Parents left scrambling weeks after Phoenix Children’s Hospital and Aetna’s contract expired

Parents tell Arizona’s Family they remain panicked and confused about what to do about their child’s care.
Published: Aug. 27, 2023 at 8:38 PM MST
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PHOENIX (3TV/CBS 5) - It’s been 20 days since Aetna dropped Phoenix Children’s Hospital from its network. The contract expired on Aug. 7, 2023, and the major insurance company and hospital said negotiations are ongoing.

In the meantime, many families across the Valley are scrambling. Parents tell Arizona’s Family they remain panicked and confused about what to do about their child’s care.

We spoke with one Valley mom who is scrambling. Rachelle has been pushing back appointments and looking for new in-network doctors, but she still hopes an agreement can be reached. Rachelle said she always puts her kids first. Her son Carson is four and was recently diagnosed with type 1 diabetes at Phoenix Children’s Hospital. “We have everything established here,” she said.

Her family relies on Aetna insurance through her husband’s job, but the insurer’s contract with PCH expired on Aug. 7. “It’s been very stressful. It’s been very emotionally tolling,” said Rachelle.

Right now, paying for future treatment out-of-pocket isn’t an option. “We don’t have thousands of dollars to just drop. I mean, like, I would do anything for him right to get him the best care, but like, I don’t have that money. Like that’s a lot of money,” she said.

The appointment to place his glucose monitoring device was Aug. 8, the day after the contract between PCH and Aetna ended. It cost her family hundreds of dollars since they were no longer in-network. She is concerned by the lack of communication during this transition. “Whenever I’ve called Aetna, they’ve just said, ‘Do you want a list?’ Well, that’s not going to help me. Like, I need someone. Do you have someone directly that could take my son that you know is going to be covered and that you know works with pediatrics with a new diagnosis at this young of age of type 1? Like that’s my concern,” said Rachelle.

The last few weeks, she’s been searching for support, figuring out how to transfer medical records, and locking down a new in-network doctor. She said it’s become a full-time job to find care for her son.

“I do feel abandoned because I feel like it’s just been OK; we’re no longer covered like on the 7th, and it’s like OK great well now what? Like there was no ‘here’s how we’re going to help you guys move to another in coverage hospital system.’ It was just like OK good luck, figure it out,” she said.

Phoenix Children’s said Aetna isn’t holding up its end of the deal when it comes to honoring in-network rates for some time, claiming the insurance company has delayed or rejected nearly all requests. On the other hand, Aetna said they’re still trying to agree with PCH and are dedicated to helping members through the next steps.

Below is the latest statement from Phoenix Children’s Hospital:

Below is the latest statement from Aetna:

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