qa - st. clair
TRANSCRIPT
Q A&Health insurance in our region is changing rapidly, from the Affordable Care
Act to the scheduled end of the Highmark-UPMC agreement. Fortunately,
St. Clair Hospital makes navigating these changes easier because St. Clair
participates with every major insurer in almost every product.* THAT MEANS
St. ClAir iS AN iN-NetWork ProviDer FOR THESE INSURERS AND
PRODUCTS. And, if you choose a health insurance product (like a high
deductible health plan) that requires you to share in the cost of paying for
services, you’ll be pleased to know St. ClAir iS ofteN tHe loWeSt CoSt
ProviDer. So, when you choose a health plan, make sure you have one of the
nation’s 100 Top Hospitals®, close to home, in your network.
As you navigate the new healthinsurance landscape, make sure St. Clair is in your network.
*
In advance of annual health insurance enrollment deadlines,
the Hospital answers key questions below:
Q: WILL ST. CLAIR HOSPITAL PATIENTS
BE AFFECTED WHEN THE CONTRACT
BETWEEN HIGHMARK AND UPMC
EXPIRES ON DECEMBER 31, 2014?
A: No. Hospital and physician services
provided at St. Clair Hospital will not be
affected by the expiration of the contract
between Highmark and UPMC.
Q A&
Q: WHAT ABOUT SERVICES PROVIDED
AT ST. CLAIR’S EMERGENCY ROOM, ITS
URGENT CARE CENTER, AND ITS
OUTPATIENT CENTERS?
A: Again, nothing will change as a result
of the expiration of the contract between
Highmark and UPMC on December 31,
2014.
Q: WHAT ABOUT CLINICAL SERVICES
SUCH AS RADIATION ONCOLOGY AND
MEDICAL ONCOLOGY IN WHICH
ST. CLAIR PARTNERS WITH UPMC
CANCER CENTERS? WILL THOSE
SERVICES BE AFFECTED?
A: No. St. Clair’s clinical service partnerships
and joint ventures with UPMC will remain
in-network.
Q: WHAT ABOUT OTHER HEALTH
INSURERS? IS ST. CLAIR IN-NETWORK
FOR THEM, AS WELL?
A: Yes. With the exception of the two products
listed previously,* St. Clair is in-network
for every major health insurer, including
Highmark, UPMC Health Plan, Aetna,
Cigna, Coventry Health America, and
United Healthcare, as well as all major
Medicare Advantage plans, and all major
Medicaid managed care plans.
Q: WHAT TYPES OF SERVICES DOES
ST. CLAIR HOSPITAL OFFER?A: St. Clair Hospital and its medical staff
provide a wide range of advanced clinical
services, as well as women’s and children’s
care. All of these services will remain
in-network for every major health insurer
in almost every product.*
Q: WHO SHOULD A PATIENT CONTACT
WITH ADDITIONAL QUESTIONS ABOUT
HEALTH INSURANCE COVERAGE AT
ST. CLAIR HOSPITAL?
A: Please call the Customer Service line at
412.344.3408 to speak to a St. Clair
representative.
Q: IF A PATIENT WANTS TO SWITCH TO A
ST. CLAIR-AFFILIATED PHYSICIAN, HOW
CAN HE OR SHE FIND A PHYSICIAN
A: Please use our physician finder at
www.stclair.org/physicians/directory,
or call 412.942.6560.
St. Clair Hospital does not participate in two new “ultra-narrow network” products:(1) the Community Blue Medicare HMO Medicare Advantage product offered by Highmark;and (2) UPMC Advantage Select HMO/PPO/EPO products offered by UPMC Health Plan onthe federal health insurance marketplace (www.healthcare.gov). St. Clair Hospital will beout-of-network for patients who select either of these products.
Q A&