Aetna, BJC nearing deal to continue coverage next year

Health insurer Aetna and St. Louis-based BJC Health are nearing an agreement that will keep the health care provider in Aetna's coverage network next year, both sides reported Tuesday.

An Aetna spokesperson said in an email that the two sides had agreed on "key terms" and "are working to finalize documentation for an uninterrupted contract renewal effective January 1, 2026, for Aetna’s commercial and Medicare Advantage plans."

"Members will be notified once the agreements are finalized," said Monica Prinzing, spokesperson for CVS Health, which owns Aetna.

Laura High, a spokesperson for BJC, said the information from Aetna is correct and that "we will have more details in the coming days."

The update comes less than a week before the Sunday deadline for this year's Medicare Advantage open enrollment period.

Without a new agreement, BJC Health will be out of Aetna's coverage network employer-sponsored commercial plans and Medicare Advantage plans starting Jan. 1.

As of 2023, Aetna controlled more than 8% of the market for large employer group comprehensive medical expense insurance in Missouri, according to state figures. It had about 2.5% of the individual Medicare Advantage market.

It is not the first time health insurance companies and large healthcare providers have taken negotiations to the 11th hour.

The Mercy health care system and Anthem Blue Cross Blue Shield, for example, announced a deal extending coverage for more than 2 million Missourians in early December last year, less than a month before Mercy was scheduled to be dropped from Anthem’s network if no agreement was reached.

St. Louis patients in limbo as BJC, Aetna remain at odds in coverage talks

Without a new agreement, BJC Health will be out of Aetna's coverage network employer-sponsored commercial plans, starting Jan. 1.

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WashU, BJC doctors will accept UnitedHealthcare marketplace plans, despite website error

BJC and UnitedHealthcare are partnering next year, even though that's not clear on Healthcare.gov.

View life in St. Louis the week of Nov. 23, 2025

View life in the St. Louis area through the Post-Dispatch photographers' lenses. Edited by Jenna Jones.

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