The contract between Dameron Hospital and Health Net will be terminated July 31, 2024.
As a result, Dameron Hospital will no longer be an in-network provider for all Health Net plan members effective August 1, 2024. This contract termination applies to Commercial and MediCal Health Net members. Please review Dameron’s website (Accepted Insurances) to see alternative health plans you can select for your care and continued to access Dameron Hospital.
Your continued access to health care is important to us. We have created a list of frequently asked questions (FAQ) below with information regarding the contract termination and your options surrounding continuity of care.
We are saddened that we were unable to come to an equitable resolution with Health Net and wish you the best in your healthcare journey. Thank you for trusting Dameron Hospital with your care—it has been an honor to serve you.
Dameron Hospital – Health Net Contract
Frequently Asked Questions
Q: What has happened between Dameron Hospital and Health Net?
A: The contract between Dameron Hospital and Health Net expires July 31, 2024, and a resolution for a new, equitable contract was unable to be reached. As a result, Dameron Hospital will no longer be an in-network provider for all Health Net plan members effective August 1, 2024.
Q: Why weren’t you able to come to a resolution with Health Net?
A: To continue to serve as a reliable source for high-quality, convenient care for our community, we need sustainable reimbursement from Health Net and other health insurance companies, especially when healthcare providers across the country are experiencing the crushing weight of rising costs and out-of-control inflation.
While Health Net recognizes the continued surge in costs facing healthcare providers, they are unwilling to pay fairly for the care we provide.
Q: When does the contract with Health Net end?
A: The current contract with Health Net ends on July 31, 2024. Until then, nothing changes for patients with Health Net health insurance. You can continue to access in-network services at Dameron Hospital until July 31, 2024.
Q: Which Health Net health plans are affected by the termination?
A: Health plans affected by the negotiations for the Hospital
- Healthnet Commercial Full Network
- Health Net Commercial Blue/Gold/Smart care
- Health Net Medi-Cal
- Health Net Medicare Advantage
Q: Which Dameron Hospital facilities are impacted by the negotiations?
A: The negotiations cover any care provided by Dameron Hospital.
Q: What if I have an elective procedure scheduled at a Dameron Hospital facility on or after July 31, 2024?
A: We understand that some patients may have appointments scheduled on or after July 31, 2024. If this is the case, you should call your provider or physician’s office to request that the appointment or procedure be rescheduled prior to July 31, if possible. For care that occurs after July 31, you may have to pay higher out-of-pocket costs.
Q: Can I still use Dameron Hospital’s Emergency Room after July 31, 2024?
A: By law, patients always have access to our emergency room, regardless of our contract status with Health Net.
Q: What if I’m in the hospital when the contract ends on July 31, 2024?
A: If you are already admitted to the hospital prior to July 31, 2024, you will be covered at in-network rates through the end of your inpatient stay.
Q: What can I do to ensure I have continued in-network access to Dameron Hospital?
A: Contact your broker. If you have a Medicare Advantage or Exchange plan, you might have chosen the plan through a broker. Ask them about coverage options that will allow you to maintain in-network access to Dameron Hospital.
Speak with your HR or benefits manager at work. If you receive coverage through your employer, ask your HR or benefits manager about alternate or secondary coverage options that will protect your in-network access to Dameron Hospital facilities and providers.
Select a new plan during the upcoming open enrollment period: If you purchase your own insurance from the Health Insurance Exchange, you can select a new plan during California’s upcoming open enrollment period to guarantee your in-network access to Dameron Hospital. To find a full list of in-network health plans, please visit:
https://www.dameronhospital.org/patients-visitors/accepted-insurances/
Q: Will I have to change my provider?
A: Dameron Hospital will be out of Health Net’s network starting August 1, 2024, which may cause you to pay higher out-of-pocket costs when visiting Dameron Hospital.
CONTINUITY OF CARE FAQs
Q: What are Continuity of Care benefits?
A: Certain patients, including those who are hospitalized, or undergoing an active course of treatment prior to the contract expiration date may qualify for Continuity of Care benefits through Health Net. Continuity of Care benefits allow patients to continue receiving medically necessary care from Dameron Hospital and our providers at in-network rates for a designated period of time after July 31, 2024.
Q: What are some examples of services that may be eligible for coverage under Health Net Continuity of Care program after July 31, 2024?
A: Examples of services that may qualify for Continuity of Care benefits include:
- Patients who are hospitalized for a medical or surgical condition on the date of termination or are receiving immediate post-discharge care.
- Patients receiving ongoing outpatient treatment (e.g. cancer care).
- Patients receiving treatment or palliative care for a terminal illness.
Patients can contact Health Net for more details or to determine their eligibility.
Q: How do I apply for Continuity of Care benefits?
A: Patients can call the number on the back of their Health Net health insurance card to request approval from Health Net to continue to receive services under their Continuity of Care program.
Contact Health Net for more details or to determine your eligibility.