Ballad Health Provides Update on Negotiations with Cigna Health Plan Related to Certain Cigna Products

As community members who obtain their health insurance through Medicare Advantage, the Marketplace Exchange and Commercial/Employer plans consider their health insurance options during open enrollment, Ballad Health is transparently sharing an update on ongoing negotiations with Cigna regarding a new agreement for the Cigna Medicare Advantage, Marketplace Exchange, Commercial, and Evernorth (behavioral health) plans. Commercial plans include plans offered through employers.

Medicare Advantage, the Marketplace Exchange, Commercial, and Evernorth behavioral health plan agreements between Ballad Health and expire on December 31, 2024. If agreement between Cigna and Ballad Health is not reached by this date, there remains a possibility that Ballad Health facilities and providers will be out-of-network for Cigna Medicare Advantage, Marketplace Exchange, Commercial, and Evernorth behavioral health plans.

Previous, long-term agreements reached with major insurers

In every case where Ballad Health has been in negotiations with major insurers, long-term agreements have been reached, including Blue Cross/Blue Shield of Tennessee, Anthem/Elevance, United HealthCare, Humana, Ambetter (a subsidiary of Centene) and many other plans offered in the Marketplace Exchange, Medicare Advantage and for Commercial coverage, including Behavioral Health.

We do hope that Cigna’s plans will be available throughout Tennessee, including in Northeast Tennessee and Southwest Virginia, and that Cigna can reach fair agreements to provide uninterrupted access throughout the State and in our region.

Emergency department care will remain in-network

Individuals with Cigna’s Medicare Advantage, Marketplace Exchange, Commercial, and Evernorth behavioral health plans should be aware that, after 12/31/24, if Ballad Health is out-of-network, using out-of-network facilities could result in higher out-of-pocket costs for non-emergency department services due to insurance requirements for cost-sharing. Emergency department care at Ballad Health facilities will remain covered at in-network rates.

Ballad Health encourages individuals to carefully evaluate their provider network options when making choices about their preferred plan during open enrollment. In Medicare Advantage and the Marketplace Exchange, Ballad Health is in network with numerous other insurers with plan offerings in the region including Ambetter (a subsidiary of Centene), Elevance (Anthem), United Healthcare, Sentara Health, and Blue Cross/Blue Shield of Tennessee. Certain employers offering Cigna plans to their employees also offer other plan options that include Ballad Health in network.

Ballad Health has made significant investments in our nurses and physicians to maintain access to quality care during a time of national shortages in critical medical professions. As Ballad Health has done with virtually every major insurer, Ballad Health is committed to reaching a fair agreement with Cigna for Medicare Advantage, the Marketplace Exchange, Commercial, and Evernorth behavioral health plans which support our commitments to staff and patient care without unnecessary and burdensome policies designed to place barriers between patients and their physicians.

We will keep our community updated as negotiations progress.