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NewYork-Presbyterian and Aetna Reach an Agreement

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Dear Valued Patient,

Thank you for entrusting NewYork-Presbyterian with what matters most—your health and well-being.

We are pleased to share that we have reached an agreement with your insurance provider, Aetna. This means the high-quality care provided by NewYork-Presbyterian Hospitals and NewYork-Presbyterian Medical Group clinical practices will continue to be covered as in-network with no interruption to your care. In-network care will also continue with the organizations listed below, as well as with ColumbiaDoctors and Weill Cornell Medicine.

We understand the last few weeks of this negotiation may have created frustration and uncertainty. We thank you for your support during this time and for trusting us with your care.

Sincerely,

Brian Donley, MD

Executive Vice President & Chief Operating Officer

 

The following NewYork-Presbyterian Hospitals and organizations will remain in-network for Aetna members:

  • NewYork-Presbyterian Hospital
    • NewYork-Presbyterian/Columbia University Irving Medical Center
    • NewYork-Presbyterian/Weill Cornell Medical Center
    • NewYork-Presbyterian Allen Hospital
    • NewYork-Presbyterian Brooklyn Methodist Hospital
    • NewYork-Presbyterian Lower Manhattan Hospital
    • NewYork-Presbyterian Morgan Stanley Children's Hospital
    • NewYork-Presbyterian Westchester (formerly known as Lawrence Hospital)
  • NewYork-Presbyterian Hudson Valley Hospital
  • NewYork-Presbyterian Medical Groups (Brooklyn, Hudson Valley, Queens, Westchester)
  • NewYork-Presbyterian Queens
  • NewYork-Presbyterian Westchester Behavioral Health Center
  • ColumbiaDoctors/NewYork-Presbyterian Imaging
  • Gracie Square Hospital
  • Lawrence Home Care of Westchester
  • Main Street Radiology Bayside
  • The Rogosin Institute
  • The Silvercrest Center for Nursing and Rehabilitation
  • Weill Cornell Imaging at NewYork-Presbyterian 

 

 

Patient Frequently Asked Questions

For non-NYP employees & retirees.


Please note that some of the dates referenced in the downloadable versions of the FAQ may have changed. Please refer to the latest information provided in the answers below.

 

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NewYork-Presbyterian is currently negotiating with Aetna on a contract that covers how they pay our hospitals and medical practices. The contract being negotiated is for several Aetna lines of business including commercial (employer-sponsored and professional employment organizations) and Medicare Advantage health plans. The outcome of these negotiations may affect patients who have Aetna health insurance and seek care at NewYork-Presbyterian Hospitals as well as from clinical practices that are part of the NewYork-Presbyterian Medical Groups.

Contract negotiations between health insurance companies and healthcare providers are a common part of operations, and we initiated talks with Aetna well before the contract end date. So far, Aetna has presented an unreasonable offer and if we are unable to reach an agreement, how Aetna covers services provided by NewYork-Presbyterian Hospitals as well as NewYork-Presbyterian Medical Group clinical practices would be impacted. Our request of Aetna is simple. We need them to recognize the value that NewYork-Presbyterian provides to our patients and the communities we serve, whether they rely on government-subsidized programs, have commercial insurance, or are underinsured or uninsured. We remain hopeful that Aetna will continue to engage in good faith negotiations to reach a reasonable offer that puts patients first.

If we are unable to reach an agreement by March 31, starting April 1, 2024, all NewYork-Presbyterian Hospitals and its clinical practices that are part of the NewYork-Presbyterian Medical Groups will be considered out-of-network providers for Aetna members. Until then, nothing changes for our patients with Aetna health insurance. Their in-network benefits will apply to all NewYork-Presbyterian Hospitals as well as ColumbiaDoctors, Weill Cornell Medicine, and NewYork-Presbyterian Medical Group clinical practices. We are doing everything we can to reach an agreement with Aetna before our current contract expires. Please note that care from ColumbiaDoctors and Weill Cornell Medicine providers is not immediately impacted by the April 1, 2024 expiration regardless of their office location. Their care will be delivered in-network through June 30, 2024.

These negotiations specifically affect our patients with Aetna health insurance, including those with commercial (employer-sponsored and professional employment organizations) and Medicare Advantage health plans. If we are forced out of Aetna’s network, your in-network coverage at NewYork-Presbyterian Hospitals and NewYork-Presbyterian Medical Group clinical practices for non-emergency services may be affected. You may be forced to pay higher out-of-pocket costs or have no coverage at all.

Employees, retirees, and students enrolled in Aetna medical and/or dental plans with these organizations will receive separate communications. As always, you can contact human resources teams or student health insurance offices for more information.

At this time, there is no change in your health insurance coverage from Aetna. You still have in-network coverage at the locations and with providers currently accepting Aetna through March 31, 2024. We hope to reach a mutually acceptable agreement between Aetna and NewYork-Presbyterian that will benefit everyone before then. Your in-network coverage will only change as of April 1, 2024 if we are unable to reach an agreement, at which time NewYork-Presbyterian Hospitals and clinical practices that are part of the NewYork-Presbyterian Medical Groups may be considered out-of-network providers for Aetna members. Please note that care from ColumbiaDoctors and Weill Cornell Medicine providers is not immediately impacted by the April 1, 2024 expiration regardless of their office location. Their care will be delivered in-network through June 30, 2024.

If you believe that you are experiencing a medical emergency, you can always seek care at one of our emergency rooms which will be covered as an in-network service regardless of our contract status with Aetna.

NewYork-Presbyterian Hospitals and clinical practices that are part of the NewYork-Presbyterian Medical Groups participate with many other health insurance plans. If you are receiving care from one of the impacted locations listed below or from a medical group, you may have the option of choosing a different health insurance plan in which we participate.

Aetna has made an unreasonable proposal at a time of rising costs. We believe that Aetna has failed to recognize the unique value that NewYork-Presbyterian provides to our patients and the communities in which they live and work. Our patients, whether they rely on government-subsidized programs, or have commercial insurance, are underinsured or uninsured, know that they can rely on us. NewYork-Presbyterian is one of New York’s largest non-profit hospital systems and one of its leading sources of community support, providing more than $2.1 billion in benefits in 2022 to the remarkably diverse communities we serve.

Any care or service that has received pre-authorization from Aetna and is scheduled on or after April 1 will be considered in-network if completed within 6 months from the date of pre-authorization issuance from Aetna. Additionally, Aetna will continue to pre-authorize medically necessary services through March 31 for all impacted locations and clinical practices listed below with the pre-authorization also remaining valid for 6 months from the date of issuance. You may want to contact your doctor’s office to see if your appointment can be rescheduled ahead of April 1.

It is important to know that for now, you can continue to seek care as you normally would with your doctors. However, if we are forced out of Aetna’s network, you may no longer have in-network coverage at the locations and doctor practices listed below and for non-emergency services, you may be forced to pay higher out-of-pocket costs. Please note that care from ColumbiaDoctors and Weill Cornell Medicine providers is not immediately impacted by the April 1, 2024 expiration regardless of their office location. Their care will be delivered in-network through June 30, 2024.

The following NewYork-Presbyterian Healthcare System Hospitals (NYPHS) and organizations are affected by these contract negotiations:

  • NewYork-Presbyterian Hospital
    • NewYork-Presbyterian/Columbia University Irving Medical Center
    • NewYork-Presbyterian/Weill Cornell Medical Center
    • NewYork-Presbyterian Allen Hospital
    • NewYork-Presbyterian Brooklyn Methodist Hospital
    • NewYork-Presbyterian Lower Manhattan Hospital
    • NewYork-Presbyterian Morgan Stanley Children's Hospital
    • NewYork-Presbyterian Westchester (formerly known as Lawrence Hospital)
  • NewYork-Presbyterian Hudson Valley Hospital
  • NewYork-Presbyterian Medical Groups (Brooklyn, Hudson Valley, Queens, Westchester)
  • NewYork-Presbyterian Queens
  • NewYork-Presbyterian Westchester Behavioral Health Center
  • ColumbiaDoctors/NewYork-Presbyterian Imaging
  • Gracie Square Hospital
  • Lawrence Home Care of Westchester
  • Main Street Radiology Bayside
  • The Rogosin Institute
  • The Silvercrest Center for Nursing and Rehabilitation
  • Weill Cornell Imaging at NewYork-Presbyterian  

Please note that care from ColumbiaDoctors and Weill Cornell Medicine providers is not immediately impacted by the April 1, 2024 expiration regardless of their office location. Their care will be delivered in-network through June 30, 2024.

Certain patients, including those who are hospitalized, pregnant, or undergoing an active course of treatment prior to the contract end date, may qualify for transition-of-care coverage through Aetna. If you think you may qualify, you will need to complete an Aetna Transition Coverage Request form with your provider. Please reach out to your provider’s office to learn more.

Before the expiration date, your appointments will continue as scheduled. Afterwards, if you have out-of-network benefits, you may have additional coverage options for continuing your treatments. You should contact Aetna, or your employer, and confirm if you have out-of-network benefits and what they are. If you do not have out-of-network benefits, you may qualify for up to 90-day transition-of-care coverage from Aetna. Contact Aetna for additional information.

Please note that care from ColumbiaDoctors and Weill Cornell Medicine providers is not immediately impacted by the April 1, 2024 expiration regardless of their office location. Their care will be delivered in-network through June 30, 2024.

Transition-of-care coverage temporarily allows patients who are actively receiving treatment for a condition, and whose doctor is no longer part of Aetna’s network*, to continue their care as in-network. This may include, but is not limited to, individuals who are:

  • Current in-patients
  • Pregnant
  • Undergoing cancer treatment
  • Have undergone an organ, bone marrow, or tissue transplantation
  • Are receiving care for ongoing mental illness or substance abuse
  • Have recently had surgery, or need more than one surgery to treat their condition
  • Part of therapeutic clinical trials
  • In treatment for a disabling, terminal, or congenital illness

If you think you may qualify, you will need to complete an Aetna Transition Coverage Request form with your provider. Please reach out to your provider’s office to learn more. The form must be submitted to Aetna within 90 days of the date your health care provider is no longer part of the Aetna network.

*Please note that outpatient in-office care from ColumbiaDoctors and Weill Cornell Medicine providers is not immediately affected by the April 1 expiration regardless of their office location. Outpatient in-office care will be covered as in-network through June 30, with some exceptions.

Patients will always have access to our emergency rooms in a medical emergency and will be covered as an in-network service regardless of our contract status with Aetna. Patients needing emergency care are entitled to coverage for emergency treatment plus any hospitalization that follows.

If you are a patient at the hospital prior to April 1, 2024, you will be covered at in-network rates through the end of your inpatient stay.

Commercial (employer-sponsored and professional employment organization) Patients:

NewYork-Presbyterian Hospitals and clinical practices that are part of the NewYork-Presbyterian Medical Groups participate with many other health insurance plans. You can talk to your employer today to see if there are alternative health insurance options available to you that will continue your in-network coverage. NewYork-Presbyterian is currently in network with the following commercial health plans and companies:

CignaMultiplan/PHCS
Emblem Health (HIP/GHI)MVP Health Care
Empire Blue Cross Blue ShieldOxford
Great West HealthcareUnited Healthcare
Magnacare 

Not all of the above-mentioned health insurance plans and companies are accepted at all NewYork-Presbyterian locations and affiliated practices. Please check with your doctor’s office to determine which plans they participate in.

 

Medicare Advantage Patients: 

NewYork-Presbyterian Hospitals and clinical practices that are part of the NewYork-Presbyterian Medical Groups participate with numerous Medicare Advantage plans. We are currently in the middle of the Annual Medicare Advantage Open Enrollment Period for those already enrolled in a Plan, which is January 1st through March 31st. In order to continue your in-network coverage, you may want to consider choosing coverage from one of the following health insurance companies currently contracted:

Mainstream Plan Providers 
Emblem Health (HIP/GHI)
Empire Blue Cross Blue Shield
Fidelis
Healthfirst
MVP Health Care
Oxford
United Healthcare
Wellcare

Not all of the above-mentioned health insurance plans and companies are accepted at all NewYork-Presbyterian locations and affiliated practices. Please check with your doctor’s office to determine which plans they participate in.

We will continue to keep our patients and communities informed as our negotiations progress with Aetna. For the most up-to-date information, we encourage you to visit www.nyp.org/aetna. If you have additional questions or want to speak with one of our representatives, please call (646) 697-2386 or email us at [email protected]. We thank you for trusting us with your care.