Families scrambling because Phoenix Children’s no longer accepts major insurers

PHOENIX (AZ Family) — The blame game continues after a Arizona’s leading insurance company and health system failed to reach an agreement this week.

If you have coverage with Blue Cross Blue Shield of Arizona (BCBS), more recently known as “AZ Blue,” Phoenix Children’s Hospital is now out of network.

Contract talks continue, but Children of the Phoenix says a new deal is unlikely.

It leaves many throughout the Valley wondering how they can afford out-of-pocket costs or find new doctors to provide the specialized care their children rely on.

Three-year-old Edison Gertenbach has spent much of his young life at Phoenix Children’s Hospital. His parents, Ross and Nicole, say he was born with a severe heart condition.

“The doctors didn’t know if he was going to survive,” Ross said.

So far, he’s had three heart surgeries and has been at Phoenix’s Children’s since Monday, preparing for another high-risk surgery.

“It’s just heartbreaking for us,” Ross said.

Amidst the stress of this hospitalization, Ross learned that Phoenix Children’s was no longer in network with his employer’s insurance.

“My heart sank instantly,” he said. “Technically, he was in the middle of grooming before these negotiations fell through and hopefully, you know, he was good. “The surgery alone is going to be around $300,000 and that’s what scares us.”

The two companies could not agree by this week’s deadline.

Conformable AZ Bluethe hospital turned down an $80 million raise that led to the contract dispute. Phoenix Children’s calls offering “fiction,” saying BCBS offer is closer to $43 million.

“It’s like watching a kid fight another kid,” Ross said.

Families like the Gertenbachs feel caught in the middle and hope a settlement can be reached. Because for them, this care is a matter of life and death.

“I don’t want to be unable to care for my son and watch him suffer. I’ll do everything I can for him,” Ross said. “It’s very emotional.”

Meanwhile, emergency assistance is unaffected. In addition, some patients may be able to continue care for a short period of time if they need ongoing treatment for a particular disease or medical condition.

It is best to call the number on the back of the insurance card to find out how this affects your specific benefits.

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