment Period Jan 1 - March 31, 2025.  

 We work with many other health plans that will give you in-network access to Holy Cross Health for the 2025 benefit year:  
                              •    AVMED (excluding Medicare One)
                              •    CAREPLUS (Hospital, select Specialists, Surgery Center)    
                              •    CIGNA MA 
                              •    HEALTHSUN (Hospital and Specialists) 
                              •    MEDICA (excludes Urgent Care) 
                              •    MULTIPLAN 
                              •    POSITIVE (AHF/Ryan White) 
                              •    PREFERRED CARE PARTNERS (excludes Urgent Care)  
                              •    SIMPLY (Hospital only) 
                              •    SOLIS (excludes Urgent Care)  
                              •    UNITED HEALTHCARE  (excludes Urgent Care)  
                              •    WELLCARE (excludes Urgent Care)

Contact Fairhaven Insurance Solutions licensed Medicare advisors at www.medicareondemand.com/HolyCross or 855-241-3497, TTY 711 for options to switch plans during the Annual Enrollment

• Never delay care. You will always have in-network access to our emergency department. Regardless of our network status with Aetna, you should always visit the closest emergency department if you experience a medical emergency.

• Call the number on the back of your insurance card and ask Aetna how you can keep your in-network access to Holy Cross Health and its doctors.

•If you're pregnant or receiving ongoing treatment, call the number on the back of your Aetna insurance card to receive more information about Continuity of Care—you may be able to continue in-network care at Holy Cross Health.

• If you receive insurance through your employer, ask how you can continue your in-network access and treatment relationship with Holy Cross Health clinics, and providers. Your employer may be able to provide you with secondary health plan coverage that includes access to your trusted caregivers. 

• If you purchased an Aetna plan from the ACA marketplace (also known as the Health Insurance Exchange), you may health insurance agent/broker during the Annual Enrollment Period (November 1 - January 15, 2025) to review options on how to continue your in-network access and treatment relationship with Holy Cross Health providers. We work with many other health plans that will give you in-network access to Holy Cross Health.   

• AMBETTER*
• AVMED
• CIGNA (“Connect”/EPO)
• FLORIDA BLUE**
• MOLINA
• OSCAR
* PCPs non-participating with "Select" & "Value" plans
** Except BlueSelect; MyBlue participating for Hospital & Surgery Center, but not Medical Group physicians

 

Q: What if I’m in the hospital when the contract ends?

A: If you are already admitted to the hospital before January 1, 2025, you will be covered at in-network rates through the end of your inpatient stay.  

 

Q: What if I have an elective procedure scheduled at a Holy Cross Health facility on or after January 1, 2025?

A: We understand that some patients may have appointments scheduled on or after January 1, 2025.  If possible, you should call your provider’s office to request that the appointment or procedure be rescheduled in advance of January 1, 2025. If you are unable to reschedule your appointment or choose to keep your appointment, you may have to pay higher out-of-pocket costs for your care with Holy Cross Health if Aetna forces us out of its provider network.  

 

Q:  What if I have an emergency on or after January 1, 2025, and Holy Cross Health is out of network?

A: Patients will always have in-network access to our emergency department, regardless of our status with Aetna. If you experience an emergency, you should always visit the nearest emergency room. Patients needing emergency care can receive in-network treatment until the patient is stable.  

 

Q: How can I stay up to date on the negotiations?

A: For the most up-to-date information, we encourage you to contact us by visiting this page, holy-cross.com/Aetna, or calling our patient hotline at (954) 837-9080.

 

What You Can Do

There are ways to protect your ability to affordably access Holy Cross Health in 2025, regardless of our status with Aetna. Consider the following:  

• If you are eligible for Medicare Advantage, the Annual Enrollment Period ends on December 7th and you can continue looking for plans through that time, even if you have already made a selection. You also are allowed an additional change during the Open Enrollment Period Jan 1 - March 31, 2025.  We work with many health plans, including:


• AVMED (excluding Medicare One)
• CAREPLUS (Hospital, select Specialists, Surgery Center) 
• CIGNA MA 
• HEALTHSUN (Hospital and Specialists) 
• MEDICA (excludes Urgent Care) 
• MULTIPLAN 
• POSITIVE (AHF/Ryan White) 
• PREFERRED CARE PARTNERS (excludes Urgent Care)  
• SIMPLY (Hospital only) 
• SOLIS (excludes Urgent Care)  
• UNITED HEALTHCARE  (excludes Urgent Care)  
• WELLCARE (excludes Urgent Care

Contact Fairhaven Insurance Solutions licensed Medicare advisors at www.medicareondemand.com/HolyCross or 855-241-3497, TTY 711 for options to switch plans during the Annual Enrollment Period.

• Never delay care. You will always have in-network access to our emergency department. Regardless of our network status with Aetna, you should always visit the closest emergency department if you experience a medical emergency.

• If you're pregnant or undergoing treatment for a chronic condition, call the number on the back of your Aetna insurance card to request a Continuity of Care form. This will help ensure that you can continue receiving in-network care at Holy Cross Health for a limited time but requires Aetna’s approval.

• If you receive insurance through your employer, ask about health plans that include Holy Cross Health. Your employer may be able to provide you with secondary health plan coverage that includes access to your trusted caregivers.

• If you purchased an Aetna plan from the ACA marketplace (also known as the Health Insurance Exchange), you may contact a health insurance agent/broker during the Annual Enrollment Period (November 1 - January 15, 2025) to review options on how to continue your in-network access and treatment relationship with Holy Cross Health providers. We work with many other health plans that will give you in-network access to Holy Cross Health. 

o AMBETTER*
o AVMED
o CIGNA (“Connect”/EPO)
o FLORIDA BLUE**
o MOLINA
o OSCAR


* PCPs non-participating with "Select" & "Value" plans
** Except BlueSelect; MyBlue participating for Hospital & Surgery Center, but not Medical Group physicians

• Call the number on the back of your insurance card and express how this negotiation is impacting your access to the providers and services you know and trust at Holy Cross Health.