CareFirst Blue Choice dropped Sibley Memorial from network effective today

[Anonymous]

Had a call from Sibley's Sullivan Breast Center that my diagnostic mammogram for next week has been canceled. CareFirst was negotiating with Sibley up until the last minute, couldnt reach agreement, and they are now letting all their scheduled patients know. Mind you my cancer was detected, operated on, radiated, and my breasts reconstructed all at Sibley, and my prescribing doctors and records are all with Sibley/Sullivan. I don't know if the contract failure applies to all of Hopkins Medicine, including JHU Baltimore and Suburban, or just Sibley.

Sure hope no one with BlueChoice was planning to deliver there this month!

[Anonymous]

Oh wow. I have carefirst and my recent breast surgery was at Suburban. And my breast surgeon is through Hopkins. It would be terrible if she were no longer in network!!!

I’m wondering why you need a mammogram if you had double mastectomy (I’m assuming since you said your breasts have been reconstructed)?

[Anonymous]

Is carefirst the same as FepBlue?

[Anonymous]

That is really sh*tty, OP. And crazy - it's a super common carrier. I hope you're able to find providers you like moving forward (and hope the worst is over for you!)

[Anonymous]

OP here - thanks, doing well! Reconstruction was to try and balance the breasts post-treatment (had tumors in both breasts - which the Sibley MRI detected after the first tumor was found). Really disappointed with CF. It also means that doctors I see who have privileges at Sibley won't be able to treat me there because the hospital and outpatient are not covered. I hope they can work something out. A ways back they dropped Children's Hospital from the network, and there was a huge outcry. Not sure there would be as much for Ward 3 access/preferences. They are such a miserly company, while they are sitting on huge assets while claiming to be "non-profit."

[Anonymous]

Yikes. How do we find out more about this? I'm a breast cancer patient and my surgeon, imaging, and radiation oncologist are all thru Hopkins/Suburban. Oncologist is though Maryland Hematology and Oncology. I have BlueChoice Advantage. I just did several searches on the CareFirst website and everybody is still showing up as in network. Including Sibley Hospital.

[Anonymous]

FepBlue is BlueCross BlueShield Federal Employee Program.

[Anonymous]

Anonymous wrote:OP here - thanks, doing well! Reconstruction was to try and balance the breasts post-treatment (had tumors in both breasts - which the Sibley MRI detected after the first tumor was found). Really disappointed with CF. It also means that doctors I see who have privileges at Sibley won't be able to treat me there because the hospital and outpatient are not covered. I hope they can work something out. A ways back they dropped Children's Hospital from the network, and there was a huge outcry. Not sure there would be as much for Ward 3 access/preferences. They are such a miserly company, while they are sitting on huge assets while claiming to be "non-profit."

They dropped Children's? What? That's crazy!

[Anonymous]

This is terrible. My DH works at Sibley and this is our insurance!

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here - thanks, doing well! Reconstruction was to try and balance the breasts post-treatment (had tumors in both breasts - which the Sibley MRI detected after the first tumor was found). Really disappointed with CF. It also means that doctors I see who have privileges at Sibley won't be able to treat me there because the hospital and outpatient are not covered. I hope they can work something out. A ways back they dropped Children's Hospital from the network, and there was a huge outcry. Not sure there would be as much for Ward 3 access/preferences. They are such a miserly company, while they are sitting on huge assets while claiming to be "non-profit."

They dropped Children's? What? That's crazy!

In 2002. It must have been resolved because they're on the list for CNMC now.

I am baffled by this. Sibley has CareFirst as one of the benefits providers to its own employees for 2022. Something doesn't add up.

[Anonymous]

BlueChoice may be different than the regular Carefirst.

[Anonymous]

Anonymous wrote:BlueChoice may be different than the regular Carefirst.

There are like 30 versions of CareFirst plans, no joke. When I was looking at their site and searching for my doctors it had a whole list of all the various iterations of CareFirst plans they accepted, with "Your Network" in parentheses next to one of them. Confusing as all get-out.

[Anonymous]

Anonymous wrote:

Anonymous wrote:BlueChoice may be different than the regular Carefirst.

There are like 30 versions of CareFirst plans, no joke. When I was looking at their site and searching for my doctors it had a whole list of all the various iterations of CareFirst plans they accepted, with "Your Network" in parentheses next to one of them. Confusing as all get-out.

This. OP is having issues with their very specific plan and this most likely doesn’t affect those who don’t have the same employer.

[Anonymous]

Anonymous wrote:BlueChoice may be different than the regular Carefirst.

It is—it’s an HMO.

[Anonymous]

Blue Choice is Care First’s HMO. For those that have been around a while, it is the old CapitalCare.