BCBS of Oklahoma posted an online alert, notifying its members that two Muskogee hospitals and many of the physicians swept into the Saint Francis network had been removed from its network of providers for seven plans. Saint Francis officials issued a statement Wednesday night, saying in-network services at Saint Francis Muskogee Hospital remain available to BCBS of Oklahoma members. They declined to elaborate or explain the contradicting statements. Saint Francis Health System bought EASTARs east campus and assumed the remainder of a 40-year lease for its main campus, a facility that is owned by a city trust formerly known as Muskogee Regional Medical Center. The acquisition by the Tulsa-based network of hospitals, clinics and physicians was announced in February and finalized Saturday. BCBS officials, in the online alert that was removed Wednesday following media inquiries, attributed the problems to a decision made by Saint Francis to reject reimbursement rates previously accepted by EASTAR. That decision resulted with Saint Francis Hospital Muskogee and its physicians being removed from the insurers network of providers, but the situation began to shift Wednesday. At this time, Blue Cross and Blue Shield of Oklahoma is engaged in confidential negotiations with Saint Francis with the intent to protect our members in the Muskogee community, spokeswoman Lauren Cusick said. We are unable to comment further. Saint Francis officials acknowledged in their statement that they continued to be engaged in confidential negotiations but were unable to provide additional information at this time. Local health care consumers began sharing concerns after learning they might have to find new primary care providers or travel to hospitals outside Muskogee to secure in-network savings offered by their insurance plans. Ronnie Ball said he learned about the situation when he went to a scheduled doctors appointment to get a report from lab work that had been done earlier. Ball, who has coverage through the Blue Cross Medicare Advantage PPO plan, said he learned after he arrived his insurance would not be accepted because his physician was no longer considered an in-network provider as a result of the Saint Francis-EASTAR deal. That leaves me … without a local hospital to go to unless I want to risk paying out-of-network costs or maybe having to pay 100 percent of the costs, Ball said. I wonder what was behind this decision now that there may be thousands of people in the Muskogee area who no longer have insurance coverage with local doctors or if they do they are out of network. Cusick was unable to provide information about how many people in the Muskogee area might be affected by Saint Francis decision if there is no breakthrough in the renewed negotiations.

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In this case, $5,000 of the Social Security benefit is added to taxable income (50% of the difference between total provisional income of $42,000 and $32,000) resulting in $35,000 of total taxable income. This taxable income is then offset by your deductions and personal exemptions. (For related reading, see: How Social Security Benefits Are Taxed .) Assuming we are taking the standard deduction of $12,600 (married filing jointly for 2016) and two exemptions ($4,050 each), that gives us a total of $20,700 in deductions. So youre left with $14,300 of taxable income ($35,000$20,700) which is taxed at the 10% marginal tax rate. For those filing as married (joint), they can go up to $18,550 of income and still remain at the 10% tax rate. Therefore, an opportunity exists to take an additional $4,250 of income in the form of withdrawals from your tax-deferred accounts and remain at the 10% marginal tax rate. Of course, if your provisional income wasn’t greater than $32,000 (or $25,000 for those filing a single return), your Social Security benefit would be completely tax-free, and there would potentially exist an even greater opportunity to optimize your IRA distributions. You could take up to $20,700 if you had no other income and pay zero in taxes (because its offset by your standard deduction and personal exemptions ) or take $39,250 in withdrawals, of which the first $20,700 is offset by deductions and the next $18,550 is taxed at the 10% rate, for an effective rate of 4.7%. Not too bad. Should You Delay Your Social Security Benefits?

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