GREEN BAY, WI (WTAQ-WLUK) – From groceries and clothes to healthcare and homes, the cost of just about everything is going up.
And Bellin Health says at this rate, its current reimbursement agreement with UnitedHealthcare is unsustainable without the insurance company increasing its reimbursement rate.
Bellin cites an increase in operating costs in a post-pandemic environment, along with record inflation, for making their current reimbursement rate structure with UnitedHealthcare unsustainable moving forward.
Bellin Health informed its patients if a new agreement with an increase in reimbursement rates isn’t reached with the insurance company before the end of the year, Bellin Health and affiliated providers will be out-of-network for those who carry UnitedHealthcare insurance.
In a statement to FOX 11, UnitedHealthcare said,
UnitedHealthcare continues to be engaged in productive, good-faith discussions with Bellin Health to renew our long-standing relationship prior to January 1, 2025. We are committed to utilizing the remaining time on our agreement to work toward a solution that is affordable and sustainable for Wisconsin families and employers. We hope Bellin shares our commitment and continues to work with us to reach a fair agreement to help ensure the people we collectively serve have continued, uninterrupted access to Bellin’s hospitals and physicians.
These negotiations come as Medicare’s open enrollment begins — and the healthcare marketplace is set to open Nov. 1.
“If there was a time to be worrying about your health insurance or your Medicare, it would be this year coming into 2025, just because the changes will be enormous,” said Jake Ponkratz, an insurance specialist with Green Bay Insurance Center.
According to Ponkratz, as people are searching for health insurance, they should expect to pay more in 2025.
While the care is staying the same, Ponkratz says in our region, those shopping the healthcare marketplace can expect about a 9% increase on just premiums. Co-pays for primary care visits will most likely go up, too.
Ponkratz adds, “Deductibles, max out-of-pocket, is going up $500 — that’s what I would be expecting. Just because the cost of everything is getting more expensive and when these health insurance companies are on the hook for a lot more risk, they’re going to, they need to supplement that.”
One of those risks is the change to the Medicare prescription drug plan. Starting in 2025, the out-of-pocket maximum for covered Part D drugs will be $2,000, down from $8,000 this year.
Making up that difference will need to come from somewhere, which is most likely being passed on to the consumer.
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