Northern Light-Anthem dispute may force tens of thousands of Mainers to switch doctors

By Annie Rupertus, Bangor Daily News Staff

After finding out that Northern Light may cut ties with her health insurance provider, Anthem Blue Cross Blue Shield, Eliza Watson isn’t sure if she’ll be able to stay with the doctors that have been with her through eight months of cancer treatment.

Having a sense of continuity with her doctors over the course of the year has been important, she said. “To be in a situation where I might have to switch doctors now, at the end of my treatment, feels awful,” Watson said.

Watson, who lives in Gray, is one of tens of thousands of Mainers whose health care could become out-of-network if the two organizations don’t reach an agreement by Sept. 30.

As the contract deadline approaches, patients are coming up with contingency plans. Three people who get care from Northern Light and are insured by Anthem told the Bangor Daily News that they would consider finding new providers if their doctors become out-of-network.

Watson gets health insurance through her husband’s employer, so switching to another insurance company isn’t an option for her family. She said her first step will be to request a “continuity of care” extension — a process where Anthem may be able to provide in-network costs for a “limited period” of time for people dealing with serious illnesses.

Depending on how things go with her follow-up treatment, Watson might ultimately switch to MaineHealth doctors to avoid paying out-of-network costs. 

“To have an issue like the insurance and the medical system where all of my care is — for them not to be getting along, it adds this other layer,” she said, adding that her illness has already caused so much stress around everything, from taking care of her kids to running the small business that she owns with her mom.

For some Mainers, finding new health care providers could cause significant challenges.

Liza Liezah works in special education, and Maine’s teachers get their health insurance through Anthem. She lives in Deer Isle and sees a Northern Light primary care provider on the island. 

“Currently, it is very easy to travel just a few miles down the road for a primary care visit and only need to take an hour or so away from work to do so,” she said.

If her doctor was no longer covered by her insurance, Liezah imagines she’d have to travel as far as Bangor — more than an hour away — for care. 

In certain parts of Maine, there aren’t many options besides Northern Light, one of the largest health care providers in the state.

“The doctor on the island is Northern Light. The doctor in Blue Hill is Northern Light. The doctors in Ellsworth are Northern Light,” Liezah said.

Traveling farther for a check-up would mean taking additional time off work, she said. On top of that, “it can be a significant hardship to get on and off the islands, especially in the winter,” so that means she also expects to be much less likely to visit her primary care provider unless it is an emergency.

Liezah and others also noted that they felt lucky to be in a position where they would be able to travel for health care, if they needed to.

“I can still drive, so I have the means to be able to go somewhere else if it comes down to it,” said Russ Loveland, another Anthem customer who lives in Burlington. “But I worry about a lot of these elderly people that don’t drive anymore — what are they gonna do?”

Loveland is in remission from cancer and sees an oncologist through Northern Light. “I still have to have scans and everything to make sure that the cancer is not coming back,” he said. “It’s something that I can’t mess around with.”

He said he’d rather find a new doctor than switch insurance plans, as he’s been happy with the coverage he’s gotten through Anthem. And after seeing Northern Light cut ties with Humana last year, he worries that the health system could drop other insurance providers, too.

Loveland said he could understand that both Northern Light and Anthem are in a tough position, but that they have to be able to figure out a compromise. “Because ultimately it’s us, the citizens, that are going to suffer when these insurance companies and these hospitals can’t get along and come to a reasonable agreement.”