RICHMOND, Va. β Tens of thousands of people may soon be out of network with their doctors if Bon Secours Mercy Health and Humana don't come to an agreement by the end of the year.
Jim and Joan Foldesi live just minutes from Bon Secours Memorial Regional Medical Center in Mechanicsville, so naturally, nearly all of Joan's doctors work in that hospital.
But a few weeks ago, Joan received a surprising letter from Humana, her insurance company. It states that as of January 1, 2026, Memorial Regional will no longer be part of the Humana Medicare network.
That means Joan's doctors will soon be considered out of network. The letter lists two suggested in-network providers accepting new patients, which are both roughly one hour away from Joan's apartment. One of the hospitals is located in Williamsburg. The other is in Gloucester.
"I don't know if this is something about their bottom line or something, but I would think they would be putting their the people ahead of this," Jim Foldesi said.
In a press release, a Bon Secours spokesperson said following months of contract negotiations, patients who have Humana Medicaid and Medicare Advantage plans may lose access to their Bon Secours providers by the end of the year. They said if an agreement is not reached by January 1, more than 36,000 patients in the Richmond area could be impacted.
On its website, Bon Secours says what Humana pays its doctors, nurses and caregivers is not adequate to account for the cost of providing safe, quality care. They also blame Humana's alleged failure to address persistently high claims denial rates.
But, Humana told CBS 6 it has offered proposals to reimburse Bon Secours at rates that are fair and reasonable, claiming Bon Secours has made significant financial demands that will ultimately increase healthcare costs for patients.
Both Humana and Bon Secours said negotiations are ongoing.
The Foldesis hope Bon Secours and Humana hear their voices.
"We pray about it, and that's why we also thought about Channel 6 for doing this type of stuff," Jim Foldesi said. "It's just too many people that get get hurt by these type of things that they do, and they may be just sending this letter out to get us to do something to make noise about this, but either way, both need to do something to get this straight, because it's hurting the little guy, not the big."
There is still time for Humana and Bon Secours to reach an agreement before January 1, but enrollment for Medicare and Medicaid is going on right now. So thousands of patients like Joan Foldesi are going to be scrambling to find coverage if they want to remain in-network with their providers.
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