Florida Blue has Taken Memorial Healthcare System Out of its Provider Network: Here’s What You Should Know

As a physician and surgeon at Joe DiMaggio Children's Hospital, I often see kids and families in crisis. Regardless of severity, having an ill child, or one who may need surgery or hospital admission, is incredibly stressful for the entire family. This is especially evident at a facility like Joe DiMaggio where we provide complex medical care to the sickest children in the community. Our focus is always on minimizing suffering and getting kids back to good health, school, and the activities they enjoy, and our record of quality, safety, and outcomes shows we do it extremely well.

Today, a new kind of pain is impacting patients and families at the children's hospital and throughout Memorial Healthcare System that's beyond a doctor's clinical abilities to remedy. It's the anxiety and dread that comes with having the doctors you know and trust no longer available for your family's care, the result of Florida Blue's decision to remove Memorial's in-network status from the health insurance it provides, and it's something your friends, neighbors, or maybe even your own family is experiencing right now.

Real Consequences

The choice by Florida Blue places patients at risk of higher costs, disrupted care, and leave families facing an impossible decision: either self-pay the increased costs to stay with the providers that know them best, or start over, often in the middle of a treatment regimen, with a new medical team in a different healthcare system that may require significant travel to access a lesser level of care. All because Florida Blue refuses to provide market-based reimbursement for the services we deliver, an action that prioritizes profits over patients and removes the easy access to care our community depends on.

With more than 150,000 Florida Blue's policy holders utilizing the Memorial system in the past two years alone, the impact is significant for Broward, Palm Beach, and Miami-Dade county residents. While federal law requires emergency services remain covered at in-network rates and there may be short-term exceptions for those few who fall under Continuity of Care provisions, the majority of Florida Blue's customers are left with only the aforementioned options, neither of which serves them or their families well.

What to Do

The situation, while stressful and disruptive for patients and caregivers, is hopefully not permanent, and there are actions those most affected can take:

• Patients in active treatment should call Florida Blue and ask about receiving Continuity of Care benefits, which would allow them to continue to see their Memorial providers at in-network rates, although usually only for 90 days.
• All Florida Blue policy holders should be in touch with the insurance company to let them know how important Memorial's in-network status is to the health and well-being of them and their loved ones.
• If Florida Blue keeps Memorial out-of-network, please visit the list of insurers that have Memorial in-network.
• Open enrollment provides the option to switch plans, beginning October 15 (through December 7, 2025) for Medicare and November 1 (through January 15, 2026) for ACA marketplace plans.

We'v Got Your Back

Memorial's hospitals, including Joe DiMaggio Children's Hospital, are public, safety net facilities, meaning we care for everyone, regardless of an individual's ability to pay. That's the beauty and privilege of being a practicing physician with Memorial. My colleagues and I can focus on what matters most, caring for patients, and don't worry about the financials.

That said, the cost of uncompensated care in the last fiscal year alone was more than $160 million, a shortfall our healthcare system covered out of its annual operating budget and didn't pass on to local taxpayers.

We consider that an investment in our community - the same as our funding of innovation, medical education, and charitable outreach - because we believe South Floridians should be able to access high quality care and services close to home.

Here's something to consider: If you or loved one couldn't afford the cost of their services, do you think Florida Blue would step up for your family, to the detriment of their profits, to ensure they were cared for?

Because that's something we've done at Memorial Healthcare System for more than 70 years.