Prominence Health Care, one of the major health insurance providers in Northern Nevada, has officially split ways with Saint Mary’s. Unfortunately, this means Prominence members no longer have access to Saint Mary’s Medical Group or Saint Mary’s Urgent Care locations. Here’s what you need to know about the Prominence and Saint Mary’s termination and what to do if you’re affected.
Prominence and Saint Mary’s termination
This change in coverage has been a while coming. Back in August of 2021, Saint Mary’s parent organization, Prime Healthcare, ended the hospital contract for Saint Mary’s Regional Medical Center for Prominence’s Commercial HMO and Medicare Advantage healthcare lines.
While the contract has been officially canceled for almost two years, existing Prominence members still had access to Saint Marys’ Medical Group and Urgent Care during arbitration. Now that the arbitration process has come to a close, so is coverage for Prominence Medicare Advantage members and Saint Mary’s.
What this means for Nevada healthcare recipients
Effective immediately, Prominence Health Plan members no longer have access to Saint Mary’s Medical Group or Saint Mary’s Urgent Care under their current health insurance plans. Prominence is currently reaching out to members who may be impacted by this change.
This Prominence and Saint Mary’s termination may mean that you’ll need to visit a different medical facility or urgent care than what you’re used to. If you live in Northern Nevada, there are three major hospital groups you can use for your healthcare needs besides Saint Mary’s:
- Renown
- Northern Nevada Medical Group
- Carson Tahoe Medical Group
Before you visit any of these medical facilities, check to make sure they’re covered under your current Prominence health insurance plan. Typically, Renown is not covered under Prominence plans unless in an emergency.
What to do if you’re affected by the change
If you’re a Prominence Health Care member who’s affected by these changes, there are many alternative healthcare options in the Northern Nevada area that are still covered by Prominence.
For example, Northern Nevada Medical Group is currently constructing several new locations for free-standing ER centers and a new Personalized Radiation Oncology Center — both of which are covered under many Prominence healthcare plans. The Sierra Medical Center is another new hospital that opened just this year and offers healthcare options covered by many Prominence plans.
If you have questions regarding the Prominence and Saint Mary’s termination or would like help finding a plan that will continue to cover Saint Mary’s providers, feel free to reach out to the health insurance experts at Health Benefits Associates. We’ll walk you through the options to find a health insurance plan that works for your specific needs.
