If you or a family member receives care at a BJC HealthCare facility and you are enrolled in an Aetna or Anthem Medicare Advantage plan, you need to act before December 7, 2026.

Beginning January 1, 2027, BJC HealthCare — the largest health system in Missouri and one of the largest nonprofit health systems in the country — will no longer be in-network for Aetna and Anthem Medicare Advantage plans. That includes Barnes-Jewish Hospital, St. Louis Children's Hospital, Missouri Baptist Medical Center, and the full network of BJC facilities across the St. Louis region.

This is not a minor inconvenience. For retirees who depend on BJC physicians and hospitals, it is a coverage disruption that requires immediate attention.

What This Means in Plain Terms

Medicare Advantage plans are built around provider networks. When you see a doctor or use a hospital that is in your plan's network, your plan pays at the negotiated in-network rate. When you go out of network — if your plan covers it at all — you pay significantly more, and many HMO-style Advantage plans provide no out-of-network coverage for non-emergency care.

Starting January 1, 2027, if you have an Aetna or Anthem Medicare Advantage plan and you receive non-emergency care at a BJC facility, you will be treated as an out-of-network patient. Depending on your specific plan:

• You may owe substantially higher cost-sharing
• Your plan may deny the claim entirely for non-emergency services
• Referrals to BJC specialists may no longer be honored under your plan

Emergency care is a separate matter — federal law requires Medicare Advantage plans to cover emergency services regardless of network status. But routine care, specialist visits, elective procedures, and follow-up appointments at BJC facilities are all at risk.

Which Facilities Are Affected

BJC HealthCare operates more than a dozen hospitals and dozens of outpatient locations across the St. Louis metro area. The network change affects all of them, including:

• Barnes-Jewish Hospital — the flagship academic medical center and home to the Siteman Cancer Center
• Missouri Baptist Medical Center — serving west St. Louis County
• Christian Hospital — serving north St. Louis County
• Parkland Health Center — serving Farmington and the surrounding region
• Boone Hospital Center — serving Columbia and mid-Missouri
• BJC Medical Group physician practices throughout the region

If your primary care physician, cardiologist, oncologist, or any other specialist is part of the BJC system, their services will be affected.

Why This Is Happening

Contract disputes between large health systems and insurance carriers are not unusual, but they are disruptive when they affect Medicare beneficiaries who have built long-term relationships with their care teams.

BJC and the carriers involved have not publicly resolved their contract negotiations as of this writing. Retirees should not wait to see whether a last-minute agreement is reached. The Annual Enrollment Period closes December 7 — and if no deal is in place by then, beneficiaries who have not switched plans will face the new year without in-network access to BJC.

What You Should Do Before December 7

The Annual Enrollment Period runs October 15 through December 7 each year. During this window, you can switch Medicare Advantage plans, switch from Medicare Advantage back to Original Medicare, or change your Part D drug plan. Coverage under your new plan takes effect January 1.

If you are currently enrolled in an Aetna or Anthem Medicare Advantage plan and you receive care at BJC, here are your options:

Option 1: Switch to a Medicare Advantage plan that remains in-network with BJC. Other Medicare Advantage carriers may still have contracts with BJC for 2027. An independent broker can identify which plans in your zip code include BJC facilities in their network and compare premiums, drug coverage, and out-of-pocket costs.

Option 2: Switch to Original Medicare with a Medicare Supplement (Medigap) plan. Original Medicare is accepted by any provider in the country who accepts Medicare — including all BJC physicians and facilities. Pairing it with a Medigap plan (such as Plan G or Plan N) eliminates most out-of-pocket exposure and removes network concerns entirely. You would also need a standalone Part D plan for prescription drug coverage.

Option 3: Do nothing — and understand the consequences. If you take no action before December 7, your Aetna or Anthem Medicare Advantage plan will continue into 2027, but BJC will be out of network. If your health situation allows you to transition your care to non-BJC providers, this may be manageable. For most retirees with established care relationships at BJC, it is not a realistic option.

A Note on Timing

December 7 is a firm deadline. There is no grace period, and this network change does not trigger a Special Enrollment Period on its own. If you miss the Annual Enrollment Period, your next opportunity to change plans is the Medicare Advantage Open Enrollment Period (January 1 – March 31), during which you can switch to a different Advantage plan or return to Original Medicare — but you cannot add a Medigap plan during that window without medical underwriting in most cases.

Acting now, while the Annual Enrollment Period is open, gives you the most options.

Talk to a Local Medicare Expert Before December 7

This is exactly the kind of situation where working with an independent Medicare broker makes a real difference. James Hughes has helped hundreds of St. Louis-area retirees navigate plan changes, network disruptions, and enrollment decisions — with no cost and no obligation.

He can review your current plan, identify which 2027 plans keep your BJC providers in-network, compare your total costs, and help you make a change before the December 7 deadline.

Call 314-229-6146 or visit the Contact page to schedule your free Medicare review. Do not wait — the enrollment window closes in weeks.