TAMPA, Fla. (WFLA) — If you’re one of the thousands of people who get the Medicare Advantage Plan through Florida Blue and use a BayCare facility or physician, you’ll want to pay attention to the current negotiations.

The two companies are working to reach a new contract, but if they don’t, patients could be looking for a new doctor or facility starting October 1.

BayCare is the way to go for Erica Kearney, who visits the doctor every three months.

“This has been the best care that I’ve had my whole life and to lose that would be devastating,” Kearney said.

She got the message from BayCare saying they’ve been in working with Florida Blue to reach a new, fair, network agreement that puts patients first, but BayCare said so far, the company has been unwilling to reach an agreement that would guarantee they would sustain services.

“I don’t want to go back to, you know, the what I call the ping pong game where one doctor sees you and then tosses you to another doctor,” Kearney said. “It’s very frustrating and it’s very expensive.

Florida Blue provided the following statement to 8 On Your Side:

“Florida Blue is committed to ensuring members of our health plans have access to affordable, quality health care, and we’re working to reach a resolution with BayCare. Our goal is a new, multi-year agreement that is sensible, sustainable, and allows us to continue our commitment to the communities we collectively serve. Negotiating with hospital systems is a regular part of our business and it’s our responsibility to protect our members from the burden of unexpected and major cost increases — especially with the rising cost of health care, and at a time when many individuals, families, businesses, and seniors are struggling to make ends meet.”

Here is a statement from BayCare to 8 On Your Side:

“Over the last several months, we have been working in good faith with Florida Blue to reach a new, fair network agreement that will protect patients’ ability to continue choosing the BayCare physicians, services and facilities they know and trust for their care.  

Unfortunately, Florida Blue is proposing reimbursement rates that do not keep up with the rising costs of clinical care. This would hurt BayCare’s ability to attract and retain high-quality caregivers, invest in needed services and technology and continue delivering the high-quality care West Central Florida deserves. Patients are paying higher Florida Blue premiums, but those increases are not proportionately shared with health care providers who directly care for patients. 

Nothing is changing today, and we want patients to know that BayCare is still working in earnest to help them keep their doctors and nurses. Our goal is to finalize a new agreement before the current one expires at end of day on Sept. 30, 2025, so patients retain their access to  BayCare’s extraordinary team. We encourage patients who have questions to visit our informational website, KeepBayCare.org.

On background: BayCare’s experience with Florida Blue is not unique. Several times over the past year, Florida Blue has created hardship for patients by removing health systems from its network or threatening to do so as a result of failed negotiations.“

Jason Spell with Total Care Consultants said these dealings have impacts on what he recommends to policyholders.

“You always will remember things like these when it’s time to recommend a plan,” Spell said. “I have people that move here and they’re like Florida Blue, Florida Blue but it’s not really the top of my food chain.”

Spell said having a local agent is beneficial for those who may be in a bind come October.

“We have that window to change your plans starting October 15 to December 7,” Spell said.

Kearney said waiting is the worst-case scenario, but she doesn’t have many options.

“When they want something from us, they want it right away. But when we need something, we’re made to wait,” Kearney said. “We are at their mercy at the end of the day unfortunately.”

Policyholders are advised to keep all appointments and procedures they have scheduled.

For more information from Florida Blue, click here.