Accepted Insurance Plan Changes for 2024

VUMC and BCBSTN have reached a mutual agreement to discontinue in-network care for patients insured through the BCBSTN Medicare Advantage – Blue Advantage plans. 

Patients in the BCBSTN MA – Blue Advantage plans will be out of network with VUMC and its affiliated entities after December 31, 2024. 

You may continue to access and receive care at any of VUMC’s hospitals, clinics, or other affiliated facilities until December 31, 2024.

After December 31, 2024, affected VUMC facilities and several of our affiliated partners will no longer participate in the BCBSTN Medicare Advantage Blue Advantage plans. You may continue to access and receive care at any of VUMC’s hospitals, clinics, or other facilities through your existing Medicare Advantage plans until this date.   

• Please note: BCBSTN MA plans do not have out of network benefits and therefore, if a patient chooses to continue treatment at VUMC facilities or clinics for non-EMTALA services, the patient will be completely responsible for payment of the claims. 
   
• Patients will be notified by letter from both BCBSTN and VUMC regarding this change. VUMC is partnering with BCBSTN to help our patients find new healthcare providers, to ensure they continue to have access to quality care through various alternative plans so they may remain seeing in-network providers. 
   
• If you did not receive a letter from VUMC, it is available on our website: VUMCMedicareAdvantage.com

After December 31, 2024, the following VUMC hospitals and affiliated partners will no longer be covered by BCBSTN Medicare Advantage plans:  

• Vanderbilt University Medical Center  
• Vanderbilt Psychiatric Hospital  
• Vanderbilt Wilson County Hospital  
• Vanderbilt Bedford County Hospital  
• Vanderbilt Tullahoma-Harton Hospital  
• Vanderbilt Home Care Services  
• Vanderbilt Dialysis Centers  
• Vanderbilt Cool Springs Surgery Center  
• Spring Hill Surgery Center  
• Vanderbilt Imaging Services 
• Vanderbilt-Ingram Cancer Center at Tennova Healthcare – Clarksville (radiation oncology) 
• Vanderbilt-Ingram Cancer Center at Maury Regional Spring Hill (radiation oncology) 
• All VUMC and affiliated Walk-in Clinic locations

Only the plan outlined above - BCBSTN Medicare Advantage is affected.

If you have BCBSTN's BlueCare Plan (TennCare), nothing changes for you.

If you have the Blue Cross Commercial plan, nothing changes for you.

Yes.

Transplant patients insured through BCBSTN MA plan, whether they have recently received a transplant or have just been listed, may continue to access Vanderbilt University Hospital and Vanderbilt Medical Group doctors until 12 months after their transplant due to a separate transplant agreement. 

REFER TO THE TRANSPLANT FAQ FOR ADDITIONAL GUIDANCE 

If you have specific questions or need additional information about your transplant care, please contact your specific organ transplant financial counselor.

Vanderbilt may be able to provide for your care for a period of time, until you are formally released from their care. In some situations, there will be continuity of care requirements or a subspecialty service that VUMC alone provides that may extend patient access past January 1. Discuss this need with your provider.

Yes, all Vanderbilt clinicians, physicians, and advanced nurse practitioners, are affected. Community physicians who perform procedures at any impacted facilities may be affected too.

Contact your insurance broker or benefits adviser for more information about Medicare plans and this year’s Open Enrollment period. Your broker or advisor is the best person to discuss with you options to consider which your needs. That is their area of expertise. As a patient care provider, Vanderbilt Health is not able to guide you in this decision. 

• For questions on other types of insurance coverage – please contact your broker 
   
• To schedule an appointment with your existing provider before January 1 – we will transfer you now to the appropriate clinic for assistance in scheduling

Open Enrollment begins October 15. Medicare Advantage members may make changes to your Medicare Advantage plan by December 7. Contact your insurance broker or benefits adviser to find a new Medicare plan that has Vanderbilt in its network.     

If you are affected by this change and wish to continue to receive care at VUMC, VUMC is in network with the following Medicare and Medicare Advantage plans:  

• Traditional Medicare  
• Aetna Medicare Advantage  
• Cigna HealthSpring Medicare Advantage  
• Farm Bureau Medicare Advantage  
• UnitedHealthcare Medicare Advantage

You may visit our website at VUMCMedicareAdvantage.com or call our patient assistance line at 1-855-429-2989 if you have questions.

Patients may request a transfer of their medical records to another in-network provider by either:

• Following instructions located on the website: VUMCMedicareAdvantage.com
  • VUMC now offers an online process for the release of information
  • Access the website and select the option titled "Request your Medical Records"
     
• Accessing information in MHAV (My Health at Vanderbilt) using the app or MHAV website.
  • Select "Request My Records" from the menu list
     
• Calling the Medical Records Main Call Center at 1-615-322-2062
  • Hours of operation are M-F 8am - 4:30pm CST
  • A fee is required for requests filled for a treating provider after normal hours of operation
     
• If you are a patient at one of our affiliated partners, your medical record may be requested by contact them directly:

After December 31, visits to these walk-in clinics would be out of network for any patient with the plans impacted by this change.

For existing patients, please schedule your appointment, as you normally do today, for any appointment prior to January 1.

Please follow our normal process for canceling any existing appointment.

For existing patients, please schedule your appointment, as you normally do today, for any appointment prior to January 1.

For new patients, please schedule your appointment, as you normally do today, for any appointment prior to January 1.

You can also find network providers at bcbstmedicare.com. Just select Find a doctor. 

Or call BCBSTN at 1-800-831-2583, TTY 711, to find a provider near you.

If you you’d like help finding a provider near you or have questions about this change, call BCBSTN at 1-800-831-2583, TTY 711. From Oct. 1 to March 31, you can call seven days a week from 8 a.m. to 9 p.m. ET. From April 1 to Sept. 30, you can call  Monday through Friday from 8 a.m. to 9 p.m. ET.

Open Enrollment begins October 15. Medicare Advantage members may make changes to your Medicare Advantage plan until December 7. Please contact your insurance broker or benefits adviser for more information on your potential options to find a new Medicare plan that has Vanderbilt in its network. 

To help with your decision, VUMC participates with all products of the following Medicare Advantage plans: 

• Cigna HealthSpring Medicare Advantage 
• Farm Bureau Medicare Advantage 
• Aetna Medicare Advantage 
• BlueCross BlueShield Medicare Advantage PPO 
• UnitedHealthcare Medicare Advantage plans

Contact your insurance broker or benefits advisor for more information about Medicare and this year’s Open Enrollment period and to help you find a new Medicare plan that has Vanderbilt in its network. 

To help with your decision, VUMC participates with all products of the following Medicare and Medicare Advantage plans: 

• Traditional Medicare 
• Aetna Medicare Advantage 
• Cigna HealthSpring Medicare Advantage
• Farm Bureau Medicare Advantage 
• UnitedHealthcare Medicare Advantage

Traditional Medicare - often known as Medicare Part A & B will offer the widest and easiest access to care. 

With traditional Medicare coverage, you can choose any providers who accept Medicare. You don’t need a referral to see a specialist and you don’t have to worry about your doctor leaving the plan’s network. With traditional Medicare, you can pick up a “Medi-Gap” or “Supplemental” plan to assist in coverage of your co-insurance responsibilities. You can also pick from several options to support your medication needs known as “Part-D” coverage. 

Medicare Advantage - plans resemble a private insurance plan that you may have had through an employer. The most common types are health maintenance organization (HMO) and preferred provider organization (PPO) plans. Medicare Advantage plans use preferred networks that may limit your ability to see your preferred physician and may require referrals from your primary care physicians before receiving care from a specialist. Medicare advantage plans will have medication coverage included and most often come with a set deductible rather than co-insurance. 

Both traditional Medicare and Medicare Advantage plans will come with a “premium” for most participants. It is important to compare the cost of additional components such as your Part-D coverage and Supplemental coverage along with your access options when comparing traditional Medicare and Medicare Advantage plans.

BCBSTN has provided members with a Continuity of Care form to make requests for continued treatment for a limited time at VUMC. BCBSTN will review the request and communicate with the patient whether they qualify for continued care at VUMC. These directions are included in the letter BCBSTN will send to the member.

Yes, for a period of time, until you are released from care by your provider.

If you have specific questions or need additional information about your transplant care, please contact your specific organ transplant financial counselor.

Vanderbilt may be able to provide for your care for a period of time, until you are formally released from their care. In some situations, there will be continuity of care requirements or a subspecialty service that VUMC alone provides that may extend patient access past January 1. Discuss this need with your provider.

They will be treated as in network throughout the continuity of care period until formally released from care or transitioned to another provider on a case-by-case basis. Discuss with your provider.

You may visit our website at VUMCMedicareAdvantage.com or call BCBSTN 1-800-831-2583, TTY 711.

If you think you have a medical emergency, please go to the closest emergency room.

Our emergency departments provide lifesaving and stabilizing care to all patients in an emergency, no matter what your insurance is or if you're able to pay.

While we do not expect prescriptions written by VUMC providers to be impacted, you may verify prescription drug coverage by contacting Vanderbilt Pharmacy at 615-322-6480 for retail prescriptions and Vanderbilt Specialty Pharmacy at 615-875-0080 for specialty medications. You may also reach out to your pharmacists via My Health at Vanderbilt.

No. Unfortunately, VUMC pharmacy is only able to fill prescriptions written by VUMC providers.

Please contact our VUMC Patient Relations Department at 615-936-6154. 

Office hours are 8am – 5pm, Monday – Friday.