About Amy Umble:
Amy Umble is health reporter for The Free Lance-Star

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Contract dispute means local government workers could be paying more for less

Updating the Mary Washington-Anthem contract dispute.

If Mary Washington withdraws from the Anthem network, local public employees face the possibility of paying more for less. Many of them have higher  insurance premiums this year, compared to last, and their coverage may soon be diminished.

The state government and most of the local governments in the region, including their school systems, purchase Anthem coverage for their workers. They are among Anthem’s 77,000 customers in the Fredericksburg area.

Beginning July 1, many of these workers and/or their employers started paying more to Anthem for coverage. Spotsylvania County schools, for example, saw a 7 percent increase in premiums. For Stafford County schools, the increase was 4 percent.

Now, there’s a possibility that the region’s largest health care provider could leave the Anthem network effective Jan. 1. Mary Washington Hospital, Stafford Hospital, the Fredericksburg Ambulatory Surgery Center and Snowden at Fredericksburg would be affected.

Earlier this month, Mary Washington officials promised that, if the split occurs, Anthem-insured patients will pay only the in-network, out-of-pocket amounts described in their plans. For patients, it will be as if the split never occurred, they say.

Judging by the calls I have received here, however, some Anthem patients are skeptical. Customers have different Anthem plans, with different in-network and out-of-network deductibles, copayments and out-of-pocket maximums. Will Mary Washington be able to sort it all out? Will Anthem recognize Mary Washington’s decisions?

One reader this week offered this scenario: Suppose Mary Washington and Anthem split. Suppose she goes to Mary Washington early next year for care. True to its word, Mary Washington asks that she pay only the in-network deductible called for in her Anthem plan. But to Anthem the care is out-of-network. Will she still have to meet the in-network deductible the next month when she goes, say, to Pratt Medical Center for care?

Stay tuned.

(A prior blog post on the Anthem-Mary Washington contract dispute can be found here. It contains links to other posts. Mary Washington has Anthem information on its website here. And Anthem has a Mary Washington page, here, on its website.)