CarolinaEast Medical Center Changes Medicare Advantage Status

NEW BERN, N.C. — CarolinaEast Medical Center has announced that it will no longer be an in-network provider for two Medicare Advantage plans, effective July 1.

The affected plans include Blue Cross Blue Shield and UnitedHealthcare Medicare Advantage. This change could have significant implications for seniors who rely on these services, potentially leading to higher premiums and limited coverage options, primarily restricted to emergencies.

Rachel Voris from Flatlands Jessup Insurance Group highlighted that many seniors in Craven County and eastern North Carolina are likely to experience disruption due to these changes. “We want people to know they are not alone in this,” Voris stated.

Andrea Smith, a plan holder, expressed her concern about the impact of these layoffs, especially since her husband requires a knee replacement this year. She mentioned they might have to travel to Raleigh or Durham for medical care moving forward.

“We have a lot of resources available, but it’s still going to be tough, particularly for seniors who might be isolated or lack transportation,” Smith reflected. She noted a challenging six-month period ahead, where uncertainty looms for many.

Currently, those affected by this change have two main options: either travel for treatment or switch to traditional Medicare. However, the next open enrollment period won’t begin until the fall and won’t take effect until January.

Smith pointed out that transitioning from Medicare Advantage to Medicare isn’t as straightforward as it may sound. With rising costs, she worries about managing the budget during these uncertain times.

Voris empathized with the frustration many are feeling and suggested that it would be beneficial if the Centers for Medicare & Medicaid Services offered a special enrollment period to alleviate some of the confusion. “We can take action by connecting with our local representatives,” he added.

He also advised those impacted to consult with a trusted advisor, like a SHIP counselor, to help navigate their coverage options and understand the implications of these layoffs.

The hospital reassured patients that this change will not affect them directly, as CarolinaEast doctors will still be considered in-network for both Medicare Advantage plans. Additionally, it’s worth noting that ECU Health is currently facing a reimbursement dispute with UnitedHealthcare, with some services at ECU Medical Facilities also going out of network for UHC members.