Vanderbilt's Impasse With Blue Cross Leaves Many Retirees Without Coverage | Nashville Public Radio

Vanderbilt's Impasse With Blue Cross Leaves Many Retirees Without Coverage

Dec 1, 2015

Middle Tennessee retirees are learning that Vanderbilt Medical Center and its affiliated clinics will no longer take some Medicare Advantage insurance. Blue Cross Blue Shield of Tennessee’s contract runs out at the end of the year.

Unless some kind of resolution is reached before Jan. 1, Vanderbilt will be out-of-network for anyone on a Blue Cross Blue Shield Medicare Advantage plan.

"Negotiations between healthcare providers and insurance companies are normal and a routine part of business," says a special website set up by the medical center. "These discussions also make sure that Vanderbilt and insurance companies share the responsibility to support and improve healthcare in Tennessee."

Charlie Floyd, of Hendersonville, says the news comes as a “kick in the teeth.” Even though he’s only used Vanderbilt a few times, he says that’s where he’d want to go if he had a serious problem.

“They are bickering with each other — one trying to maximize, the other trying to minimize its cost," Floyd said. "The people in the middle, trying to utilize the services of both corporations, are getting squeezed.”

Blue Cross describes Vanderbilt as a "valuable partner." But the state's largest insurer also gives its side of the story on its own special webpage.

"We offered to pay Vanderbilt the same rates for Medicare that they accept from the federal government," the site says. "We know that unless we draw the line on the cost of routine medical services, health care costs will continue to increase, and our members will be the ones who pay more."

While Blue Cross is directing patients to use other Middle Tennessee hospitals, Vanderbilt is encouraging patients to consider making a quick switch with their insurance coverage. They face a Dec. 7 deadline to pick a new carrier or lose access to Vanderbilt except in cases of emergency.