BCBSNE to extend in-network benefits for members at five CHI hospitals

Blue Cross and Blue Shield of Nebraska (BCBSNE) announced today that its customers can get in-network benefits at five CHI Health hospitals that are currently out of network—providing them with enhanced options for health care in their communities. 

Effective January 1, 2015, BCBSNE members will pay in-network deductible, copay and coinsurance at these five facilities: Good Samaritan Hospital in Kearney, Saint Francis Medical Center in Grand Island, St. Mary’s Community Hospital in Nebraska City, CHI Health Schuyler and CHI Health Plainview. 

In addition, BCBSNE will pay the same amount for covered medical services at those facilities as it did prior to the September 1 network termination. “We hope this eases the transition for our members,” said BCBSNE senior vice president Lee Handke. “We made the decision to fix the problem on behalf of our members in those communities.” 

BCBSNE made the move to help BCBSNE members who would have to pay out-of-network costs if they had used the five CHI facilities—which are the only full-service hospitals in those towns. 

CHI Health was removed from the BCBSNE network in September because its costs are 10% to 30% higher for physician and hospital services in Omaha. CHI Health included all its facilities across Nebraska under one contract, which locked out members outside of Omaha from getting care at in-network rates. 

BCBSNE proposed multiple times signing a separate agreement with CHI hospitals outside of Omaha, but CHI refused. “We were hopeful of reaching an agreement with Denver-based CHI long before now—especially in our efforts to take members in these five communities out of the middle of an Omaha problem,” Handke said. “That wasn’t happening, so we took it upon ourselves to do something about it.” 

Because the five facilities are still out of network, BCBSNE will send payment for medical services directly to the member, who will be responsible for paying the provider. CHI Health can still bill members for the difference between what BCBSNE pays and what the provider charges—although CHI officials have stated publicly they will not bill members for the difference. 

Members can get more information at www.nebraskablue.com/update, or call a special hotline at (844) 286-0855.



The percentage of the bill you pay after your deductible has been met.


A fixed amount you pay when you get a covered health service.

Tiered benefit plan

A health care plan featuring multiple levels of benefits based on the network status of a particular provider. 


The annual amount you pay for covered health services before your insurance begins to pay.

emergency care services

Any covered services received in a hospital emergency room setting.


Includes behavioral health treatment, counseling, and psychotherapy

in-network provider

A provider contracted by your insurance company to accept an agreed upon payment for covered services. 

OUT-OF-network provider

A term for providers that aren’t contracting with your insurance company. (Your out-of-pocket costs will tend to be more expensive if you go to an out-of-network provider.)


Your expenses for medical care that aren’t reimbursed by insurance, including deductibles, coinsurance and co-payments.


If you can afford health insurance, but choose not to buy it, you must have a health coverage exemption or pay a tax penalty on your federal income tax return.


The amount you pay to your health insurance company each month. 

Preventive services

Health care services that focus on the prevention of disease and health maintenance.


Services and devices to help you recover if you are injured or have surgery. This includes physical, occupational and speech therapy.

special enrollment period

The time after the Open Enrollment Period when you can still purchase health insurance only if you have a qualifying life event (losing other health coverage, having a baby, getting married, moving).


A physician who has a majority of his or her practice in fields other than internal or general medicine, obstetrics/gynecology, pediatrics or family practice.