Stony Brook hospital won't accept Aetna insurance

Talks between Aetna and Stony Brook University Medical Center broke down this week, leaving up to 24,000 Suffolk residents without health insurance coverage if they use the hospital or affiliated doctors.

"We at Aetna are trying everything we can to make this as painless as possible for members," said David Kobus, Aetna vice president for Network for New York.

Patients admitted to the hospital before the contract expired Tuesday are covered, Kobus said. So are some who have already begun a course of treatment, such as some cancer or obstetric patients.

A patient admitted "in a true emergency" to the hospital will also be covered, Kobus said. The patient would then be transferred to another hospital when medically possible.

All other hospitals on Long Island accept Aetna insurance, he said.

Another exception is those students who have signed on to the Stony Brook University Student Health Insurance Plan: Benefits remain in effect until August. Those with out-of-network benefits may also be covered.

Anyone with questions about coverage should call the number on the Aetna ID card, Kobus said.

The Aetna executive said the hospital, which has been negotiating with the health insurer for the past four to five months, had been seeking "double-digit" increases in reimbursements. "We believe that Aetna already more than covers Stony Brook's costs in delivering care," Kobus said.

In a statement, Stony Brook's chief executive, Dr. Steven Strongwater, said that while the hospital was making every effort to control health care costs, "we need to be sure there are sufficient resources for patient access to life saving and to routine, preventive care."

Both sides said they plan to continue negotiating.