EIRMC, Blue Cross of Idaho, reach 'in network' agreement on private, ACA policies

Eastern Idaho Regional Medical Center and Blue Cross of Idaho have reached an agreement that significantly impacts consumers who purchased Blue Cross of Idaho individual health coverage either privately or on the Idaho Healthcare Exchange. These two Blue Cross products are known as “Hometown East” and “Connected Care.”

There are two important elements to this agreement:

• Emergency services provided at EIRMC will be covered as an in-network benefit. This includes basic ER care; intensive care (ICU); pediatric intensive care (PICU) for children; neonatal care (NICU) for babies; and emergency surgery as a result of an ER visit. ( EIRMC is the only hospital in Idaho Falls with Emergency Services, and the only hospital in the state with a Level I ICU.)
• All other referral -based services obtained at EIRMC will be covered as in-network by Blue Cross of Idaho. Examples include -- but are not limited to -- maternity services; cancer treatment; cardiovascular services, including heart surgery; medical imaging procedures such as X-Ray, MRI, CT-scans; mammography; physical therapy; wound care; electro-physiology; stroke care; neurosurgery; in-patient behavioral health care.

Employees with Blue Cross of Idaho insurance through their workplace are not impacted by this change, as they have always been covered as “in network.”