Saint Francis plan would reimburse public school employees

Editor's note: The following story has been edited to clarify information regarding the out-of-network policy

Saint Francis Medical Center on Tuesday announced a program that will reimburse Cape Girardeau Public School District employees up to $500 per family if they choose to include the hospital in their 2014 insurance network, which will cost district employees about $40 a month.

The Cape Girardeau Public School District Board earlier this month approved a "narrow network" health-insurance plan offered by Anthem Blue Cross/Blue Shield, saving the district $317,000 for 2014. Saint Francis, Barnes-Jewish Hospital in St. Louis and facilities owned and operated by the two hospitals are not included in the network. Southeast Hospital and other St. Louis hospitals are in the network.

If a district employee wishes to include Saint Francis and Barnes facilities in their health-insurance network, they can pay an additional $41.30 per month.

If an employee does not pay to include Saint Francis or Barnes facilities and uses their services, the employee will receive only out-of network benefits, according to district information.

Saint Francis will reimburse school district employees who select the Saint Francis option and their covered dependents for co-pays and out-of-pocket expenses accumulated at the hospital in 2014 -- up to $500 a family, according to a statement on the hospital's Facebook page. A reimbursement check is to be issued to a responsible party when a $500 threshold is reached, or Dec. 31, 2014, whichever comes first.

Those who are covered or partly covered by government programs such as Medicare, Medicaid or VA, or are covered by federal supplements, will not be reimbursed because of federal regulations, the statement said.

"Once your co-pay and out-of-pocket payments total $500, we will issue you a check," the statement said. "If you have not reached the $500 threshold by Dec. 31, 2014, you will be reimbursed for whatever amount you have spent."

Superintendent James Welker said the school district board has had "no official correspondence or communication from Saint Francis" regarding the program.

Attempts to reach Saint Francis executives for comments beyond the Facebook announcement were unsuccessful Tuesday.

ashedd@semissourian.com

388-3632

Pertinent address:

211 St. Francis Dr., Cape Girardeau, MO