You deserve the best - Hutchinson, we are your partner in health.

Hutchinson Clinic going out of network on Jan. 1, 2025

Updated on November 6, 2024

Our members deserve the best and with nearly 100% of providers in network, we are committed to being your partner in health. We are disappointed with the Hutchinson Clinic’s decision to terminate their contract with Blue Cross and Blue Shield of Kansas (BCBSKS), effective Jan. 1, 2025, but our focus is on ensuring you, our members, have the care you need from providers you trust.

Our Customer Service Center representatives are available to assist you in locating a new, in-network provider by calling the number on the back of your member ID card.

Please note that there is no impact to Medicare Supplement members as they can go to any doctor or hospital that accepts Medicare. For Medicare Advantage there is no change, Hutchison Clinic continues to be out of network.

    Why didn’t you negotiate with Hutchinson Clinic?

    Hutchinson Clinic chose to leave the BCBSKS network. BCBSKS is willing to continue discussions with Hutchinson Clinic to keep them as an in-network provider. However, Hutchinson Clinic is asking for reimbursement rates that are higher than any other similar provider in the state. As champions for our members, we advocate for high-quality, cost-effective health care that gives providers a fair margin and enables us to offer competitively priced coverage to employers and members. BCBSKS cannot agree to their requested rates. Our reimbursement rates are the same for all professional providers of the same licensure across the state. We also include additional reimbursement opportunities for those who meet higher quality metrics. We communicate with providers in July regarding reimbursement rates. Providers then have until Sept. 3 to choose whether they want to remain in our network. This is the standard, annual contract procedure.

    How will this impact my access to care?

    BCBSKS is committed to helping our members have broad access to affordable, quality health care choices close to home. Beginning Jan. 1, 2025, Hutchinson Clinic will be considered out-of-network for BCBSKS members.

    • BCBSKS members can still access in-network care at Hutchinson Clinic through Dec. 31, 2024.
    • Please review your policy for out-of-network coverage details that would apply to the Hutchinson Clinic beginning Jan. 1, 2025.
    • Please review your Summary of Benefits and Coverage so you know what your responsibilities will be and whether your plan includes out-of-network coverage.
      • If your plan does have out-of-network coverage, BCBSKS will reimburse the member for any covered services you receive according to your benefits and you’ll pay the provider directly, in addition to any deductibles, coinsurance or copayments. You may be billed more than what BCBSKS reimburses.
      • If your plan doesn’t include out-of-network services, you’ll owe 100% of the charges.
      • After Dec. 31, 2024, Hutchinson Clinic won’t be able to access your benefits and eligibility info. They won’t have access through our systems or Customer Service. If you have any questions about your benefits, BCBSKS will be here to help you directly.
    • Emergency care: Emergency care will always be covered by BCBSKS with no out-of-network penalties.
    • Serious and complex medical conditions: For members currently undergoing treatment for serious and complex conditions, BCBSKS may allow services to be covered as in-network for up to 90 days as part of the Consolidated Appropriations Act. Contact our Customer Service Center at 1-800-432-3990 (toll-free) to see if this applies to you.
    • Medicare Supplement (Medigap) members: There will be no changes to the way you access in-network care through the Hutchinson Clinic. There is no impact to Medicare Supplement members as they can go to any doctor or hospital that accepts Medicare. For Medicare Advantage there is no change, Hutchison Clinic continues to be out of network.
    • Commercial/ACA/On-exchange members: Members who have purchased their plan on healthcare.gov will no longer have coverage at the Hutchinson Clinic except for emergency care. If members choose to receive care at the Hutchinson Clinic, they would have to pay 100% of the cost of care.
    • Federal Employee Program retirees: If Medicare is your primary coverage (meaning it pays first) and you have Federal Employee Health Benefits and Postal Service Health Benefits Standard Option, we will continue to provide secondary coverage. If you have Basic Option, FEP Blue Focus, Medicare will pay their portion of your service; however, we will not pay as secondary.
    Will my pharmacy benefits still work with Hutchinson Clinic Pharmacy?

    You may continue to use Hutchinson Clinic Pharmacy for prescription benefits. Hutchinson Clinic Pharmacy has a separate contract through Prime/ESI, our pharmacy benefit manager.

    What are my options for in-network providers?

    We know having in-network care close to home is important for you. Thankfully, there are other options, both in Hutchinson and in neighboring towns, where you can transfer your care. We encourage you to visit our online directory for a listing of alternative contracting providers in your area. When searching, members will need to view the full provider profile and check the affiliated clinic section to ensure the provider is not associated with the Hutchinson Clinic.

    Is Hutchinson Regional Healthcare System still in-network?

    Yes, Hutchinson Regional Healthcare System is in the BCBSKS network.

    What does it mean when you say you’re a not-for-profit, member-owned mutual company and how does that benefit me as a member?

    This means we are owned by our members, and we only exist to serve you. We do not have shareholders to pay or stock prices to worry about. That allows us to solely focus on doing what’s right for our members and our communities.

    As a member, you are a co-owner of the company. Every dollar that comes to BCBSKS through premiums is either used to pay member claims, pay taxes, or cover operating expenses. We’re not lining our coffers – any money we have is earmarked to reinvest in the company and the communities we serve.

    We are Kansans serving Kansans. Our members are our neighbors, friends, and colleagues. We care deeply about the health of our community – which is why we are constantly looking for ways to improve affordability and access.

    • Providers have told us that they appreciate that we pay accurately, promptly and offer peace of mind.
    • We are finding innovative ways to bring even more value to our members:
      • MiResource: Helps connect members with the right in-network mental health care.
      • Prime Therapeutics: Integrated pharmacy benefits
      • Meds Your Way: Lowest price for prescription drugs
      • We partner with local organizations across the state and provide resources to make lasting changes to improve Kansans’ health.
      • Through our Blue365 program, members have access to weekly deals and discounts related to fitness and healthy eating. It’s easy to sign up for weekly email reminders!
      • With STRIVE, members receive unlimited access to doctor-designed, powerful online tools, including a personalized health risk assessment and more.
      • Our Healthy Options wellness program brings wellness to your worksite and empowers your employees with one-on-one support, coaching and education.
    • Learn more about how BCBSKS partnerships help the Hutchinson community.
    Resources