Oct

16

UnitedHealthcare Commercial Contract Non-Renewal

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 As of March 1, 2024, UnitedHealthcare will no longer cover care at the UVM Health Network as in-network for commercial plans. These are plans typically provided through an employer or purchased directly.

The following plans have NOT been impacted:

  • Non-commercial UnitedHealthcare plans regulated by the state or federal government – such as Medicare Advantage, Managed Medicaid, VA Community Care Network 
  • United Medicare Supplement plans including, but not limited to AARP plans
  • United Behavioral Health plans (see question 6 below for additional details)
  • United The Empire Plan for New York State Employees

We realize this may cause stress and anxiety if you are impacted by this news. As a safety net provider, the UVM Health Network will always provide emergency care to anyone who walks through the door, regardless of what insurance they have or whether they have insurance at all.

United customers who wish to remain in-network with the UVM Health Network after February 29, 2024, are encouraged to explore other health insurance options during their upcoming open enrollment period.

Helpful Resources:

  • Members with insurance through an employer can contact United using the phone number on the back of their insurance card for the fastest service.
  • Members with insurance through the New York state exchange can contact United using the phone number on the back of their insurance card for the fastest service.
  • Members in Vermont can contact the Department of Vermont Health Access to determine their eligibility for insurance through Vermont Health Connect: 1-800-250-8427

The UVM Health Network works with patients to determine if they are eligible for discounted and free care through our Financial Assistance Program. Patients may also qualify for our Health Assistance Program, which covers the cost of medications, dental care, glasses and other medical equipment for low- and middle-income patients. For more information visit UVMHealth.org/Health-Wellness.

FAQs

The following FAQs have been developed to help answer questions you may have. These may change as we find out more specifics from UnitedHealthcare. For the latest information, please visit this webpage or contact United directly.

Which United plans are affected?

Commercial United plans, such as those provided by your employer, or purchased by you directly, are impacted.

What plans are not affected?

The following plans have NOT been impacted:

  • Non-commercial UnitedHealthcare plans regulated by the state or federal government – such as Medicare Advantage, Managed Medicaid, VA Community Care Network 
  • United Medicare Supplement plans including, but not limited to AARP plans
  • United Behavioral Health plans (see question 6 below for additional details)
  • United The Empire Plan for New York State Employees

Why are you making this decision now?

Despite extensive efforts to negotiate a new contract for well over a year, The University of Vermont Health Network and UnitedHealthcare were unable to reach a renewal agreement. Non-profit health care organizations, like the UVM Health Network, must negotiate with insurance companies to secure reasonable, responsible contracts that cover the expenses of caring for its patients. For a number of years, our ability to provide timely and appropriate care to our patients covered by commercial plans under UnitedHealthcare, one of the nation’s largest for-profit insurance carriers, has been affected by significant administrative and operational issues.   

What does this mean for me?

Patients insured under UnitedHealthcare’s commercial plans will no longer be able to receive in-network care at the UVM Health Network’s hospitals, outpatient facilities, clinics, and provider practices as of March 1, 2024. This means you may hold full financial responsibility for the cost of care. Furthermore, as an out-of-network provider, UVMHN Network may not bill United on your behalf. You may want to seek authorization from United in advance of receiving services for UVM Health Network to confirm they will reimburse the cost of care.

Patients who wish to continue receiving in-network care at the UVM Health Network post February 29, 2024 should explore alternative insurance options during their upcoming open enrollment period.

I thought coverage was only available through the end of 2023?

Since we last announced the extension through the end of 2023, we have continued negotiations with United to have them remain in-network. Unfortunately, we were not able to reach agreement and both parties agreed to extend coverage through the end of February 2024 to give our patients time to transition to a new health care provider or insurance carrier.

Which UVM Health Network health care partners are impacted by this termination?

The following health care partners and all related entities are affected:

  • Alice Hyde Medical Center (including The Alice Center)
  • Central Vermont Medical Center (including Woodridge Rehabilitation and Nursing)
  • Champlain Valley Physicians Hospital (including CVPH Skilled Nursing Facility)
  • Elizabethtown Community Hospital
  • Porter Medical Center (including Helen Porter Rehabilitation and Nursing)
  • The University of Vermont Medical Center

Services Not Impacted:

  • UVM Health Network Home Health & Hospice will continue to accept United commercial insurance.
  • Central Vermont Medical Center and Champlain Valley Physicians Hospital are currently the only UVM Health Network partners contracted with United Behavioral Health, and they will remain in-network.
  • Home infusion therapies through UVM Medical Center will also remain in-network.

Are my UVM Health Network providers impacted by this termination?

Yes, physicians, physician assistants, and nurse practitioners employed by our hospitals, outpatient facilities, clinics and provider practices will no longer accept United commercial insurance plans or participate in the United commercial provider network.

Do I have to change my health insurance?

If you have health insurance through your employer, you should talk with them about your available options. For patients who have enrolled in health insurance through non-employer plans, you may wish to change insurers during the upcoming open enrollment period to ensure that your care at the UVM Health Network remains in-network.

What insurance plans are accepted at the UVM Health Network?

A list of accepted health insurance plans can be found on the websites of each UVM Health Network health care partner.

What happens if I choose to seek care at a UVM Health Network location on and after March 1, 2024?

If you receive services at a UVM Health Network location beyond this date, United may consider this care out-of-network, which means you may hold full financial responsibility for the cost of care. Furthermore, as an out-of-network provider, UVM Health Network may not bill United on your behalf. You may want to seek authorization from United in advance of receiving services from UVM Health Network to confirm they will reimburse the cost of care.

What if I need to choose a new specialist that is in-network with United?

For a list of specialists who are in-network, please contact UnitedHealthcare. Your new specialist provider may require a referral from your current UVM Health Network provider. Additionally, you or your new specialist provider may need to request the transfer of records from UVM Health Network to your new specialist.

What if I have an emergency on or after March 1, 2024?

You may always receive emergency services regardless of your insurance status. United should process emergency services as in-network. Always visit the nearest emergency room if you have an emergency.

What will happen if I am in the hospital on March 1, 2024?

If you are in the hospital between now and March 1, 2024, United should process your care as in-network until you leave the hospital.

What if I have a procedure booked for on or after March 1, 2024?

Please reach out to United for guidance if you currently have an appointment or procedure scheduled at a UVM Health Network location on or after March 1, 2024.

What happens if I am pregnant or actively receiving treatment for a medical condition?

The extension of the agreement through February 29, 2024, is intended to give patients time to explore other insurance options or transition to non-UVM Health Network providers and facilities. While we expect patients with ongoing care needs to begin receiving care elsewhere or switch to an in-network insurance carrier well in advance of February 29, 2024, some patients undergoing treatment as of the end of February might be entitled to continued coverage at the in-network level for a further transition period. Patients anticipating the need for care beyond February 29, 2024, should contact United for specifics.

Are there any services that will remain in-network?

  • Services provided by UVM Health Network Home Health & Hospice will continue to be in-network for patients with United commercial insurance.
  • In-network behavioral health services may be available to some patients with United commercial insurance at Central Vermont Medical Center and Champlain Valley Physicians Hospital.
  • Home infusion services provided by The University of Vermont Medical Center will continue to be in-network for patients with United commercial insurance.
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