Florida Blue Insurance Coverage – Important Update

What This Means for You:

• Emergency services remain covered. All emergency care is covered at in-network rates, even though Memorial is now out of network.
• Continuity of Care. Patients in active treatment may be eligible to continue seeing their Memorial providers for a limited period. Florida Blue determines eligibility.  If you are in active treatment:
  • Call the number on the back of your Florida Blue insurance card to request Continuity of Care.
• Coverage choices. Depending on your coverage, you can switch plans during open enrollment to stay in-network with Memorial:
  • Medicare Open Enrollment: October 15 – December 7, 2025 (Includes Medicare Advantage)
  • ACA Marketplace Open Enrollment: November 1, 2025 – January 15, 2026

For updates, visit this website or call our patient information line at (954) 276-5501

Why staying with Memorial matters:

• Trusted, Top-Ranked Care Close to Home
  Memorial serves nearly 2 million South Florida residents through six hospitals, three urgent care centers, 14 primary care practices, and more. Families trust Memorial because the system consistently ranks among Florida’s top hospitals for rehabilitation, neonatology, orthopedics, and pediatric behavioral health.
• Proven Leadership in Quality and Safety
  Memorial Hospital Pembroke and Memorial Hospital Miramar both earned “A” Hospital Safety Grades from The Leapfrog Group in Spring 2025, and Miramar holds a CMS 5-star rating. These results reflect Memorial’s steadfast focus on safe, high-quality care.
• Nationally Recognized Centers of Excellence
  Joe DiMaggio Children’s Hospital and our institutes in cancer, trauma, cardiac, and behavioral health, Memorial’s programs earn national recognition and deliver outcomes on par with the best in the country.
• Comprehensive Services for Every Stage of Life
  Memorial provides a full continuum of care, from maternity and primary care to advanced specialties like cardiac, cancer, neuroscience, orthopedics, and rehabilitation, ensuring patients of all ages receive the care they need in one trusted system.
• Committed to Community, Centered on Patients
  As a not-for-profit health system, Memorial reinvests over $900 million annually into South Florida. Every dollar goes towards improving patient care, expanding access, and advancing technology for the benefit of the community we serve, and not the benefit of shareholders.

Frequently Asked Questions – Out–Of–Network

Q: Is Memorial still in network for Florida Blue members?
A: As of September 1, 2025, Florida Blue has placed all Memorial Healthcare System hospitals and facilities out of network for their health plan members. 

Q: What does it mean to be “out of network”?
A: Out of network means Memorial no longer has a contract with Florida Blue. When you receive care from an out-of-network provider or facility, your insurance may cover less or none of the cost. This could lead to higher out-of-pocket expenses for you.

We strongly recommend that Florida Blue members contact Florida Blue directly to understand what your plan will cover for out-of-network care. You can reach Florida Blue using the phone number on the back of your insurance ID card.

Q: Which Florida Blue plans are affected?
A: All Florida Blue plans are impacted, including:

• Employer-sponsored (commercial) plans
• ACA Marketplace plans
• Medicare Advantage plans

Q: Will my emergency care still be covered?
A: Yes. Under federal law, emergency medical care must be covered at in-network rates, even if the provider or hospital is out of network. This includes visits to the emergency room.

Q: What if I'm in the middle of treatment?
A: If you are in the middle of an active course of treatment (such as pregnancy, cancer care, or a scheduled surgery), you may qualify for Continuity of Care benefits. This allows you to continue care with your current Memorial provider for a limited time.

To apply, contact Florida Blue directly using the phone number on the back of your insurance card.

Q: How will being out-of-network affect my costs?
A: If you receive non-emergency care at Memorial while out of network, your costs may be significantly higher. You could be responsible for the full bill, or your plan may cover only part of it. Call Florida Blue to understand your plan’s out-of-network coverage and what your costs might be.

Q: Can I still schedule appointments if I choose to pay out of pocket?
A: Yes. Patients may continue seeing Memorial providers and pay for care themselves. However, without insurance coverage, you will be responsible for the full cost of services. We can provide estimates to help you understand potential costs before your appointment.

Q: Can I change my insurance plan to keep Memorial in-network?
A: YES. You have options to keep your access. Depending on your coverage, you can switch plans during open enrollment to stay in-network with Memorial:

• Medicare Open Enrollment: October 15 – December 7, 2025
  (Includes Medicare Advantage)
• ACA Marketplace Open Enrollment: November 1, 2025 – January 15, 2026

If you want to continue your care with Memorial doctors and hospitals, review your plan options carefully and select a plan that keeps Memorial in-network.

Q: What can I do if I want Memorial to be back in network with Florida Blue?
A:

• Call the number on the back of your Florida Blue ID card and tell them you want Memorial Healthcare System back in network.
• Consider switching to a health plan that includes Memorial in network during your plan’s open enrollment period:
  • Medicare Open Enrollment: October 15 – December 7, 2025 (includes Medicare Advantage)
  • ACA Marketplace Open Enrollment: November 1, 2025 – January 15, 2026
  • If you have employer-sponsored coverage, ask your employer’s HR or benefits team about available plan options that include Memorial.

Check back on this webpage for updates or call our patient information line at (954)-276-5501

Why didn't an agreement happen?
A: Memorial proposed multiple reasonable solutions to protect patient access and sustain high-quality care. Florida Blue declined to close the significant gap between what they pay and fair market reimbursement.

What can I do?
A: Call the number on the back of your Florida Blue insurance card and tell them you want Memorial Healthcare System back in-network. You can also explore new coverage options during open enrollment to keep your Memorial doctors and hospitals in-network.

What if I have an upcoming appointment at Memorial?
A: If you have an appointment, contact Florida Blue before your visit to confirm your eligibility.

Will I get a surprise bill if I get care at Memorial while out of network?
A: Receiving care from an out-of-network provider may result in higher bills. Under the federal No Surprises Act, you are protected from balance billing in emergency situations, but this protection does not apply to scheduled (non-emergency) care. Always ask for a cost estimate before receiving non-emergency services.

Where can I get more information?
A: 

• Call Florida Blue using the number on your insurance card to ask about your benefits.
• Call Memorial’s patient information line at (954)-276-5501 for general questions.
• Check this webpage regularly for updates on Memorial’s network status.