Aetna and Community Medical Centers and Community Health Partners have failed to reach a resolution on a contract extension, leaving some Fresno teacher retirees without coverage. Photo illustration by Cecilia Lopez

Retired Fresno Unified educators relying on Medicare coverage will have to find alternative health insurance after contract negotiations between Aetna and Community Medical Centers and Community Health Partners failed to reach a resolution.

The parties were unable to decide on a contract prior to the Dec. 31 deadline, leaving retirees in limbo to start the new year.

Retirees were notified of the expiration through the Fresno Unified Joint Health Management Board (JHMB) website.

A statement from Fresno Unified School District Superintendent Misty Her added that retirees will still be seen for emergencies.

“I want to assure our retired employees that the JHMB, in coordination with the district’s benefits team and external consultants, have been and are actively evaluating all options, reviewing data requested from Aetna, and assessing potential paths forward,” a statement from the superintendent’s office reads. “We understand that uncertainty about healthcare access is concerning, particularly for our retirees with ongoing medical needs.”

Her said the district is committed to ongoing transparent communication and will aim to provide new, verified information as it becomes available.

FUSD Trustee Susan Wittrup, however, criticized the district’s response, saying that she learned about this situation from retirees reporting that their claims have been denied by Aetna.

“Aetna and Community have NOT been able to negotiate their contract, and our retirees are being used as pawns,” Wittrup added. “The situation is not only life-threatening but it falls far below any standard of care for educators who spent their lives devoted to our students.”

Community Medical Centers has warned patients of potential changes to contracts with certain health insurance plans as negotiations with insurers continue. The system said talks are part of ongoing efforts to secure reimbursement rates that support patient care and hospital operations.

“If a patient in this group is in active treatment with a Community Health Partners physician, they can request authorization from Aetna for a ‘continuity of care’ provision,” said Community’s Division President of Insurance Services & Managed Care Aldo De La Torre. “This would allow Community providers to continue to provide services for up to one year upon Aetna’s approval to allow ample time for the patient to transition to another provider while still receiving the care they require.”

Community advises patients to review their coverage and confirm insurance status prior to receiving care, adding that they are working to limit disruptions and encourage patients to contact their insurer or hospitals with questions about coverage.