You might have heard about a legal disagreement between Asante and ATRIO Health Plans. Because this is a matter for the courts, we aren’t going to talk about any pending litigation, share our opinions on it, or tell you what decisions to make. Instead, we want to focus entirely on you.
Your Health Comes First
At ATRIO, our only goal is to make sure you are healthy and happy. We care about our neighbors here in Oregon. We believe you should always have the freedom to choose the healthcare that works best for you. If our plan isn't the right fit for your needs, we truly understand—we just want you to find what makes you feel safe, healthy, and seen.
Know Your Rights
It is very important that you know how Medicare works. No matter what insurance you have, please remember for ALL enrolled in Medicare:
- In an Emergency or for Urgently Needed Care: If you are hurt or very sick and experiencing a medical emergency, any hospital or doctor must help you. It does not matter if they are "in our network" or not. Federal law requires Medicare-participating hospitals like Asante to provide emergency medical screening and stabilizing treatment to anyone who needs it, regardless of insurance, network status, or payment disputes—this is required under the federal Emergency Medical Treatment and Labor Act (EMTALA). Medicare Advantage regulations further require your ATRIO plan to cover emergency and urgently needed services from any qualified provider (in or out of network), with no prior authorization allowed before you are stabilized. Asante must see you for these services and cannot turn you away or make you pay in advance.
- Fair Costs and No Balance Billing: Most doctors who see Medicare patients are only allowed to charge the amount that Medicare (or your Medicare Advantage plan) says is fair. They cannot bill you extra, even out-of-network. Your cost-sharing for services is strictly limited to the lower of your plan’s in-network cost-sharing or the federally capped amount. Out-of-network providers, such as Asante, are prohibited from balance billing you or sending you bills beyond your plan’s approved cost-share. They must accept your ATRIO plan’s payment as payment in full (plus only your cost-share). You are fully protected from surprise bills or extra charges for these services.
- Our Promise: For every dollar we receive, we must spend at least 85 cents directly on your medical care, and at ATRIO, we spend more than that. We put your health before our profits.
We Are Your Neighbors
We are more than just a company; ATRIO and our employees are also part of your community. Our offices in Salem and Roseburg are open if you want to stop by and talk. If you can’t make it in person, please give us a call (877-672-8620). Our team is ready to help, and since many of us live right down the road, you might find out you're talking to a neighbor!
Remember, we are always here to help and to make sure your choices, rights, and protections are honored.
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