Insurance squabble leaves thousands of seniors in limbo

The Medicare Advantage policies are in question because of a contract dispute between Regence BlueShield and Optum Health Care.

ARLINGTON, Wash — At 74 years old, Jo Ford keeps herself in good shape by line dancing every week at the Stilly Senior Center in Arlington, but she worries what shape her health insurance is in right now.

“I felt like the rug had been pulled out from under us,” she said.

Ford has been a client at The Everett Clinic for nearly 50 years.

Last month, she received a letter from her insurer, Regence BlueShield, stating the clinic decided to leave the Regence provider network because of a dispute over rising costs and payments.

A Regence spokesperson told KING 5 that the company is, “work with (its) Medicare Advantage members to ensure they receive the care they need.”

Yet, the company confirmed some Regence Medicare Advantage customers have been getting turned away from clinics because their insurance is no longer accepted.

“We thought we had good coverage,” Ford said. “We never thought it would come to this.”

Ford has been going to the Everett Clinic for nearly 50 years.

At 74, she’s now having to search for new insurance, and likely new doctors, while delaying care for her husband and herself until June or July.

“It’s upsetting to have to make these changes,” she said. “It’s one thing if you make the change. It’s another when a big company makes a change for you and leaves you high and dry.”

Optum Health Care owns both the Everett Clinic and Polyclinic in Seattle.

A clinic spokesperson said 4,000 clients were impacted by the dispute, adding, “Our priority and focus continues to be providing compassionate, affordable, quality care for our patients and communities.”

The Everett Clinic emailed a list of Medicare Advantage providers who are partnering with Optum Health Care for 2023. They are:

  • Humana Medicare Advantage HMOs, PPOs & D-SNPs,
  • Kaiser Permanente Medicare Advantage HMO
  • Premera Blue Cross Medicare Advantage HMO
  • UnitedHealthcare Medicare Advantage HMO, PPO, D-SNP, & I-SNP

For now, Ford is focusing on staying healthy and trying to stay in step with the complicated dance of the healthcare industry.

“It’s scary. It keeps you awake at night,” she said. “At this stage in our lives, why should we be shopping around for other providers when we have other things to worry about?”

Optum and Regence continue contract negotiations, but at this point there is no agreement in sight.

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