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No Contract, No Coverage: Major health care changes coming to 500K Washington patients

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EVERETT, Wash. -- A half-million people in Washington will soon have to find a new doctor or pay more expensive out-of-network costs for medical expenses.

Providence Health & Services ended contract talks with Premera Blue Cross.  It’s not just Providence hospitals, but urgent care, walk-in clinics and all of Providence’s affiliates.

“Fighting to breathe is usually his issue, his asthma,” said Premera customer Julie Shore.

That’s why Julie Shore brought her husband to a Providence walk-in clinic.  Shore and other Premera customers like Leah Curula and her daughter are worried about the changes ahead.

“Seems like insurance is always upping their rates and it changes every year. I know through my work, getting new insurance coverage every year,” said Curula.

But in January, using a Premera insurance card won’t get you far in the Providence Health & Services network.  No contract means no coverage.

“I had no idea. It’s pretty surprising. I wish they would’ve sent something in the mail,” said Curula.

“There are so many members in the Premera system. I don’t know what we’re all going to do,” said Shore.

The next closest facility in network…

“Probably 25 minutes,” said Shore.

“It would be a real pain; very inconvenient,” said Curula.

And it’s a he-said, she-said between Providence and Premera.

In a statement from Providence, “As a not-for-profit organization committed to serving everyone, we were hopeful for positive, collaborative discussions. However, Premera has been unwilling to approach these discussions with the same intent.”

Premera countering by citing its relationship with other health care providers.

“…these major providers have committed to more aggressively control costs, improve the quality of care with performance-based payments, and enhance the patient experience. We invited Providence to similarly meet the needs of our customers…”

Representatives for Premera say they’re still optimistic they can get back on the drawing board and come to terms with Providence.  That’s exactly what Premera customers we spoke to, both on and off camera, want to happen before January.