Keeping health care affordable and accessible
Our network agreement with Providence in Oregon ended on December 31, 2024. For more than 9 months, we have been working to renew our contract with Providence to keep their Oregon facilities and providers in our networks. Unfortunately, they have continued to demand terms that would burden our members and plan sponsors with significant cost increases, which is why we weren’t able to reach an agreement.
What this means for you
As of January 1, 2025, Providence providers and facilities in Oregon are no longer part of our Commercial and Medicare Advantage health plan networks, except Providence providers in Jackson and Josephine counties, which will remain in network through February 17, 2025. However, we are continuing our contract discussions in hopes of reaching an agreement that will bring them back into our health plan networks.
Members that continue receiving care from a provider that is no longer part of their health plan network would pay more out of pocket than when the provider was in network. The amount depends on whether their health plan covers services from providers not in their plan’s network. Generally, members pay less out of pocket when they use providers in their plan’s network. We recommend members check their health plan details before seeing a provider not in their plan’s network to understand their costs.
We are here for you
We are here to assist members who need help finding a new provider. They can visit the
Aetna website
to find providers that are part of their health plan network or contact us by calling the number on the back of their ID card.
Commercial and Medicare health plan members receiving an active course of treatment from a Providence facility or provider in Oregon that is continuing past December 31, 2024 should work with their care team to request Transition of Care coverage. The one exception is members seeing Providence providers located in Jackson and Josephine counties for professional services will continue to have their care covered at the in-network benefit level through February 17, 2025. However, Providence hospitals are still out of network after December 31. 2024 for any referrals from these providers.
Members can get a Transition of Care request form by calling the phone number on the back of their member ID card. Transition of Care coverage requests are subject to approval by Aetna. More information about Transition of Care coverage is available in the
FAQ.
This material is for information only. Health benefits and health insurance plans contain exclusions and limitations. Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Information is believed to be accurate as of the production date; however, it is subject to change.
For more information about Aetna plans, refer to www.aetna.com.
Aetna is the brand name used for products and services provided by one or more of the Aetna group of companies, including Aetna Life Insurance Company and its affiliates (Aetna). Aetna, CVS Pharmacy® and MinuteClinic, LLC (which either operates or provides certain management support services to MinuteClinic-branded walk-in clinics) are part of the CVS Health® family of companies. Information is accurate as of the production date but may change.
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