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Health InsuranceORLANDO, Fla. —A change in insurance coverage at Florida Hospital leaves one Orlando mother bedridden while she awaits surgery.

Florida Hospital is no longer accepting Humana Commercial Health plans except for patients in need of emergency services and patients with Medicare. At just 39 years old, Rebecca Kurta suffers from severe osteoarthritis, which makes walking, raising her two boys and even sitting down to talk with WESH 2's Matt Grant a major challenge.

"There is nothing more important in life than having good health," Kurta said. "The last three weeks I've been 100 percent bedbound."

Her scheduled surgery was suddenly cancelled when Florida Hospital dropped her insurance. Kurta said an MRI revealed serious loss of cartilage and said doctors told her she needs a hip replacement as soon as possible.

"(The surgery) would allow me to completely regain my mobility, to be able to enjoy life again and be part of the family again," Kurta said.

The surgery was scheduled for Oct. 29 at Florida Hospital in Altamonte Springs, but she said hospital staff just told her the procedure was off. That's because WESH 2 has learned Florida Hospital canceled its contract under the type of plan Kurta has through her insurance provider, Humana.

"We've invested a lot of money into this plan with the understanding that we pay the money for the plan and the plan will take care of our medical needs as long as we stay in network," Kurta said.

Florida Hospital said an agreement couldn't be reached due to "outstanding issues" but wouldn't elaborate. It is unclear how many patients will be impacted but WESH 2 was told the decision affects elective care at eight area Florida hospitals, 23 Centra Cares and four Florida Radiology Imaging locations. Humana patients on Medicare or seeking emergency services will not be effected.

In a statement, Humana said they have "an extensive provider network in the Orlando area that will continue to ensure member access to in network hospitals and continuity of coverage."

In this health care showdown, Kurta is caught in the middle.

"It makes me pretty angry," Kurta said.

The new change affects only the Florida Hospital System. Hospitals that are part of the Orlando Health System continue to accept all Humana Plans.

Humana released the following statement: "In mid-June, Florida Hospital notified Humana of its intention to terminate its Commercial contract on October 18, 2014, for Humana Commercial health plans. Since then we have been in active negotiations yet, unfortunately, we were not able to reach an agreement before the deadline. The contract termination only affects in-network access to the Florida Hospital Orlando facilities for Humana commercial and individual on and off exchange health plan members in the Orlando area. Humana Medicare plans are not impacted. It also does not affect Humana commercial health plan member access to Florida Hospital facilities in Orlando for emergency services. Humana has an extensive provider network in the Orlando area that will continue to ensure member access to in-network hospitals and continuity of coverage. We also have comprehensive processes in place ensuring continuity of care for our affected members and employer groups."

Florida Hospital released the following statement: "Florida Hospital attempted to negotiate a contract with Humana for its commercial plans, but an agreement was not reached before the existing contract expired Oct. 19. Despite ongoing efforts to settle outstanding issues, there has been little closure on items that need to be resolved. The impacted customers were notified several weeks ago that this may impact their ability to access elective care at in-network benefit levels at eight Orlando-area Florida Hospitals, 23 Centra Cares and four Florida Radiology Imaging locations. Emergency services at the eight Orlando-area Florida Hospitals will continue to be covered at in-network benefit levels. "This commercial contract expiration does not impact Florida Hospital's participation in Humana's Medicare Advantage plans, such as Gold and Gold Plus. We know it is important for patients to have access to our health care services, and Florida Hospital remains open to dialogue with Humana to engage in resolving our differences. It is our hope that Humana will work with Florida Hospital so that member disruption will be minimal."

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Make sure you have the right policy for your needs. Call Prestige Insurance Group, Inc. at (305) 969-8776 for more information on Miami health insurance.

(Article courtesy: WESH.com)
Posted 9:00 AM

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