Starting Oct. 1, 2025, Catholic Medical Center and employed providers may no longer be participating providers in the WellSense Clarity ACA Exchange (HIX) insurance plan.
We are working very hard right now to prevent this from happening. We certainly understand how unsettling this prospect may be for you, and assure you we are actively negotiating in good faith to reach an agreement with WellSense. Our goal is to reach a compromise with WellSense so you and your loved ones can continue to have the convenient access you expect within your community.
If a compromise cannot be reached by Oct. 1, 2025, our facility and employed providers will no longer be part of the WellSense Clarity plan. This means that as a WellSense Clarity member, you may either not be covered for non-emergency medical services at our facilities or physician clinics, or you may be required to pay higher out-of-network costs for those services.
Whether or not we are able to reach an agreement with WellSense, all patients, including those with the WellSense Clarity insurance plan, are always able to receive emergency services at our hospitals.
We remain firmly dedicated to providing healthcare services to support the health and wellness of our community.
For more information about your coverage for services at our facilities, please call the telephone number located on the back of your WellSense insurance care.
Thank you for your understanding and for the privilege of caring for you and your family.
Frequently Asked Questions
Yes. Regardless of what happens with the WellSense negotiations, everyone with WellSense Clarity insurance still has access to Catholic Medical Center for emergency services. Our colleagues, physicians and nurses are here for anyone who needs help in an emergency.
If a new agreement is not reached, then as of Oct. 1, 2025, Catholic Medical Center will no longer be part of the WellSense Clarity provider network. This means that patients with WellSense Clarity insurance may either not have coverage for non-emergency medical services at Catholic Medical Center, or WellSense may require them to pay higher out-of-network co-pays and deductibles for those services. Emergency care, of course, is always available regardless of insurance plans.
While WellSense represents a small portion of the total admissions to our hospital, all other major insurance companies in the area continue to contract with us.
No. We want to continue our relationship with WellSense, but it is critical that we are able to agree on a reasonable contract that allows us to maintain access to quality care that our patients, physicians, leadership and staff have come to expect.
No. We want to continue our relationship with WellSense, but it is critical that we are able to agree on a reasonable contract that allows us to maintain access to quality care that our patients, physicians, leadership and staff have come to expect.
As far as we know, you will be able to continue any treatment you have already started this year at our hospital that was previously authorized by WellSense Clarity. You may wish to contact WellSense directly to find out if we can continue to provide the next phases of your treatment planned for after Sept. 30, 2025.
No. This expiration does not involve the WellSense Medicaid nor the WellSense Medicare products. CMC remains in network with the Medicaid and Medicare products.
Yes. If a new agreement is not reached, then as of Oct. 1, 2025, Catholic Medical Center will no longer be part of the WellSense Clarity ACA Exchange (HIX) insurance provider network. This means that patients with WellSense Clarity insurance may either not have coverage for non-emergency medical services at our hospitals, or WellSense may require them to pay higher out-of-network co-pays and deductibles for those services. Emergency care, of course, is always available regardless of insurance plans.