As Hoboken and Bayonne hospitals prepare to drop Horizon insurance, where do patients turn?

HOBOKEN AND BAYONNE – Horizon Blue Cross Blue Shield will drop the Hoboken University Medical Center from in-network care as of June 1 and the Bayonne Medical Center as of May 1, according to a letter from Hoboken Mayor Dawn Zimmer to the Hoboken City Council dated April 22.
For patients who come in through the emergency room in an emergency, this shift won’t alter their medical expenses since a New Jersey statute requires such bills to be the same across all hospitals. However, it’s not so clear cut for patients who need non-emergency treatment.
Officials from CarePoint Health declined to comment Tuesday afternoon about the change, but in recent reports say they will continue to seek to renegotiate a contract with Horizon.
For-profit hospitals have, over the years, dropped certain insurance companies if they could not negotiate what they believe are reasonable rates. They may still see the patients, but they are not covered in network.
For the time being, the upcoming shift has led Zimmer to implore the city to change healthcare providers for municipal workers in order to save millions.
At a meeting to discuss the possible opening of a Trader Joes in Hoboken on Tuesday, April 26 at 7 p.m., the Hoboken City Council will also consider two agreements related to health insurance for employees.
“If we were to remain with Horizon, the city’s medical claims could increase by an estimated $5 million, and employees would face higher payroll deductions and out of pocket expenses with all CarePoint Health facilities and physicians being out of network,” Mayor Dawn Zimmer said in the letter.
Instead, Zimmer noted, the city has been in talks to land a deal with United Healthcare/UMR, which would allow patients to continue to use CarePoint Health facilities (Hoboken University Medical Center, Bayonne Medical Center and Christ Hospital) and “mirror” the benefits received under Horizon.
Close to 3,000 city employee currently use the city’s healthcare provider and the city says United Healthcare has more doctors in-network than Horizon. – Steven Rodas

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