Philadelphia (WPVI) – After Jefferson Health, the largest health system in our area, consumers who are seriously concerned about their healthcare are turning alarms. It was announced earlier this week Failure to finalise a new contract with Cigna Insurance.
Emergency care for all Cigna members remains networked and patients with the Medicare Advantage Plan are also unaffected. However, Jefferson Health is currently out of the network of Cigna members that are insured through their employers.
“I feel frustrated and worried. My wife's healthcare provider is all through Jefferson,” Fairmount's David Rosenberg told Action News. “She has many appointments, including mammograms.”
Rosenberg says his wife's family has a history of breast cancer, so she is very wary of her health checkups.
He received a letter from the practice of a child's pediatrician that it is currently out of network.
Rosenberg is not comfortable leaving a trusted provider.
“They know our family and they know their medical history,” David said.
Jefferson Health said the previous contract with Cigna is unsustainable due to rising costs.
“Since 2020, Cigna's reimbursement rate has only increased by around 3%, but the cost of providing care has increased by over 20%,” said Dr. Edmund Pribitkin, a leading physician at Jefferson Health.
Signa argues that “Jefferson Health has chosen to leave our network due to demands for an unfair interest rate hike that increases the health costs of those we serve.”
What can the patient do?
“The first thing you can do is get the phone, call your insurance company and ask if you're eligible for what you call a continuous care patient,” Lisa Gill said in a consumer report.
Gill says that pregnant women and cancer patients are examples of people who can receive and receive windows for around 90 days to continue care with current providers.
She says other patients should ask, “Do you want to at least allow them to file out-of-network claims? Can they cover either of them? Many plans cover 40%, 50%, and sometimes more.”
In the meantime, Jefferson has pleaded with patients and healthcare providers to contact Cigna directly to express their concerns. Cigna says customer service advocates are available 24/7 at 1-800-244-6224. Website Or the app.
Cigna and Jefferson said they are committed to continuing negotiations and that they could reach an agreement.
Some may remember that Tower Health Hospitals and Doctors were out of the network of Cigna members for four months last year, but those parties ultimately agreed to a new deal.
Action News continues to post about what happens in the case of Cigna and Jefferson Health.
A full statement on Cigna Healthcare's action news:“Unfortunately, Jefferson Health has chosen to leave the network due to requests for unreasonable rate increases that increase the health costs of those we serve. The benefits plans for almost all employer clients are self-funded. Patients transition and guide them to high quality local network care.”
Jefferson Health's full statement: “Despite their best efforts to reach a fair agreement, Jefferson Health and Cygna were unable to finalize the new contract. As a result, as of March 15, 2025, Jefferson Health is considered outside the network of Cigna's commercial members.
“We understand that this news can raise concerns and want to reassure you that we are committed to providing quality care to our patients. We continue to negotiate in good faith with Cigna to reach a fair and sustainable resolution for our patients, providers and communities.
“For over 20 years, Jefferson Health has been a reliable provider of CIGNA members. However, current contracts do not reflect the true cost of providing high quality care. Since 2020, CIGNA's reimbursement rate has only increased by 3%, but the hospital's wage index has reached 20% and CPI-U has increased below 21%. Our community's insurance companies are aware of these economic realities, and Jefferson has successfully reached an agreement with them.
“Emergency care for all Cigna members remains networked regardless of their contract status.
“Some patients may qualify for a care program transition to maintain benefits within the network, please check with CIGNA.
“Many Signaplans include off-network perks that could allow for continued access to Jefferson providers.
“We encourage Cigna members to contact Cigna directly to understand coverage options and advocate for ongoing access to Jefferson Health Providers.
“Our priorities continue to provide the highest quality care while ensuring a fair contract that supports our mission. We are committed to your patience and support towards resolution.”
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