Promedica Sends Network Change Notifications to Patients
TOLEDO, Ohio – If you’re looking for healthcare services through Promedica, it might be worth checking your mailbox. You might have already seen some communication in your email.
This healthcare system has started alerting patients who utilize Mutual Medical Insurance or Paramount Healthcare. The message indicated that if an agreement isn’t reached, Promedica might drop out of the insurance network.
“Starting January 1st, we’ll only have six months to find new services through any of these hospitals,” stated Terry Spitnale.
Spitnale, who works with Mutual Medical clients, received a letter dated July 23rd. He mentioned that he utilized Promedica’s primary care lab recently but now finds himself outside the network.
Unless a contract is finalized, the system will not be part of the network as of January 1, 2026.
Spitnale expressed that this situation resonates deeply with him—not only because of his partner’s needs but also due to his experience working in insurance.
“We often discussed key terms like networks, out-of-network, and participation,” he reflected.
Being in-network typically ensures that insurance covers some or all of medical costs. If Promedica becomes out-of-network, patients relying on Medical Mutual may face higher costs, potentially having to pay full expenses out-of-pocket, except for emergency situations.
Spitnale emphasized the importance of informing others about the possible outcomes if the negotiations don’t go well.
“I’ve seen people receiving unexpected bills simply because they weren’t aware of their out-of-network status,” he recalled from his time in the insurance field.
He suggests that anyone who’s gotten the letter should start seeking new healthcare providers while confirming their network status with insurance.
A Promedica spokesman noted, “With healthcare costs rising faster than expected reimbursements, it’s critical for Promedica to renegotiate with commercial payers like Medical Mutual.”
Leaders at Promedica are in the process of finalizing a new commercial insurance contract.
“This move is vital for Promedica to keep enhancing the people, facilities, and technologies necessary for providing top-notch care close to home,” the spokesperson added.
Promedica has also identified facilities and providers that could potentially be impacted for patients using Medical Mutual. These include:
- Ohio Promedica Physician Group, covering all services at hospitals, clinics, and emergency care centers
- Promedica Toledo Hospital
- Promedica Russell J. Ebeid Children’s Hospital
- Promedica Flower Hospital
- Promedica Bay Park Hospital
- Promedica Wildwood Orthopedic Surgery and Spinal Hospital
- Promedica Defiance Regional Hospital
- Promedica Fostoria Community Hospital
- Promedica Memorial Hospital (Fremont)
This list is similar for Paramount Healthcare, which also includes:
- Promedica Monroe Regional Hospital
- Promedica Charles and Virginia Hickman Hospital
As things stand, a deal is still pending.
