Frequently Asked Questions
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Why is Ascension Texas ending its contract with Wellcare?
Ascension Texas’s primary goal has always been to provide the highest quality care and the best possible experience for our patients. Unfortunately, Wellcare Medicare Advantage plans have presented challenges that impact our ability to consistently provide the quality of care we strive for. Ending this contract will allow us to focus more on enhancing patient care without the constraints and limitations imposed by Wellcare’s plan structures.
Medicare Advantage used to offer some of the most reliable and accessible coverage options. However, over time, we've seen an increase in denials, pre-authorization requirements, and other challenges that can delay or complicate access to care. While Wellcare has presented some of the biggest challenges, we are also working to address similar issues with other Medicare Advantage plans.
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When do Ascension Texas contracts with Wellcare expire?
All Wellcare health insurance contracts for Ascension Texas facilities and providers expire on December 31, 2024, which means we would be considered an out-of-network provider for patients with Wellcare insurance as of January 1, 2024.
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What types of Wellcare health insurance plans are impacted by this negotiation?
All Wellcare Medicare Advantage health insurance plans.
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Which Ascension Texas facilities and providers are impacted by this negotiation?
All Ascension Texas facilities and providers are impacted by this negotiation.
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What if a patient has a medical emergency on or after December 31, 2024?
Patients should always go to the closest emergency room if they’re experiencing any type of emergency. Patients will always have in-network access to our emergency departments, regardless of network status with Wellcare, until they are stable and can independently determine if they would like to be transferred to an alternate facility to be covered under in-network rates for the duration of their care.
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What if a patient is receiving critical care for a chronic illness that will require care on or after December 31, 2024?
Certain conditions, such as care for chronic or complex illnesses, may be eligible for Continuity of Care which would provide approved patients the opportunity to continue seeing their current care team at in-network rates for a certain period, even if Ascension Texas is out of network with Wellcare. Patients must apply for Continuity of Care through Wellcare, and they will review and approve or deny those applications on a case-by-case basis.
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Should patients with Wellcare insurance reschedule existing appointments or stop scheduling future appointments?
This change does not impact in-network status for the remainder of 2024 and you can continue to access care at Ascension Texas as you normally would.
Ascension Texas will no longer be “in-network” with Wellcare Medicare Advantage health insurance plans as of January 1, 2025. This means services at our facilities will be considered out-of-network under your current Wellcare plan, which may affect your out-of-pocket costs.
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What can patients do to stay in-network with Ascension Texas?
Talk to your broker about your options. To receive in-network coverage at Ascension Texas next year, you will want to choose a new health plan during the open enrollment period beginning October 15, 2024. Ascension Texas is in-network with the following plans:
- Aetna Medicare Advantage
- Baylor Scott & White Medicare Advantage (Waco Only)
- Blue Cross/Blue Shield Medicare Advantage
- Humana Medicare Advantage
- Preferred Providers Health Plan
- Traditional fee for service Medicare
- United Health Medicare Advantage