Marketplace Blue Cross is out of Network for EIRMC in 2017

November 1, 2016

A trip to the emergency room or surgery for some locals with Blue Cross health insurance could become a major financial crisis next year.  The Marketplace Blue Cross plans will be out of network with Eastern Idaho Regional Medical Center starting in January 2017. 


Message from Doug Crabtree from EIRMC:


I wanted to keep you apprised of a change that has significant implications for those who purchase a Your Health Idaho Exchange Blue Cross of Idaho health insurance product.


The 2017 Blue Cross products on the Your Health Idaho Exchange do not include Eastern Idaho Regional Medical Center (EIRMC) in its provider network.    As a result, beginning January 1, 2017, the Blue Cross of Idaho policies sold on the Your Health Idaho Exchange considers EIRMC as “Out-of-Network.”  


This change does not impact patients on Blue Cross plans secured through their employer; it only affects patients who’ve purchased the Your Health Idaho Exchange Blue Cross insurance product.


Simply put, healthcare options are severely limited for people who purchase the Blue Cross of Idaho Health Exchange products for 2017. EIRMC is the only hospital  in Idaho Falls with emergency services (ER), intensive care (ICU), Level III neonatal intensive care (NICU), cardiac heart surgery/interventional heart procedures (cardiac catheterization for heart disease), and many other services.


Many of these services cannot be planned for, and require immediate medical treatment.  EIRMC’s “out of network” status will result in significantly higher out-of-pocket costs for these patients. 


The good news is there are many other insurance plans that can be purchased on the Your Health Idaho Exchange that consider EIRMC as an “in network” provider. 


In fact, there are several products that are less expensive than Blue Cross and provide more healthcare options and greater access.  These plans include:

·         Regence BlueShield (BridgeSpan)

·         SelectHealth

·         PacificSource

·         Mountain Health Co-Op


Our team has worked very hard over the years to expand the number of health plans that include EIRMC as a participating provider. Ultimately, our goal is to provide your patients with unlimited access to quality health care delivered at Eastern Idaho Regional Medical Center.


If asked, we hope you will inform your patients of other available healthcare plans that provide access to EIRMC. Blue Cross has notified their current plan enrollees that their policies will auto-renew unless action is taken by Dec. 15.  


You are welcome to talk with Dr. Peterson and our staff for advice about the upcoming change. 



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