Important information for patients with Excellus health insurance
St. Joseph’s Health is negotiating for a new agreement with Excellus so that we can continue providing high-quality care to those we serve. Our negotiations impact patients with the following Excellus coverage:
- Commercial (employer-sponsored and ACA marketplace) plans;
- Medicare Advantage plans;
- Medicaid plans;
- Essential Plan plans
Our agreement expires effective January 1, 2025, and impacts in-network access to St. Joseph’s Health Hospital, facilities, and health care providers—including select St. Peter’s Health Partners Medical Associates practice locations in Fulton, Montgomery, Warren, Saratoga, Schenectady, and Ulster counties. For now, nothing changes. Continue to visit your trusted hospital, facilities, and physicians as you normally would.
As a not-for-profit health care system, we rely on fair payment from health insurers so we can provide the services and invest in the high level of care patients depend on and need. Our current contract with Excellus does not appropriately cover the true cost of care and we are asking Excellus to step up and do their part, just as other health insurers have done.
We believe Health Comes First
As a trusted local care provider, we work tirelessly to care for our patients and communities. We also continue to reduce costs and implement efficiencies to ensure we can continue providing top-quality care to our patients. We are asking health insurers to put patients first just like we do. Without them doing their part, access to care is at risk. Find out how St. Joseph’s Health invests in our community.
Health insurers, including Excellus, continue to reimburse health systems at low rates, delay payments and frequently deny patient claims. We cannot continue to do more with less. To learn more, visit Health Comes First.
Frequently Asked Questions
You deserve access to high-quality health care
At St. Joseph’s Health, we believe our community members deserve options for high-quality care, and we are proud to be one of New York's most trusted health care providers. That’s why we’re working to protect our ability to serve patients for generations because health comes first.
If you do not find the answers to your negotiation-related questions on this site, please contact us directly via this website through our contact us page or call our patient line at (315) 273-3700. This website will be updated as our negotiations continue, so please check back for the most up-to-date information.
A: St. Joseph’s Health is negotiating with Excellus for new agreements that more appropriately cover the cost of the care we provide Syracuse patients with Excellus commercial, Medicare Advantage, Medicaid and Essential Plan health plans. Our negotiations may also impact patients that receive services at certain St. Peter’s Health Partners Medical Associates practices located in Fulton, Montgomery, Warren, Saratoga, Schenectady, and Ulster counties. St. Peter’s Health Partners Medical Associates is affiliated with St. Joseph’s Health.
Our current contract will expire January 1, 2025.
Although negotiations are a routine part of doing business, we have tried to do our best to avoid disruption for as long as possible, but our relationship with Excellus is no longer sustainable. Like other local health care providers, Excellus’ low payment to our health system has not kept up with the rate of inflation.
A: We’ve always put this community first, but for more than a decade, low and delayed payments and frequently denied patient claims have been too common with Excellus. These issues make it harder for us to continue to invest in the medical innovations, leading-edge technologies, and programs that our community relies on. We provide critical behavioral health services including the only Comprehensive Psychiatric Emergency Program (CPEP) in Central New York. We also lead the region in general surgery volume and the St. Joseph's Health Cardiovascular Institute is among the best heart care programs in the country. Our patients need our expertise and higher level of care, and Excellus is putting that at risk. We are asking Excellus to step up and do their part to pay us fairly for the care we provide.
A: Our current agreements will expire effective January 1, 2025.
A: For now, nothing changes. You should continue to visit St. Joseph’s Health Hospital, facilities, and physicians as you normally would. We are working hard to reach a new agreement before January 1, 2025, to avoid care disruption, but Excellus needs to step up and put patients first. If we are unable to reach agreement before our contracts expire, New York law provides continued access to St. Joseph’s Hospital through February 28, 2025, for fully insured and ACA marketplace commercial, Medicaid and Essential Plan health plans.
A: Excellus commercial (including employer-sponsored and ACA marketplace), Medicare Advantage, Medicaid and Essential Plan health plans.
A: All St. Joseph’s Health hospital, facilities, and employed providers are impacted by these contract negotiations, including select St. Peter’s Health Partners Medical Associates physicians in Fulton, Montgomery, Warren, Saratoga, Schenectady, and Ulster counties.
- St. Joseph’s Health Hospital and all associated facilities and locations
- St. Joseph’s Health Hospital Clinics and Providers
- St. Joseph’s Physicians
- St. Peter’s Health Partners Medical Associates practices located at:
- Cardiology Associates of Schenectady - 23 Arterial Plaza 30-A, Gloversville
- Cardiology Associates of Schenectady - 425 Guy Park Avenue, Amsterdam
- SPHPMA Radiology Division - 1 Tallow Wood Drive, Clifton Park
- Cardiology Associates of Schenectady - 103 Sitterly Road, Clifton Park
- Saratoga Family Practice - 11 Hampstead Place, Saratoga Springs
- Albany Associates in Cardiology - 1735 Route 9, Halfmoon
- Albany Cardiothoracic Surgeons - 1735 Route 9, Halfmoon
- Capital Region Urology - 1735 Route 9, Halfmoon
- St. Peter’s Vascular Associates - 1735 Route 9, Halfmoon
- St. Peter's Primary Care - 2537 State Route 9, Ballston Spa
- St. Peter's Primary Care - 377 Church Street, Saratoga Springs
- St. Peter's Family Medicine - 4 Congress Place, Saratoga Springs
- Saratoga Cardiology Associates - 6 Care Lane, Saratoga Springs
- Albany Advanced Imaging - 648 Plank Road, Clifton Park
- Capital District Colon & Rectal Surgery Associates - 855 Route 146, Clifton Park
- Capital Region Urology - 855 Route 146, Clifton Park
- St. Peter's Diabetes & Endocrine Care - 855 Route 146, Clifton Park
- St. Peter's Neurology - 855 Route 146, Clifton Park
- Cardiology Associates of Schenectady - 115 Saratoga Road, Glenville
- SPHPMA Radiology Division - 1270 Belmont Avenue, Schenectady
- Cardiology Associates of Schenectady - 2546 Balltown Road, Schenectady
- Cardiology Associates of Schenectady - 3757 Carman Road, Schenectady
- Saugerties Wellness Center - 854 Route 212, Saugerties
- Albany Associates in Cardiology - 156 Quaker Road, Queensbury
A: While we work to find a solution, you can explore your options to maintain in-network access to your trusted hospitals, doctors, and specialists in 2025:
- Call Excellus. Using the number on the back of your insurance card, let Excellus know how vital it is to have in-network access to St. Joseph’s Health and our affiliated providers.
- Speak with your HR or benefits manager at work. If you receive health insurance through your employer, reach out to your HR contact to request a health plan in the upcoming selection period that includes St. Joseph’s Health and our affiliated providers.
- If you have a Medicare Advantage plan through Excellus, contact your health insurance agent or broker for options to switch plans during Open Enrollment beginning October 15 – December 7, 2024. We work with many other health plans that will give you in-network access to St. Joseph’s Health for the 2025 benefit year:
- Trinity Health Plan New York (formerly MediGold; an affiliate of St. Joseph’s Health)
- Traditional Medicare
- Fidelis Care
- MVP Health Plan
- Nascentia Health
- WellCare
- Dually-enrolled - Call 1-800-MEDICARE. Dually enrolled patients in a Medicare/Medicaid plan may also take action. Call 1-800-633-4227 to see if you are eligible to make a change in your plan.
- Visit https://www.health.ny.gov/health_care/medicaid/members/. If you are covered by an Excellus Medicaid plan, you can consider alternative health care coverage that protects your ability to affordably access Joseph’s Health or St. Peter’s Health Partners Medical Associates regardless of our status with Excellus. Additionally, patients enrolled in a Medicaid plan can call the state helpline at 800-541-2831.
A: If you are already admitted to the hospital before January 1, 2025, you will be covered at in-network rates through the end of your inpatient stay.
A: We understand that some patients may have appointments scheduled on or after January 1, 2025. If possible, you should call your provider’s office to request that the appointment or procedure be rescheduled before January 1, 2025. If you are unable to reschedule your appointment or choose to keep your existing appointment date, you may have to pay higher out-of-pocket costs for your care with St. Joseph’s Health if Excellus forces us out of its provider network.
A: Patients will always have in-network access to our emergency rooms, regardless of our status with Excellus. If you experience an emergency, you should always visit the nearest emergency room. Patients needing emergency care can receive in-network treatment until the patient is stable.
A: For the most up-to-date information, we encourage you to contact us by visiting sjhsyr.org/Excellus or call our patient hotline at (315) 273-3700.
What You Can Do
There are ways to protect your ability to affordably access St. Joseph’s Health and our affiliated providers in 2025, regardless of our status with Excellus. Consider the following:
- Call Excellus. Using the number on the back of your insurance card, let Excellus know how vital it is to have in-network access to St. Joseph’s Health and our affiliated providers.
- Speak with your HR or benefits manager at work. If you receive health insurance through your employer, reach out to your HR contact to request a health plan in the upcoming selection period that includes St. Joseph’s Health and our affiliated providers.
- Contact your broker. If you have a Medicare Advantage plan administered by Excellus, you can consider alternative health care coverage during the Annual Open Enrollment Period that runs from October 15 – December 7, 2024.
- Dually-enrolled - Call 1-800-MEDICARE. Dually enrolled patients in a Medicare/Medicaid plan may also take action. Call 1-800-633-4227 to see if you are eligible to make a change in your plan.
- Visit https://www.health.ny.gov/health_care/medicaid/members/. If you are covered by an Excellus Medicaid plan, you can consider alternative health care coverage that protects your ability to affordably access St. Joseph’s Health or St. Peter’s Health Partners Medical Associates regardless of our status with Excellus. Additionally, patients enrolled in a Medicaid plan can call the state help line at 800-541-2831.