Carson Medical Group and Prominence Health Plan have confirmed that the agreement between their organizations is not in place for Health Insurance Exchange members for the 2016 year.
This announcement was last Friday, December 18th. This came three days after the last day of enrollment. This has a January 1st effective date with the new 2016 Prominence plans. Carson Medical Group and Prominence have not come to terms regarding the exchange.
Known details of the non-agreement include:
- This non-agreement will apply only to those individuals and families. These are plans that are purchased through the Nevada Exchange and/or the Federal Healthcare.gov website. This non-agreement will not impact small or large group clients. This is true with the Prominence Premier HMO North list or the Prominence ChoicePlus physician lists.
- Prominence will not be reimbursing Exchange Health Plan Members that use Carson Medical Group after January 1st, 2016. Although the Carson Medical Group is still included on the online Prominence Doc List as a key part of their 2016 health plan.
- Individuals that have chosen one of the 16 physicians that make up the staff of Carson Medical Group will need to find new Primary Care Doctors. Before you get medical treatment, we highly recommend finding a new doctor.
This non-agreement comes at a very awkward time. Especially for Carson residents that have based their health plan decision on the use of the Carson Medical Group. Furthermore, neither Prominence physician list includes any other services in the Carson City area. Members seeking services for pregnancy issues will need to use Reno physicians.
For more information about this non-agreement, please don’t hesitate to contact us here at Health Benefits Associates. We represent your interests free of charge.