Critical Network Updates:
Main Line Health,
The Ohio State University Health System,
Lifeline Medical Associates
In This Edition:
- Main Line Health (SEPA): Out-of-Network for Highmark MA Members Effective January 1, 2025
- The Ohio State University Health System (OH): Out-of-Network for Highmark MA Members Effective January 1, 2025
- Lifeline Medical Associates (DE): Negotiations Ongoing, Out-of-Network Date for Highmark ACA Members Extended to March 2, 2025
- Contacts and Additional Resources
Effective January 1, 2025, Highmark Medicare Advantage members no longer have in-network access to Main Line Health physicians and facilities.
Members impacted by this disruption received communications from Highmark in early October, alerting them to the possibility of Main Line Health going out-of-network. Members who have questions about continuity of care or finding an alternative in-network provider or facility should call the member services number on the back of their ID card.
Main Line Health is still in-network for Highmark’s FEP, ACA, and CHIP members.
Anthem, a large Blue Cross Blue Shield Plan in the mid-west and western US, has notified us that The Ohio State University Health System is no longer in its Medicare Advantage network, effective January 1, 2025. This contract termination affects Medicare Advantage members only.
Since an agreement could not be reached, The Ohio State University Health System became out of network for Anthem’s Medicare Advantage PPO network on January 1, 2025. Since Highmark members have in-network access to facilities that contract with Blue Cross Blue Shield Plans nationwide, this means The Ohio State University Health System is now considered out-of-network for Highmark’s Medicare Advantage members.
Members who have questions about continuity of care or finding an alternative in-network provider or facility should call the member services number on the back of their ID card.
Last month, we communicated about Lifeline Medical Associates, a women’s health provider with locations in Delaware, requesting to terminate from our Commercial, FEP, and ACA networks. At that time, we indicated the termination would likely be effective February 1, 2025.
At this time, contract negotiations are ongoing. We have signed a 30-day contract extension with Lifeline, moving their out-of-network date from February 1, 2025 to March 2, 2025.
We will continue to provide updates on these negotiations as soon as they become available.
The information on this website is for agent use only and not intended for the general public.
