Update For more information about HSHS and Aetna Illinois click here

HSHS and Aetna Illinois Update

June 14, 2024 

Updated: June 14, 2024
To our valued Aetna Illinois patients, 

HSHS continues to negotiate in good faith with Aetna representatives. We have heard from many patients and understand the concerns if we become out of network for Aetna members. 

Share your concerns with Aetna: We encourage you to let Aetna know that it is important for you to continue receiving quality health care services at our facilities and with HSHS providers. 

Your comments and concerns for Aetna to continue engaging with us and come to an agreement can be shared with Aetna by calling the customer service number on your insurance ID card or 1-855-335-1407

If no agreement is reached, Hospital Sisters Health System (HSHS) will be considered out-of-network providers for all patients with Aetna, effective July 1, 2024. This includes all nine HSHS Illinois hospitals, Prairie Cardiovascular, and HSHS Medical Group. Members with this coverage will have to choose another provider outside the HSHS hospital and medical group network, beginning July 1. HSHS will ensure medical record information, with your permission, is shared with new providers. Regardless of their benefit plan, every Aetna member still has access to emergency services at all HSHS hospitals.

IMPORTANT: Aetna has a variety of plans that may not be impacted. It is important that every member check their plan requirements for network provider use. 

  • Supplemental plan (traditional Medicare is primary, Aetna pays after Medicare) - These plans do not require use of contracted providers. HSHS accepts Medicare and the Aetna Supplemental plans. Members with this coverage can continue to receive care from HSHS hospitals and providers.
  • State of Illinois retiree Medicare program (TRAIL) - This plan does not require use of contracted providers.  HSHS accepts Medicare so the TRAIL members can continue to use HSHS providers. Benefit information is on the TRAIL website. Members with this coverage can continue to receive care from HSHS hospitals and providers.
  • Medicare Advantage PPO - Check specific benefit plan: Aetna Medicare PPOs do not require use of contracted network but may have different out-of-pocket costs.
  • Aetna Better Health - The current contract discussions between HSHS and Aetna do not involve Aetna’s Illinois Medicaid program, Aetna Better Health. Members with this coverage can continue to receive care from HSHS hospitals and providers.

Aetna as secondary commercial insurance follows the same provider network requirements as if primary. If Aetna is secondary to Medicare (as in a supplemental plan), there is no requirement to use contracted network. To review your Aetna plan coverage, visit www.aetna.com or call 855-335-1407.

HSHS is committed to ensuring that our patients continue to receive the care they need. We participate with other insurance providers, and a comprehensive list of these in-network insurance plan options is available on your local hospital web page. Patients can also call Patient Financial Services at 1-833-464-1778 or email PFS@hshs.org for further assistance.

Thank you for choosing HSHS for your healthcare needs. We understand this potential change may cause concern, and we assure you that we are working diligently and in good faith with Aetna to reach a favorable resolution.

Questions: Please call Patient Financial Services at 1-833-464-1778 or email PFS@hshs.org with any questions or concerns. 
 
FAQ
 
Would this potential split affect people with Medicaid, such as Aetna Better Health Medicaid? 

The current contract discussions between HSHS and Aetna do not involve Aetna’s Illinois Medicaid program, Aetna Better Health.

Would this affect retired State of Illinois employees who have Aetna Medicare plans? 

The Aetna Medicare State of Illinois retiree plan does not require using the Aetna provider network, so Medicare-eligible retirees can seek care from any provider, including HSHS hospitals and physicians.

HSHS and Aetna Illinois Update
Media Contact

Kelly Barbeau

System Director, Communications & Public Relations