Latest Updates (as of 9/23/2022): Until December 5, 2022, Johns Hopkins caregivers will remain in-network for patients who have CareFirst health insurance. We continue to regularly meet with CareFirst and are doing everything we can to come to a fair agreement before December, so that there is no change in coverage.
Important Information About CareFirst Coverage
Your health is our top priority.
What CareFirst BlueCross BlueShield (CareFirst) pays Johns Hopkins’ doctors, nurses and other caregivers has not kept up with inflation. In fact, what CareFirst insurance pays for Johns Hopkins’ care is lower than what most other area insurance companies pay. It is very hard for Johns Hopkins — or any health care system — to provide care at the rates we are currently paid by CareFirst.
Johns Hopkins doctors, nurses and other caregivers, as well as ambulatory surgery centers, may have to leave the CareFirst network as soon as December 5, 2022. This means that after December 5, CareFirst may cover less — or none — of the care you receive at Johns Hopkins, leaving you to pay more to see your doctors, nurses and caregivers.
What does this mean for patients who have CareFirst insurance?
We are doing everything we can to reach a fair agreement with CareFirst before the December deadline. While we negotiate to stay in the CareFirst insurance network, we wanted to make sure that we answer all your questions and provide you with the resources you need.
- For details about these potential changes to CareFirst’s coverage and for answers to common questions, please read the frequently asked questions (FAQs) below.
- If you want to speak with someone to understand whether these potential changes to CareFirst’s coverage could impact you, we have set up a special call center at 443-997-0549. The call center will be open Monday through Friday from 8 a.m. to 5 p.m. EST. You can also contact CareFirst directly at the customer service number on the back of your CareFirst health insurance card.
CareFirst Coverage Changes – Answers to Frequently Asked Questions
No, you will not be affected. If you have CareFirst Medicare supplemental coverage you can continue to see your Johns Hopkins caregivers and your coverage will not change. If we are unable to reach an agreement by Dec. 5 and Johns Hopkins leaves the CareFirst network, only patients with a commercial PPO or HMO plan through CareFirst, a BlueCross BlueShield FEP plan or an out-of-state Blue Cross Blue Shield plan with Blue Card access, will be affected.
If we reach Dec. 5 without a fair agreement in place, then patients with a commercial PPO or HMO plan through CareFirst, a BlueCross BlueShield FEP plan or an out-of-state Blue Cross Blue Shield plan with Blue Card access, could have less – or none – of the care they receive at Johns Hopkins covered by their health insurance.
We know changes in coverage can have a huge impact on families that need medical care, especially those with ongoing needs. We wanted to let our patients know about the potential change in advance, so they have as much time as possible to make informed decisions about their coverage and care.
We want to reassure you that our patients with CareFirst BlueCross BlueShield can still see their Johns Hopkins caregivers at in-network rates, and as a patient there is nothing you have to do at this point in time. Your coverage won't change unless we reach Dec. 5 without resolution, but we are hopeful that everything will be resolved before that date. We continue to regularly meet with CareFirst and are doing everything we can to come to a fair agreement. Because we recognize that our patients want answers and clarity around next steps, we will be regularly updating this website with the latest information and will be communicating any significant developments to all our affected patients.
CareFirst may cover less, or none, of the care you receive at Johns Hopkins Medicine starting as soon as December 5, 2022. At that point, patients would have to pay more to see a Johns Hopkins doctor, nurse or caregiver, or to visit one of our standalone ambulatory surgery centers, such as those at Green Spring Station, White Marsh, or Bethesda.
Your CareFirst coverage is based on your health insurance plan. If you have questions about what your health insurance plan covers, and how much CareFirst would cover if you saw your Johns Hopkins doctor after December 5, you can contact CareFirst directly at the customer service number located on the back of your CareFirst health insurance card.
If you are unsure whether these changes will impact you, please call 443-997-0549 to speak to someone to learn more. The call center will be open Monday through Friday from 8 a.m. to 5 p.m. EST.
“Out of network” means that there is not a contract between the caregiver or hospital and the health insurance company. Health insurance companies cover more of the cost of seeing a doctor, nurse or caregiver or going to an ambulatory surgery center that is in their network, and less of the cost — or none of the cost — of getting care somewhere that is “out of network”.
It is best to check with CareFirst directly about what they will cover if Johns Hopkins has to leave CareFirst’s network. You can call the CareFirst customer service number on the back of your health insurance card to get more information.
What CareFirst pays Johns Hopkins doctors, nurses and other caregivers has not kept up with inflation. In fact, CareFirst pays Hopkins less than what most other area insurance companies pay. Even though the cost to provide health care has gone up more than 21% in the last decade, CareFirst’s payments to Johns Hopkins have gone up by just 10%. CareFirst’s low payment rates also hurt our ability to hire and keep the very best doctors and nurses, because many other academic medical institutions across the country are paid more on average than what CareFirst pays Johns Hopkins. Johns Hopkins Health System, or any health care system, is not able to provide world-class care unless health insurance companies pay fair rates.
We are doing everything we can to reach an agreement with CareFirst, but if we don’t reach an agreement by December 5, then our contract ends, and Johns Hopkins doctors and nurses and ambulatory surgery centers will be removed from CareFirst’s network.
Our hospitals will not go out of network on December 5. It is our health care professionals — such as your doctor or the nurses who care for you — and our standalone ambulatory surgery centers (such as Green Spring Station, White Marsh, or Bethesda) that could go out of network starting on that date.
If we still can’t come to a fair agreement with CareFirst by March of 2023, then it is possible that CareFirst could change their coverage of visits to Hopkins hospitals in Maryland as well.
In an emergency you can and should go to the nearest emergency room.
Nothing will change until December 5, and we recommend that you keep your scheduled treatments and appointments at Johns Hopkins.
It is up to health insurance companies whether they will make coverage exceptions for patients receiving certain types of medical care or who are in certain medical situations. CareFirst may allow patients in certain medical situations an extended period of time for in-network care from Johns Hopkins. This is called “continuity of care” and is determined by CareFirst. If you are currently receiving care at Johns Hopkins or have care scheduled with a Johns Hopkins doctor or nurse, call CareFirst to see if the company will continue to cover your care even if Johns Hopkins is out of CareFirst’s network.
In addition, in the state of Maryland, the law requires CareFirst to cover primary care for 90 days after CareFirst notifies you of changes to your insurance coverage. If you have questions about whether you will be able to see your Johns Hopkins primary care doctor after December 5, please contact CareFirst directly at the customer service number located on the back of your health insurance card.
If you are currently seeing a specialist or receiving ongoing care from Johns Hopkins and you have CareFirst as your insurance plan, call our Johns Hopkins call center at 443-997-0549 to speak to someone and understand your options. The call center will be open Monday through Friday from 8 a.m. to 5 p.m. EST.
If you have questions about what your benefit plan covers, and how much CareFirst would cover if you saw your doctor or nurse after December 5, contact CareFirst directly at the customer service number located on the back of your health insurance card.