Imagine finding out you have cancer.

After processing the news and meeting with doctors to figure out what the treatment options are, you schedule surgery, have radiation, and have regularly scheduled checkups to help you kick cancer to the curb.

Now imagine that a little less than a year later, you are notified that Memorial Slone Kettering (MSK) – your cancer treatment facility – will no longer be an option because your insurance carrier will not renew the existing contract with them.

“[Anthem] Blue Cross Blue Shield [New York] cannot come to an agreement with MSK,” said Carrie Regan, ovarian cancer survivor who is facing this exact situation.

Carrie Nolan, who lives in Pine Bush and teaches high school teacher elsewhere in Orange County, said she recently received a letter from MSK advising her that they would not be a part of Anthem’s network of providers after Dec. 31, stating that “Anthem has refused to agree to a reasonable contract that would ensure uninterrupted access to MSK’s life-saving cancer care.” As the date the cancer center will stop being an in-network provider draws closer, MSK said their letter was to make sure Nolan and others aren’t left scrambling to try to find doctors at the last minute.

Diagnosed in September 2023, Nolan said she was admitted to the hospital the month before thinking she had an appendicitis, but a huge mass picked up via a CT scan led doctors to believe that much more was going on.

“The physician assistant ran a CA 125 test [which measures a particular cancer antigen protein] in the E.R.,” Nolan said. While normal range falls between 0 and 35 U/mL (units per millimeter), her level was in the thousands, which made her a candidate for treatment at MSK.

There was a week between her first MSK visit and her first surgery, Nolan said, followed by trips back every three to four weeks for scans and bloodwork, which meant she saw her treatment team there quite often.

The letter from MSK gave her an 1-800 number to connect with Anthem and inquire about keeping the cancer center as a network provider.

“The lady I spoke to said it was just a scare tactic – don’t worry about it. But I am worried about it,” Nolan said.

She added that Anthem keeps pointing her to their website to find a new provider, but because cancer treatment can involve regularly needing to see multiple types of specialists, it’s not quite so simple.

“Sloan essentially takes over your primary care once you are diagnosed. These doctors I’ve spent a lot of time with. They know me. They know what this is,” she said. “The level of care you receive there is unbelievable.”

From the Explanation of Benefits forms she’s received, Nolan said that her surgical care alone has cost hundreds of thousands of dollars and estimates that her out-of-pocket expenses – which include insurance copays, travel to New York City, parking, and meals while there – easily topped $5000 over the past year. Those expenses make using MSK if they are no longer an in-network provider quite a financial challenge.

But the mother of a 15-year-old, 12-year-old twins, and an 8-year-old said she would like to definitively know what her options are sooner rather than later.

“I’ve started looking at different cancer centers like Dana Ferber in Boston, but as a single mom with four kids, it’s a hard proposition.”

As appointments with cancer treatment specialists are usually made months in advance, Nolan said she’s concerned that once she hears from Anthem, it may be quite difficult to get in to see new doctors and get her medical records transferred as the end of year holidays get closer.

“Someone told me that if you break your leg, you don’t want to go to a doc who specializes in wrists,” she said. “I think you should be able to continue if you are under the care of a certain doctor.”

As Anthem Blue Cross Blue Shield New York offers healthcare options for many federal employees, Nolan said that she’s aware that civil servants in New York City have started letter writing campaigns to try to get some answers.

According to a statement on Anthem’s website, the insurance carrier is “is currently in discussions with Memorial Sloan Kettering Cancer Center (MSK) to keep them in our network through 2025 and beyond” and as such will keep the provider in their network until at least March 1, 2025.

The issue, they said, is financial.

Although Anthem said they currently reimburse MSK “at rates at or above other national cancer centers,” MSK is now asking for double digit price increases each year for the next three years, which Anthem said would be “directly felt by our members and their employers.”

As an example, Anthem said that under MSK’s proposed price increase, a mastectomy would cost $23,800 more in 2027 than it does now.

“We remain confident an agreement will be reached that keeps MSK in our network beyond March 1, 2025. However, if an agreement can’t be reached and MSK chooses to leave our network, any member who begins receiving services prior to March 1, 2025, will be covered through their entire course of treatment,” Anthem stated.