Area residents who want to keep using University of Pittsburgh Medical Center facilities, at in-network rates, should check with their employers as to what insurance options will be available next year.
As of June 30, Highmark insurance holders will be considered out-of-network users at all UPMC facilities, which includes Bedford County's only hospital. The only two exceptions will be the Hillman Cancer Center and Magee Women's Hospital, both in Pittsburgh.
UPMC Bedford Memorial is covered by the existing contract between UPMC and Highmark, but that relationship is ending as of June 30, UPMC spokesman Paul Wood said Friday.
"There will be no denying of treatment ... because hospitals are open to all comers," Wood said.
"But Highmark subscribers won't have access to the preferred rates at UPMC facilities. ... They'll be considered out-of-network."
The turn-of-events affects only those covered by health insurance plans offered by their employers. Those covered through Medicare and Medicaid will not be affected, Wood said.
Negotiations on a successive contract between UPMC and Highmark broke down in the spring, when reports surfaced about Highmark's plans to acquire the financially troubled West Penn Allegheny Health System in Pittsburgh.
That was the "show stopper" in the negotiating process, UPMC's chief legal counsel Thomas McGough Jr. told Allegheny County Council on Wednesday, according to the Pittsburgh Post-Gazette.
The acquisition transforms Highmark from an insurance company into a UPMC competitor, Wood said.
"And competitors don't contract with each other," Wood said.
"We know that most people would rather keep their doctors and hospitals and switch insurances ... so when the employer has open enrollment ... doing so may be as easy as checking a different box."
UPMC, in addition to its own insurance, also has contracts with Aetna, United, HealthAmerica and Cigna so holders of those insurance policies will have access to in-network rates at UPMC facilities.
"This is the time for employees to talk to their employers ... because most employers, we think, are beginning to offer more choices in health insurance," he said.
Mirror Staff Writer Kay Stephens is at 946-7456.