To ensure our ability to continue providing quality care to our community, Kimball Health Services, Kimball Health Services Clinic, and Kimball Health Services Pine Bluffs Clinic will no longer be in-network for any Medicare Advantage plan, effective January 1, 2025.
Open enrollment for Traditional Medicare is from October 15 to December 7. We are providing this information to our patients and residents to help them make an informed decision.
Click here to view the notification letter sent to our patients.
A 2022 report from the U.S. Department of Health and Human Services of Inspector General (HHS-OIG) showed that Medicare Advantage plans sometimes denied or delayed patients’ access to medically necessary services, even though the request met Medicare coverage rules. Watch the video below to learn more.
To provide safe and timely care, we can no longer be under contract with plans that may cause delays in patient care, longer hospital stays, and denials of care. Medicare Advantage patients frequently have delayed outpatient care and longer hospital stays due to pre-authorization requirements and denials.
Effective January 1, 2025, Kimball Health Services, Kimball Health Services Clinic, and Kimball Health Services Pine Bluffs Clinic will no longer be in-network for any Medicare Advantage plan.
Patients with Medicare Advantage plans can still schedule visits or procedures with Kimball Health Services after December 31, 2024. However, they will be subject to their plan's out-of-network coverage guidelines. Regardless of insurance or ability to pay, all patients will continue to have access to emergency care through the emergency department.
Patients can continue care with Kimball Health Services by enrolling in Traditional Medicare during the open enrollment period, which occurs annually from October 15 to December 7. Alternatively, patients can receive care subject to their plans' out-of-network coverage guidelines.
We encourage you to contact your local insurance broker to review what Medicare options are best for your specific circumstances. You can also contact the State Health Insurance Program (1.877.839.2675) or call 1.800.MEDICARE.
Local, independent agencies may assist you in reviewing your options and making any changes.
We suggest contacting:
H.E. Ferguson Agency, Inc.
Scottsbluff Nebraska
Ph: 308-632-6915
If you wish to explore your insurance options, we suggest:
Carin Long, local SHIP representative
308-765-5546 or call SHIP (1.877.839.2675) or go to shiphelp.org.
This line is free and open 24/7. Counselors are available to answer questions and provide information about Medicare options.
Alternatively, please call 1.800.MEDICARE or go to medicare.gov to review and enroll in a Traditional Medicare plan.
Recently it has become nor common for hospitals and health systems to move away from accepting Medicare Advantage insurance plans. Below are links to reports that explain in more detail.
Becker’s Hospital Review, December 15, 2023: Hospitals are dropping Medicare Advantage left and right
NBC News, October 31, 2023: 'Deny, deny, deny': By rejecting claims, Medicare Advantage plans threaten rural hospitals and patients, say CEOs
NHA Report, October 2023: Medicare Advantage: Failing Patients and Jeopardizing Nebraska Hospitals
NPR, October 17, 2023: Medicare Advantage keeps growing. Tiny, rural hospitals say that's a huge problem
Kimball Health Services will continue to schedule or allow walk-in appointments for outpatient and elective services on or after the contract ends for patients on the affected Medicare Advantage plans on December 31, 2024.
However, patients with Medicare Advantage plans will be subject to their plan’s out-of-network coverage guidelines. We recommend contacting your health insurance provider directly by calling the phone number on your insurance card to determine specific coverage and payment.
Beginning January 1, 2025, you will be able to continue to schedule visits or procedures with any of the Kimball Health Services providers, but you will be subject to your plan's out-of-network coverage guidelines.
This page is for information purposes only. Patients should thoroughly review their health needs and research insurance products to make their decisions on coverage.
