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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 

 

 

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Patient FAQs: Transition-of-Care

For non-NYP employees & retirees.

 

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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.

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.

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.

Health care professionals including doctors, physical therapists, occupational therapists, speech therapists, and agencies that provide skilled home care services, such as visiting nurses, may be covered.

In most cases, transition-of-care coverage lasts up to 90 days, however, this can vary based on your condition. Aetna will send you a letter (via U.S. Mail) that will notify you if your request has been approved or denied. If approved, the letter will also include information regarding how long your coverage will last.

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.

Please reach out to your provider’s office to request the Aetna Transition Coverage Request form. You will need to work with your care team to complete this form and submit it to Aetna.

Yes, you will need to apply for transition-of-care coverage for each impacted provider you receive care from.

The following NewYork-Presbyterian Hospitals and organizations are affected by these 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