We know how important it is for you and your family to receive care from the trusted doctors, nurses, and staff at St. Mary’s. As a not-for-profit, local care provider, we work tirelessly to care for our patients and communities. We also continue to reduce costs and implement efficiencies to ensure we can continue providing top-quality care to our patients. We are asking health insurers to put patients first just like we do. Without them doing their part, access to care is at risk. St. Mary’s Health Care System provides high-quality care in our community while doing our part to make health care affordable – in 2023 alone, we've invested more than $9.5 million in community benefits. Unfortunately, Aetna’s focus appears to be their profits. We are asking Aetna to put patient health over their wealth. For us, Health Comes First.
Important information for patients with Aetna health insurance
St. Mary’s is negotiating with Aetna for new agreements that appropriately cover the true cost of care that we provide to our patients with Aetna commercial and Medicare Advantage plans.
Our agreement expires effective January 1, 2025, and impacts in-network access to St. Mary’s hospitals, facilities, and health care providers.
For now, nothing changes. Patients should continue to visit St. Mary’s hospitals, facilities, and physicians as they normally would. Negotiations are a routine part of business, and we are doing our best to reach an agreement to minimize the impact on patients. What’s not routine is the significant impact inflation has had on our cost to provide the high-quality care you expect, we need Aetna to do its part to ensure you have access to our care.
Our request to Aetna is simple: to be paid fairly and in line with other providers in our market. We cannot maintain access to the care and services patients depend on and need without fair agreements from commercial health insurers. We need Aetna to provide reimbursement that covers the true cost of care.
Frequently Asked Questions
You deserve access to high-quality health care.
At St. Mary’s, we believe our community members deserve options for high-quality care, and we are proud to be one of Georgia’s most trusted healthcare providers. That’s why we’re working to protect our ability to serve patients for generations because health comes first.
If you do not find the answers to your negotiation-related questions on this site, please contact us directly via this website through our Contact Us page or call our patient line at (706) 381-0005. This website will be updated as our negotiations continue, so please check back for the most up-to-date information.
I have an Aetna health plan. What does this mean for me
For now, nothing changes. You should continue to visit St. Mary’s hospitals, facilities, and physicians as you normally would. If Aetna does not work with us to reach a fair agreement before January 1, 2025, St. Mary’s will be forced out of network and patients may have to pay more when seeking care with our hospitals, clinics, and providers.
What is happening?
St. Mary’s is negotiating with Aetna for new agreements that appropriately cover the cost of the care we provide patients with Aetna commercial and Medicare Advantage plans. Our current contract will expire January 1, 2025. Negotiations are a routine part of business, and we are doing our best to reach an agreement to minimize impact to patients. What’s not routine is the significant impact inflation has had on our cost to provide the high-quality care you expect, and we need Aetna to do their part to ensure you have access to our care.
Why is this happening?
As a trusted local care provider, we work tirelessly to care for our patients and communities. We also continue to reduce costs and implement efficiencies to ensure we can continue providing top-quality care to our patients. However, Aetna's focus appears to be their profits, which topped $5.6 billion in 2023. We cannot maintain access to the care and services patients depend on and need without a fair agreement from Aetna.
When does the contract with Aetna end?
Our current agreements will expire effective January 1, 2025.
Which Aetna health plans are affected by the negotiations?
To see a full list of insurance plans we accept, please visit our accepted insurance page. Please note that we are also in negotiations with Humana.
Which providers and facilities are impacted?
All St. Mary’s hospitals, facilities, and employed providers are impacted by these contract negotiations.
- St. Mary’s Hospital, Athens, Ga.
- St. Mary’s Sacred Heart Hospital, Lavonia, Ga.
- St. Mary’s Good Samaritan Hospital, Greensboro, Ga.
- St. Mary’s Medical Group – practices across Northeast Georgia
- St. Mary’s Inpatient Rehabilitation Hospital/Center for Rehabilitative Medicine
- St. Mary’s Home Health Care/Hospice Services
- St. Mary’s Outpatient Services
- St. Mary’s Wound Care and Infusion Therapy Center
What Patients Can Do to Maintain Access to St. Mary’s Hospitals, Facilities and Health Care Providers in 2025
While our negotiations with Aetna continue, you can take these steps to protect your access to in-network care with St. Mary’s:
- Never delay care. You will always have in-network access to our emergency department. Regardless of our network status with Aetna, you should always visit the closest emergency department if you experience a medical emergency.
- Call the number on the back of your insurance card and make sure your health plan will provide you with in-network access to St. Mary’s and its doctors.
- If you receive insurance through your employer, ask about how you can continue your in-network access and treatment relationship with St. Mary’s hospitals, clinics, and providers. Your employer may be able to provide you with secondary health plan coverage that includes access to your trusted caregivers.
- If you have Medicare Advantage plan, you can contact MedicareCompareUSA licensed Medicare advisors at MedicareOnDemand.com or call our Medicare insurance helpline toll-free at (855) 562-7230 during Open Enrollment beginning October 15 – December 7, 2024 to review what options include St. Mary's providers. We work with many health plans that will give you in-network access to St. Mary’s for the 2025 benefit year. To view the complete list of insurance plans we accept, click here. Please note that we are also in negotiations with Humana.
What if I’m in the hospital when the contract ends?
If you are already admitted to the hospital before January 1, 2025, you will be covered at in-network rates through the end of your inpatient stay.
What if I have an elective procedure scheduled at a St. Mary’s facility on or after January 1, 2025?
We understand that some patients may have appointments scheduled on or after January 1, 2025. If possible, you should call your provider’s office to request that the appointment or procedure be rescheduled in advance of January 1, 2025. If you are unable to reschedule your appointment or choose to keep your appointment, you may have to pay higher out-of-pocket costs for your care with St. Mary’s if Aetna forces us out of its provider network.
What if I have an emergency on or after January 1, 2025, and St. Mary’s is out of network?
Patients will always have in-network access to our emergency rooms, regardless of our status with Aetna. If you experience an emergency, you should always visit the nearest emergency room. Patients needing emergency care can receive in-network treatment until the patient is stable.
How can I stay up to date on the negotiations?
For the most up-to-date information, we encourage you to contact us by visiting www.stmarys-health.org/aetna or call our patient hotline at (706) 381-0005.