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Phoenix Children’s Hospital dropped by Obamacare provider for 2018

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PHOENIX — Patients at Phoenix Children’s Hospital could soon find themselves in trouble after the only insurance provider in the Affordable Care Act marketplace insurance plan dropped the hospital from its network.

Health Net announced this week that it would not cover services under its Ambetter plan at the children’s hospital starting on Jan. 1.

Health Net is the only Affordable Care Act insurance provider in both Maricopa and Pima counties and Ambetter is its insurance package for ACA consumers.

Douglas Myers, the hospital’s vice president and chief financial officer, told KTAR 92.3 FM he was “surprised” when Health Net officials said they were cancelling the contract, adding that they did not give a reason as to why.

Myers said the hospital’s mission is to provide care for all the children in the Valley who need access to essential services and that they will work to figure out ways to help those who need it.

Myers claimed the move would affect about 1,000 patients. Health Net Arizona spokeswoman Monica Coury said she could not give a specific number of affected patients, but said it was “not a very large number.”

Coury said patients who will lose coverage at Phoenix Children’s Hospital can seek nearly all of the same services at Banner’s Cardon Children’s Medical Center in Mesa.

The provider will also continue to cover services at PCH’s emergency room, Coury said.

However, Coury said Health Net will work with members who need services that are only provided by Phoenix Children’s Hospital.

Both Myers and Coury said there is no active conversation to welcome the hospital back into the network, but both sides said they would be open to the possibility.

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