Two Tulsa hospitals announced this week they won't take certain health care plans. News on 6 reporter Jennifer Loren tried -again- to get answers from the hospitals as to why.
St. John says it won't participate in Humana or Sterling Medicare plans and St. Francis says it won't participate in those two plans plus Secure Horizons Direct. They announced that in these two full-page ads this week, but again Wednesday, we got no â€œofficialâ€ response from either hospital, but we did get some answers.
Sue and Jere Daykin are retired. A few years back, Jere began having several serious health problems. Even with his 17 different prescription drugs, his health has recently gotten worse. Sue Daykin: "His congestive heart failure started acting up again and he was supposed to go tomorrow, today to have another test done."
But the Daykins put that appointment on hold because Tuesday they heard our report, that their doctors at St. Francis will no longer accept Jere's health plan with Secure Horizons Direct. So the cost of that test would have to come out of their pocket. "He can't afford, with his heart and things, to just lay there on a gurney thinking oh well, you know, I've got to go scrounge up some money somewhere."
When the Daykins called St. Francis to ask why they wouldn't take their plan, a St. Francis rep said it's because those plans are not paying 100% Medicare rates.
The News on 6 talked to executives at those insurance companies. They say that's not true. In an e-mailed response from a Humana rep, he says, "Yes, we do. If the hospital believes otherwise, they have yet to give us evidence of that." The News on 6 called hospital administrators to get some answers. â€œSo we're really hoping to get an answer from you all. Okay. Well, let me visit with a couple of people and I'll have to get back to you."
Again, they never called, but one thing we did learn on our own. St. John and St. Francis are suggesting that these patients enroll in one of three other plans, including Community Care, which they own. "St. John and St. Francis are both part of Community Care."
On another note, many people who called us had concerns that their military health coverage through TRICARE would also be affected by this change because it's connected to Humana. We found out that Humana is not completely connected to TRICARE. So, those TRICARE patients should still be covered.
The bottom line, if you have questions about your coverage, call your doctors.