Frequently Asked Questions

 Montefiore Health System and UnitedHealthcare (United) have reached an agreement on a new contract. This means starting December 1, 2021, patients with the following insurance plans can now see their trusted Montefiore doctor(s) and hospital in-network: commercial insurance products under the branding UnitedHealthcare and UnitedHealthcare Oxford, UMR, and UnitedHealthcare Community Plan Medicare Dual Advantage (Medicare and Medicaid eligible). Our new contract covers the care we provide to patients with United insurance plans at Montefiore Medical Center, Montefiore Mount Vernon, Montefiore New Rochelle, Montefiore Nyack, Montefiore St. Luke’s Cornwall Hospital and White Plains Hospital and all of our employed providers. 

 Contract negotiations between insurance companies and providers are very common. We have reached an agreement with United, so that our patients with UnitedHealthcare and UnitedHealthcare Oxford, UMR, and UnitedHealthcare Community Plan Medicare Dual Advantage (Medicare and Medicaid eligible) coverage can automatically regain in-network access to their trusted Montefiore doctor(s) and hospitals without disruption. 

There is nothing for you to do. Montefiore and United have reached an agreement on a new contract. You can see your trusted doctor(s) and hospital as needed. 

Our new contract with United restores in-network access to Montefiore for patients with the following United health plans: 

  • UnitedHealthcare Commercial and UMR (employer-sponsored plans) 
  • UnitedHealthcare Oxford Commercial (employer-sponsored plans) 
  • UnitedHealthcare Community Plan Medicare – Dual Advantage – dual eligible special needs plan – where a patient has both Medicare and Medicaid 

For now, these plans will remain NON-PARTICIPATING until further notice. United and Montefiore are still working to complete these contracts in the near future. 

  •  UnitedHealthcare Community Plan Medicaid will remain out-of-network.

  • UnitedHealthcare Medicare Advantage & AARP Medicare Advantage will remain out-of-network for Montefiore as has been the case since January 1, 2018.

  • Montefiore St. Luke’s Cornwall Hospital and Providers will continue to remain PARTICIPATING with UnitedHealthcare Medicare Advantage & AARP Medicare Advantage. Please make a note this is the only exception for Medicare Advantage in the health system. 

With our new contract with United, all Montefiore Health System hospitals have restored in-network access starting December 1, 2021 for patients who have UnitedHealthcare and UnitedHealthcare Oxford, UMR, and UnitedHealthcare Community Plan Medicare Dual Advantage (Medicare and Medicaid eligible) health plans 

  • Montefiore Medical Center
  • Montefiore Mount Vernon
  • Montefiore New Rochelle
  • Montefiore Nyack
  • Montefiore St. Luke’s Cornwall Hospital
  • White Plains Hospital

With this new contract, there is nothing for you to do. Patients with United/Oxford commercial insurance plans can and should seek the care they need, when they need it from their Montefiore physician(s) and hospital starting December 1, 2021

Individual Exchange Patients – NON-PARTICIPATING for now Patients with Compass individual exchange insurance plans will remain out-of-network with Montefiore for now. Patients with United Compass Individual Exchange plan will always have in-network access to our emergency rooms in urgent situations. However, Individual Exchange patients who would like in-network access to their trusted Montefiore doctors may be able to switch during open enrollment to one of the Exchange plans that has Montefiore in-network. United and Montefiore are still working to complete this contract in the near future. Montefiore is In Network with these Individual Exchange plans:

  • HealthFirst
  • EmpireBCBS HealthPlus
  • Oscar
  • Emblem
  • MVP

With this new contract, there is nothing for you to do. Patients with United Community Medicare Dual Eligible Plans can and should see their trusted Montefiore doctor(s) and hospitals as they need starting December 1, 2021 

Unfortunately, despite extensive discussions, Montefiore and UnitedHealthcare were not able to come to an agreement on in-network coverage for UnitedHealthcare’s Community Medicaid plan. Montefiore continues its commitment to provide care to anyone, regardless of their ability to pay. Patients who remain covered by UnitedHealthcare’s Community Medicaid Plan will always have in-network access to emergent care provided in Montefiore’s emergency rooms. 

However, Medicaid patients who would like in-network access to their trusted Montefiore doctors may be able to switch to one of the many Medicaid plans that has Montefiore in-network. 

Patients covered under a Medicaid plan are eligible to switch plans within 90 days of enrolling, or any time after they have been in their plan for at least twelve (12) months. 

Patients with Community Plan Essentials 1,2,3, or 4 plans will remain out-of-network with Montefiore for now. Patients with Essential plans will always have in-network access to our emergency rooms in urgent situations. However, Essential Plan patients who would like in-network access to their trusted Montefiore doctors may be able to switch one of the many Medicaid plans that has Montefiore in-network. United and Montefiore are still working to complete this contract in the near future. 

Patients covered under an Essential Plan are eligible to switch plans within 90 days of enrolling, or any time after they have been in their plan for at least twelve (12) months. 

Montefiore is in-network with the following Essential Plans: 

  • EmpireBCBS HealthPlus Essential Plans (Excluding White Plains Hospital and Physicians)
  • HealthFirst Essential Plans
  • EmblemHealth Essential Plans
  • MVP Health Care Essential Plans
  • Fidelis Care Essential Plans
  • Molina Health (Formerly Affinity) Essential Plans

Yes. Montefiore and United have reached an agreement for a new contract that restores your in-network access to our doctors and hospitals for patients with UnitedHealthcare and UnitedHealthcare Oxford, UMR, and UnitedHealthcare Community Plan Medicare Dual Advantage (Medicare and Medicaid eligible) coverage. 

We have a very fair financial assistance program which may be able to help you manage your payments. Please contact your hospital’s financial department for more information: 

  • Montefiore Medical Center, Montefiore Mount Vernon and Montefiore New Rochelle – call 718-920-5658 
  • Montefiore Nyack Hospital – call 845-348-2323 
  • Highland Medical, P.C – call 866-550-4672 
  • Montefiore St. Luke’s Cornwall Hospital – call 845-458-4000 
  • White Plains Hospital – call 914-681-1004