The recent news that Blue Shield HMO’s are not in the UCLA network have affected many policy holders here in Santa Monica, Brentwood and Pacific Palisades, and their effort to finding quality affordable health insurance.
Not only HMO group insurance policy holders but also many Seniors, who have a Medicare Advantage plan with Blue Shield, have to switch insurance plans in order to keep their UCLA doctor or Bay Area UCLA Medical doctor; and still be able to have affordable health insurance.
UCLA and Blue Shield are currently in negotiation on the PPO insurance side. The negotiations are not finalized yet, but it does seem there might be a chance that even PPO policy owners might not be able to see their UCLA doctor comes January. We had the same scenario couple of years ago, and PPO policy owner could not visit their doctor for a couple of months. Until Blue Shield and UCLA were able to come to an agreement on the hospital and doctor charges
With the most recent acquisition of the Bay Area Medical group by UCLA many more policy holders in Santa Monica, Pacific Palisades and Brentwood are affected by Blue Shield and UCLA not being able to come to an agreement.
The Ronald Reagan UCLA hospital is considered one of the top five hospitals in the country. UCLA Santa Monica Center with their brand new Orthopedic Hospital, the Resnick Neuro Psychiatric Hospital and UCLA Mattel Children Hospital along with the UCLA Medical Center and now also the Bay Area UCLA Medical Group have given UCLA such an importance on the West Side of Los Angeles, that it has to be a very difficult decision by Blue Shield to leave this important group out of their network. But if UCLA is asking for unreasonable rates for their doctors and hospital charges, than Blue Shield, in order to keep their premiums for their policy holders low, must leave UCLA.
For me as an insurance agent I have not only be considered about finding affordable health insurance for my clients but also that they my client get the quality doctors In Santa Monica, Brentwood and Pacific Palisades. As much as I liked Blue Shield credit to their policyholders, not having UCLA in their network will make it hard to recommend Blue Shield for 2012. I hope that UCLA and Blue Shield will find an agreement , so that we have more carriers to choose from to offer affordable health insurance in Santa Monica, Brentwood and Pacific Palisades to our clients.