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LVHN to stop participating in Aetna insurance

The Lehigh Valley Health Network plans to stop accepting Aetna insurance next year, according to a notice the network released Thursday.

As a result, those with Aetna will no longer be able to get “in network” care at LVHN beginning March 13, 2023. Patients will, however, have the option to continue care at LVHN facilities on an out-of-network basis or by paying out of pocket. Patient responsibility amounts are often higher when care is accessed out of network.

The network notified Aetna of the termination on Thursday and created a webpage to answer patients’ questions.

“This is a fluid situation and a lot can change in 120 days,” according to https://www.lvhn.org/aetna-participation, which also invites patients to call 888-402-5846 for more information.

The network notes it will keep patients posted with updates.

“For now, we are only certain the notice of termination we have sent Aetna will go into effect on March 13, 2023,” it notes.

Because patients’ coverage won’t be impacted until March, the network advises them to keep their scheduled treatments and appointments at LVHN.

“Importantly, LVHN is committed to ensuring continuity of care for patients whose care cannot, and will not, be interrupted, like those battling cancer or those trusting LVHN to care for them through their pregnancy,” according to the network.

In a video on the LVHN site, Dr. Robert X. Murphy Jr., LVHN’s executive vice president and chief physician executive, said, “We have observed Aetna taking steps behind the scenes to delay or even deny coverage for the care you need.”

Murphy added, “The situation has gone on since 2017 and as a result, LVHN informed Aetna we will terminate our agreements with them effective March 13, 2023. It’s not just administrative delays. Aetna has continuously denied coverage for the services our doctors, nurses and caregivers provide for a significant amount of important patient care over the years. This makes it very hard for LVHN or any health care system to continue working with Aetna under those conditions.”

Those who have Aetna as a supplement to their Medicare will likely not be impacted but are encouraged to contact Aetna for clarification.

Furthermore, those whose children have CHIP health insurance under Aetna Better Health Kids will not be impacted and can continue to receive care in-network after the proposed termination date.

The network notes that it did not “take this decision lightly and recognize this news will likely impact your relationship with and ability to receive care at LVHN. We are committed to doing everything in our power to avoid disrupting your care.”

Lehigh Valley officials declined to comment on the matter Friday.

An estimated 39 million people have coverage with Aetna, a CVS Health company.