Aetna won't abandon any pregnant women.
In a story on Saturday's front page about the health insurer's contract dispute with the UNC Health Care System, a member who is 35 weeks' pregnant discussed her fears of having to change her doctor and hospital.
Jennifer Marks is scheduled to deliver her baby next month at Rex Healthcare, the Raleigh hospital owned by UNC Health. For Aetna members, Rex is "out of network" now that the insurer's contract has expired, following a fight about how much Aetna should pay UNC Health for medical care.
Marks had filled out several forms with Aetna to make sure she wouldn't face extra charges at the facility and was told she would have an answer within 7 to 10 days.
But Bruce Norman, an Aetna medical director based in North Carolina, called Marks personally today to assure her that her coverage won't change.
"He apologized for the confusion," and mentioned seeing the N&O article, said Marks, who lives in Willow Springs. "I'm still dumbfounded."
Marks said she's relieved, but she still wonders why she had to go through the hassle of filling out and faxing forms to Aetna about her coverage.
"They're obviously still sorting through these transitions," she said. "If this is their policy, why wasn't I notified a few weeks ago? It doesn't make a lot of sense that they didn't notify the customer first."
Aetna's policy is to continue full coverage for all members who have entered the second trimester of pregnancy, said spokesman Walt Cherniak. Marks' coverage will pay for her delivery at Rex and all related expenses, and up to 60 days of post-partum care.
"She received the wrong information," Cherniak said. "She is clearly covered. This is not a gray area.
"We don't want to leave a misleading impression in the community," he added. "It's not like someone's flipping a coin here."
But after 60 days, assuming Aetna still doesn't have a contract with UNC Health, Marks will have to find a new, non-UNC doctors' practice.
