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What Methodist's split with Blue Cross Blue Shield of Tennessee means for those under their coverage

Those with Blue Cross Blue Shield of Tennessee will no longer be covered at several Methodist-Le Bonheur Health Care locations.

MEMPHIS, Tenn. — After failing to reach an agreement, several Memphians may need to seek different health care options.  For those with Blue Cross Blue Shield of Tennessee you will no longer be covered at several Methodist Le Bonheur Health Care locations.  The two entities had been in negotiations for over a month, but did not finalize a new contract by the Dec. 31 deadline.

The following locations have been removed from Blue Cross Blue Shield of Tennessee networks including Blue Network P, Bluecare Tennessee, TennCare Select, Cover Kids and The Dual Special Needs Plan:

  • Methodist University Hospital - 1265 Union Ave, Memphis, TN

  • Methodist Healthcare – Germantown  - 7691 Poplar Ave, Germantown, TN

  • Methodist Healthcare – North Hospital - 3960 New Covington Pike, Memphis, TN

  • Methodist Healthcare – Olive Branch Hospital - 4250 Bethel Rd, Olive Branch, MS

  • Methodist Healthcare – South Hospital - 1300 Wesley Dr, Memphis, TN

  • Methodist Blood and Marrow Transplant Center - 2 Shorb Tower, 1265 Union Ave, Memphis, TN

  • Methodist Comprehensive Breast Center – Germantown and Midtown locations - 1381 S Germantown Rd, Germantown, TN & 1801 Union Ave, Memphis, TN

  • Methodist Le Bonheur Children’s Hospital - 848 Adams Ave, Memphis, TN

  • Methodist Le Bonheur Germantown  - 7691 Poplar Ave, Germantown, TN

  • Methodist Le Bonheur Germantown Surgery Center - 1363 S Germantown Rd, Germantown, TN

  • Wolf River Surgery Center (effective Oct. 23, 2023) 

Methodist Le Bonheur Children’s Hospital and Methodist Le Bonheur Germantown have also been removed from Blue Network S.

While Methodist facilities will no longer be covered, the doctors employed at MLH will still be in network, so it could be possible to see them at a different hospital.

Blue Cross says a new contract was needed because the rates Methodist Le Bonheur Healthcare system charged were significantly higher than their average rates for facilities in the Memphis area - and in the case of the Methodist Le Bonheur Children’s Hospital, their rates were the highest of any children’s hospital in Tennessee by far.  The insurance company adds it hopes to find a solution that would bring the children’s hospital and the Germantown location back to both Network P and Network S.

However, several facilities have already been removed from Network S permanently, including Methodist Alliance Home Care Services, Home Medical Equipment, Methodist Healthcare Minor Medical Centers, and Methodist Le Bonheur Germantown. Wolf River Surgery Center will join these facilities starting October 23rd and Methodist Alliance Hospice will do so starting October 31st.

Methodist released it’s own statement saying MLH has absorbed major cost increases between the pandemic, inflation, labor shortages and supply chain disruptions. MLH claims it offered Blue Cross a deep discount to keep patients in-network, but says Blue Cross refused the offers and made unreasonable demands.

If you have a procedure or surgery scheduled for 2023, the healthcare system asks you to contact Blue Cross Blue Shield to see if your procedure or surgery will still be considered in-network. Methodist says this change will only affect those covered by Blue Cross Blue Shield of Tennessee, and not by other states.

Blue Cross Blue Shield is asking coverage members currently being treated at Methodist facilities to call the health insurance provider using the number on the back of their member ID to help figure out their care moving forward.

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