Thousands of Medicare Advantage patients across Kansas City and St. Louis are being warned that their longtime hospital system will no longer accept their Aetna coverage starting January 1, 2027. BJC HealthCare, which operates in combination with Saint Luke’s in Kansas City, has told Aetna it is pulling back access for Medicare Advantage members, a move that also reaches into Washington University School of Medicine’s physician network and Saint Luke’s facilities in St. Louis.
According to KCTV, the change was confirmed directly to Aetna by BJC HealthCare, and it extends beyond the Kansas City market to affect Washington University School of Medicine physicians and Saint Luke’s operations in St. Louis as well. Saint Luke’s has spelled out the shift in plainer terms on its own website, stating that beginning January 1, 2027, it will no longer participate in Aetna Medicare Advantage plans, and that its physicians and other providers and facilities will be considered out of network for those members once the date hits, according to Saint Luke’s.
Saint Luke’s said the split follows a prolonged effort to find common ground, noting that despite longer-term negotiation efforts, it was unable to achieve a satisfactory agreement with Aetna Medicare Advantage plans. The hospital system added that it expects to remain in-network with Traditional Medicare, most Medicare Supplement or Medigap plans, and other Medicare Advantage plans in 2027, meaning the fallout is specific to Aetna rather than a wholesale Medicare pullback.
Patients Could See Higher Costs
For patients who stay enrolled in an affected Aetna Medicare Advantage plan, Saint Luke’s warns the consequences could hit the wallet. In most cases, the hospital system says, this could result in higher out-of-pocket costs or different coverage rules when a patient seeks care from Saint Luke’s providers after the switch takes effect…