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TennCare warns parents about insurance issues with Le Bonheur

MEMPHIS, Tenn. — Some Mid-South parents are panicking after receiving a letter that TennCare won’t pay got their child’s care at Le Bonheur Children’s Hospital in the new year.

The first line of the letter reads “Starting December 31 of this year, TennCare won’t pay for you to go to Le Bonheur Children’s Hospital.”

Sarah Marbry is a mother of four. Her 4-year-old daughter who was born with down syndrome received the letter this week.

“I was heartbroken. I was in tears speaking to the representative from Blue Care,” Marbry said. “We rely a lot on her physicians and specialist at Le Bonheur and not being able to go there for her care is going to be detrimental for her.”

WREG reached out to Methodist Le Bonheur Healthcare for answers. We received this statement from spokesperson Sarah Farley:

Contract negotiations with Blue Cross Blue Shield of Tennessee are ongoing. Our goal is to come to a balanced and fair resolution before the end of the year, that benefits both parties and meets the needs of our system, providers, and the patients and families we serve.

An upset Marbry made a post on Facebook that’s been shared by over a hundred families.

Marbry who lives in Hardeman County says Le Bonheur is the only major children’s hospital in the area. She and others could be forced to drive to Vanderbilt which is costly.

“A lot of these children on BlueCare are disabled children, low-income families, children in foster care,” she said.

In a statement, Blue Cross Blue Shield says it understands concerns.

“Tennessee employers and BlueCross members are always asking for help with the rising cost of health care, and we’re working to negotiate a new contract with Methodist Le Bonheur Healthcare that will bring them in line with other providers in the Memphis market. BlueCross remains focused on making sure members have access to high-quality care they can afford, and we hope to reach a new agreement with Methodist Le Bonheur that supports this goal.”

“Insurance companies want to make more money. Hospitals and medical providers want to make more money,” Marbry said. “I understand that but I just don’t think our children should have to suffer in the process.”

If an agreement is not reached by the end of the year, TennCare says it will help patients transition their care. The agency’s Communications Director, Amy Lawrence, shared this statement:

“BlueCare, a TennCare health plan, is in the middle of active contract negotiations with Methodist/Le Bonheur. However, because the term date is scheduled for 12/31/2022, BlueCare has sent the required letters informing members that as of 1/1/2023, Methodist/Le Bonheur will not be in Blue’s network. If the parties can come to term prior to 1/1, there will be no impact to members.

TennCare health plans are required by contract to provide continuity of care and will work to transition care if an agreement is not signed.”