About 85,800 people in the St. Louis area who have Medicare Advantage through Aetna or Anthem will see BJC HealthCare hospitals and Washington University physicians leave their plan networks on Jan. 1, 2027. The contract talks ended without a deal. Anyone who wants to keep using those doctors and hospitals at in-network prices has until Dec. 7 to move to a plan that covers them.
The count comes from federal enrollment data reported by Live Insurance News. Aetna has just over 72,000 Medicare Advantage enrollees across the 15-county Missouri and Illinois metro area, and Anthem has about 13,800, nearly all on the Missouri side. The 85,800 total is that outlet’s sum of the two.
Who loses what on Jan. 1
BJC says on its Medicare page that BJC physicians, other BJC providers and BJC hospitals will be out of network for Aetna and Anthem Medicare Advantage plans starting Jan. 1, 2027. BJC says it made the decision after years of unresolved administrative and payment problems. BJC spokesperson Laura High said the system could not reach a satisfactory agreement with the plans…