Any Highmark customers with UPMC doctors?

My doctors are all at Magee also, so I'am in the same boat you are. Don't know what to do yet.

You do realize this is a problem that only people who live in the SW Pa region will have any clue what you are talking about, don't you ?

For those others -- there is a sorta war going on in the SW Pa. region between the insurance side of the University pf Pittsburgh Medical Center - they are a group of hospitals and an insurance company too - can you say conflict of interest? and the Highmark Blue cross and Blue shield co and the much smaller hospitals they own - yes, own, in Pittsburgh. At this point , after about 3 years of squabbling they are each refusing to take each others insurance. Add to it that UPMC requires their doctors to be exclusive to them so the docs can't straddle the line. The state insurance commissioner should have stepped into this a long time ago but has not - most people feel he is in UPMC's back pocket. Those on medicare are more fortunate because the feds say that all medicare hospitals have to take ALL medicare patients so this does not apply to them, but for the remainder of the population it is a huge mess. UPMC is a big fish in the small pond and thought they would put BC/BS out of town but BC/BS is a huge national company so they have chosen to fight back and committed their resources to this.The people of SW Pa. atre really caught in the middle of the mess. I had the misfortune to work for UPMC - a horrid place to wortk - the final 10 years of my career because they were , in fact almost successful at putting the hospital where I was working out of business.

If I lived in Pittsburgh area and I was able to I would switch to UPMC simply because they would give you access to more facilities and doctors.

One would hope when they get a new governor in Pa he would appoint a new insurance commissioner and that person would straighten this mess out. Allowing hospital systems to own ins co and ins co to own hospital systems is ridiculous.

On 10/24/2014 Luv My Cresties said: Frankie, I am in the same boat too. I live in NW PA and have Federal Emp. BC/BS. I AM 62 and have Medicare as my primary, BC/BS as the secondary. I have MS (reason for the Medicare). Last week I received a letter from BC/BS stating that my Neurologist was under UPMC and as of 01/15 she would not be covered. Off to the right of the letter, they showed recommendations of whom to see instead. Their suggestions were all Cardiac specialists. Hmmm...so I should see them for my MS? I wonder how well that will go?

If i were you i would call them because MEDICARE says that in order for any doctor or facility to be a medicare provider they are REQUIRED to take any medicare patient regardless of their secondary insurance. That's why UPMC puts ads on TV all the time saying they take medicare patients no matter what their secoindary ins is - because the feds are making them.

On 10/24/2014 happy housewife said:

You do realize this is a problem that only people who live in the SW Pa region will have any clue what you are talking about, don't you ?

For those others -- there is a sorta war going on in the SW Pa. region between the insurance side of the University pf Pittsburgh Medical Center - they are a group of hospitals and an insurance company too - can you say conflict of interest? and the Highmark Blue cross and Blue shield co and the much smaller hospitals they own - yes, own, in Pittsburgh. At this point , after about 3 years of squabbling they are each refusing to take each others insurance. Add to it that UPMC requires their doctors to be exclusive to them so the docs can't straddle the line. The state insurance commissioner should have stepped into this a long time ago but has not - most people feel he is in UPMC's back pocket. Those on medicare are more fortunate because the feds say that all medicare hospitals have to take ALL medicare patients so this does not apply to them, but for the remainder of the population it is a huge mess. UPMC is a big fish in the small pond and thought they would put BC/BS out of town but BC/BS is a huge national company so they have chosen to fight back and committed their resources to this.The people of SW Pa. atre really caught in the middle of the mess. I had the misfortune to work for UPMC - a horrid place to wortk - the final 10 years of my career because they were , in fact almost successful at putting the hospital where I was working out of business.

I wanted to add to this - the Childrens Hospital in Pittsburgh is a UPMC hospital so that complicates it for parents with children who have BC/BS from their employer.

On 10/24/2014 happy housewife said:

On 10/24/2014 happy housewife said:

You do realize this is a problem that only people who live in the SW Pa region will have any clue what you are talking about, don't you ?

For those others -- there is a sorta war going on in the SW Pa. region between the insurance side of the University pf Pittsburgh Medical Center - they are a group of hospitals and an insurance company too - can you say conflict of interest? and the Highmark Blue cross and Blue shield co and the much smaller hospitals they own - yes, own, in Pittsburgh. At this point , after about 3 years of squabbling they are each refusing to take each others insurance. Add to it that UPMC requires their doctors to be exclusive to them so the docs can't straddle the line. The state insurance commissioner should have stepped into this a long time ago but has not - most people feel he is in UPMC's back pocket. Those on medicare are more fortunate because the feds say that all medicare hospitals have to take ALL medicare patients so this does not apply to them, but for the remainder of the population it is a huge mess. UPMC is a big fish in the small pond and thought they would put BC/BS out of town but BC/BS is a huge national company so they have chosen to fight back and committed their resources to this.The people of SW Pa. atre really caught in the middle of the mess. I had the misfortune to work for UPMC - a horrid place to wortk - the final 10 years of my career because they were , in fact almost successful at putting the hospital where I was working out of business.

I wanted to add to this - the Childrens Hospital in Pittsburgh is a UPMC hospital so that complicates it for parents with children who have BC/BS from their employer.

Yes, Childrens is a UPMC Hospital, but they will still take Highmark. Contract with them goes until 2022.

What makes me made are the commericals telling you to have your employer change to UPMC. Like an employee has that authority. I currently have UPMC my employer; but they won't even give us a quote for 2015. To high of usage by employees.

It does make me made that the governor and nobody in the legislator will do anything about this. The ones that are going to lose are the consumers.

Thanks everyone. If I could switch to UPMC I would - can't 'till I'm Medicare eligible. I can switch to Aetna which UPMC will accept. Not sure what to do yet. But I'm leaning toward just switching doctors. Then switching back when I can get UPMC insurance. I love Magee - hate to give them up though.