We have concluded our standard re-negotiation process with UnitedHealthcare (United). Below are changes which impact some of our patients and plans starting on Nov. 1, 2024.
For patients covered under the UnitedHealthcare Medicaid Community Plan for Kids (CHIP), UnitedHealthcare Dual Complete (DSNP), and UnitedHealthcare Nursing Home (ISNP) Medicare Advantage plans, we are pleased to share that WellSpan will continue to participate in United’s network. There will be no disruption in care for patients currently participating with these plans, and they can continue to receive services at WellSpan as usual.
For patients with UnitedHealthcare AARP and UnitedHealthcare Group Medicare Advantage insurance, despite significant effort, there is not yet an agreement on a new contract which will provide a sustainable way forward for our organization. As a result, WellSpan Health no longer participates with any UnitedHealthcare AARP Medicare Advantage insurance plans as of Nov. 1, 2024. Beginning Jan. 1, 2025, WellSpan will no longer participate with UnitedHealthcare Employer Group Medicare Advantage insurance plans.
For patients with UnitedHealthcare’s Medicare Supplement plans, which are secondary to traditional Medicare insurance coverage, these plans will continue to be accepted by WellSpan; they are not impacted by the Medicare Advantage plan changes occurring Nov. 1, 2024, or Jan. 1, 2025.
Q. Will WellSpan continue to see patients with United Medicaid Community Plan for Kids (CHIP), as well as UnitedHealthcare Dual Complete (DSNP) and UnitedHealthcare Nursing Home (ISNP) Medicare Advantage insurance?
A. Yes, WellSpan has reached agreement with United on coverage for these insurance plans and patients can continue to be seen at WellSpan facilities after Oct. 31, 2024.
Q. Why has WellSpan made the decision to no longer accept UnitedHealthcare AARP Medicare Advantage and UnitedHealthcare Group Medicare Advantage insurance?
A. As the region’s largest community-based non-profit health system, WellSpan is committed to keeping healthcare affordable for our patients and communities we serve by negotiating the appropriate contracts with insurance companies. One of the ways we ensure affordability is by negotiating fair contracts with insurance companies to ensure what we are reimbursed covers the cost of providing exceptional care.
Q. What UnitedHealthcare Medicare Advantage plans are impacted by this change?
A. This includes UnitedHealthcare AARP Medicare Advantage and UnitedHealthcare Group Medicare Advantage plans.
Q. I thought that WellSpan was already out of network with UnitedHealthcare Medicare Advantage – what’s changed?
A. WellSpan is currently participating with a portion of UnitedHealthcare Medicare Advantage plans as well as accepting UnitedHealthcare Group Medicare Advantage. Effective Nov. 1, 2024 – or Jan. 1, 2025, for UnitedHealthcare Group Medicare Advantage – WellSpan has made the decision for these members to seek services from participating UnitedHealthcare providers.
Q. Can patients use their current UnitedHealthcare AARP Medicare Advantage insurance until November 1, 2024 (or January 1, 2025, for Group Medicare Advantage plans)?
A. Yes, any covered services you receive prior to Nov. 1, 2024 – or Jan. 1, 2025, for UnitedHealthcare Group Medicare Advantage – will be submitted to your plan for payment.
Q. What other insurance plans does WellSpan accept?
A. At WellSpan, we accept other insurance plans which are listed on our website – WellSpan Health Plans; this page includes a number of insurance plan options with whom WellSpan participates for you to consider for you/your family.
Q. If a claim is not paid by the patients’ plan before Nov. 1, 2024 (or January 1, 2025, for Group Medicare Advantage), will they be responsible for the costs?
A. Services provided before Nov. 1, 2024 – or Jan. 1, 2025, for patients with UnitedHealthcare Group Medicare Advantage – will be submitted to your current insurance plan for payment. Only amounts which are not covered by your insurance carrier would need to be paid personally.
Q. Are patients able to continue to access emergency care?
A. Yes, we continue to welcome any patient needing emergency care services across our WellSpan Emergency Department locations.
Q. If patients have further concerns or questions about in network care options, who should they be referred to?
A. Please refer patients to contact their insurance plan, employer or nursing home facility, if applicable – to discuss questions and concerns about participating providers in their network.
Q. Will services scheduled after Nov. 1, 2024 – or January 1, 2025, for patients with UnitedHealthcare Group Medicare Advantage – need to be cancelled?
A. For patients with UnitedHealthcare AARP Medicare Advantage, yes, services scheduled after Nov. 1, 2024 – or Jan. 1, 2025, for patients with UnitedHealthcare Group Medicare Advantage – will need to be redirected. Patients should work with their insurance plan to find a participating provider and location to reschedule any procedures or services.
Q. Will WellSpan transfer my medical records if I have to select a new provider for services?
A. Requests for transfer of medical records can be made to the WellSpan Release of Information Department by completing the Authorization to Use or Disclose Health Information form. The form is available in English, Spanish and Haitian Creole. Many components of your electronic health record are also available via our secure patient portal – MyWellSpan.
Q. Will WellSpan still be able to see me after Nov. 1, 2024 – or January 1, 2025, for patients with UnitedHealthcare Group Medicare Advantage – if I am in ongoing treatment?
A. Continuity of care under PA statute allows for patients to continue to be seen for ongoing treatment up to 60-days after a provider ceases to participate with a payor. Patients should be referred to UnitedHealthcare member services to request an application for continuity of care.
