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CHRISTUS Health Southeast Texas, Spohn and Santa Rosa Hospitals and Ambulatory Surgery Centers
Aetna Healthcare - Commercial and Medicare Contracts
Pending Termination Effective July 1, 2023
CHRISTUS Health Southeast Texas, Spohn and Santa Rosa hospitals and ambulatory surgery centers have accepted Aetna Healthcare insurance for decades and we fully intend to continue. However, Aetna Commercial and Medicare customers will no longer have in-network coverage at the above CHRISTUS Health locations if we are unable to reach an agreement by July 1st.
We have been in negotiations with Aetna for months to secure a reimbursement rate that is reasonable for the services we provide. Although we are pursuing an increase in reimbursement; we will continue to be the most economical choice for our patients. Aetna’s responses have been unfavorable thus far, however, we will continue to communicate with Aetna in hopes of finalizing an agreement.
Negotiated increases will support our viability and allow CHRISTUS Health to continue to serve the needs of our community just as we’ve done for years. CHRISTUS Health has always been there for the communities we serve, even during times of crisis, such as the COVID pandemic and destructive storms; that will never change, and our commitment remains unwavering. Aetna wants to compound the difficulty our communities have endured by endangering their access to the affordable and high-quality health care they need from CHRISTUS Health.
We recognize that patients expect health care services that are high quality and high value. CHRISTUS Health is working hard to keep health care costs affordable for you while continuing to provide high-quality and safe service to our patients and their families. We encourage you to call the Aetna customer service number located on your insurance card to let them know how important it is for CHRISTUS hospitals and ambulatory surgery centers to remain “in network” so that you have access to the full provider network and benefits you pay for as an Aetna member.
The pending termination will not interrupt access to your trusted CHRISTUS Trinity Clinic physician. The physicians will remain in-network with Aetna. Additionally, the Aetna Better Health (Medicaid) contract will remain active for all CHRISTUS Health entities.
We will continue to be available to serve you, your family, and neighbors any time you need us. Our emergency departments will always be available, even if we go out of network with Aetna on July 1, and we will do all we can to ensure that you get the affordable, quality care you need and deserve.
Please note, we are committed to working with Aetna, even on an out-of-network basis, in order to ensure their members continue to have access to the high quality care we provide at CHRISTUS Health. Aetna has transition-of-care policies which may allow patients with certain medical conditions (pregnancy, terminal illness, life-threatening conditions, or chronic conditions, etc.) to continue their treatment at in-network benefit levels for a defined period of time. To initiate a request for transition-of-care, a physician or Aetna Healthcare patient must submit a continuity of care form. You can access the form below or by calling the customer service number on the back of your Aetna identification card.
Aetna Transition of Coverage Request Form
We will continue to post important updates here, so please continue check our website. Now more than ever, our communities need a trusted healthcare partner. CHRISTUS Health is truly honored to serve you for all your health care needs. We thank you for putting your trust in us.
Frequently Asked Questions:
CHRISTUS Health Southeast Texas:
- CHRISTUS Health Southeast Texas St. Elizabeth Hospital
- CHRISTUS Health Southeast Texas Jasper Memorial Hospital
- CHRISTUS Health Southeast Texas Orthopedics
- CHRISTUS Health Southeast Texas Bariatric Center
- CHRISTUS Health Southeast Texas St. Elizabeth Outpatient Pavilion
- CHRISTUS Health Southeast Texas St. Mary Outpatient Center Mid County
CHRISTUS Santa Rosa Health Care System:
- CHRISTUS Santa Rosa Hospital Medical Center
- CHRISTUS Santa Rosa Hospital Alamo Heights
- CHRISTUS Santa Rosa Hospital Westover Hills
- CHRISTUS Children’s
- CHRISTUS Santa Rosa Hospital San Marcos
- CHRISTUS Santa Rosa Hospital New Braunfels
- CHRISTUS Santa Rosa Rehabilitation Services New Braunfels
- CHRISTUS Santa Rosa Outpatient Imaging New Braunfels
- CHRISTUS Santa Rosa Emergency Center Alon
- CHRISTUS Santa Rosa Emergency Center Bandera
- CHRISTUS Santa Rosa Emergency Center Creekside
- CHRISTUS Surgery Center Olympia Hills
- CHRISTUS Surgery Center Alamo Heights
- CHRISTUS Santa Rosa Physician Ambulatory Surgery Center Stone Oak
- CHRISTUS Santa Rosa Physician Ambulatory Surgery Center New Braunfels
- CHRISTUS Santa Rosa Physician Ambulatory Surgery Center San Marcos
CHRISTUS Spohn Health System:
- CHRISTUS Spohn Hospital Corpus Christi South
- CHRISTUS Spohn Hospital Corpus Christi Shoreline
- CHRISTUS Spohn Hospital Alice
- CHRISTUS Spohn Hospital Beeville
- CHRISTUS Spohn Hospital Kleberg
- CHRISTUS Spohn Cancer Center
- CHRISTUS Spohn Cancer Center Calallen
CHRISTUS is legally obligated to notify patients of any potential changes to their healthcare coverage when one of our contracts is set to end.
You will continue to receive the same high-quality and compassionate care on July 1st that we provided on June 30th, whether we’re in or out of network. We encourage you to review your benefits to ensure you can continue to seek care at a non-network provider under your benefit plan provisions.
If we are out of network with Aetna, your out-of-pocket costs could vary significantly. To understand your specific benefits, we encourage you to call Aetna Healthcare customer service at the number listed on the back of your insurance identification card. In addition, we encourage you to call Aetna today to let them know you want to keep CHRISTUS in your network and let your employer or agent know that CHRISTUS is your preferred choice for health care.
First and foremost, we’re committed to your health and to reaching an agreement with Aetna. Should we be unable to reach an agreement, we expect Aetna will work to facilitate transition of care in accordance with a member’s benefit plan, so that member can still be treated at CHRISTUS. We will continue to assist Aetna members get the appropriate access to care.
Yes, Aetna has a “transition of care” coverage program, which is considered when a member has special circumstances such as:
- life-threatening illness, or
- a high-risk pregnancy, or a pregnancy past the 24th week or beyond
According to Aetna, this coverage is only applicable to the requested doctor. If you need more information about your specific situation, or how the Aetna transition process works please refer to the back of your insurance identification card to reach an Aetna Healthcare representative.
No. Emergency care is covered at your in-network benefits under the Emergency Medical Treatment and Labor Act, a federal law that requires anyone coming to an emergency department to be stabilized and treated regardless of their ability to pay.
CHRISTUS participates in many national and local insurance plans, including most other major insurance companies.