Information for Patients with Compass Individual Exchange Health Plans

The Latest:

We’ve offered United a proposal that not only restores your in-network access immediately, but also would ensure continued long-term in-network access at the same terms as United previously agreed to in our last contract.  Montefiore has also asked United to remove an expiration date from the agreement to prevent this type of disruption again. It’s up to United to say yes. 

Unfortunately, right now, the only way to guarantee in-network access to your trusted doctors and hospitals is to switch insurance coverage.  The new Open Enrollment period runs February 15 through May 15. Visit nystateofhealth.ny.gov. We participate with the following individual exchange plans:

  • HealthFirst
  • EmpireBCBS HealthPlus
  • Emblem, MVP, Oscar

During these uncertain times, we can offer you the following:

During these uncertain times, we can offer you the following:

  • In case of emergency, you should always visit the nearest emergency room. You will be covered for emergency services.
  • If you or a family member are pregnant or undergoing treatment for a chronic condition, you may qualify for Continuity of Care benefits. Call the customer service number on the back of your United health insurance card to request an application and then call your physician.
  • Finally, we will work with you during this period of disruption to minimize any financial impact. For questions about costs for office visits or scheduled procedures, please visit org/information-about-charges or contact your physician’s office. For questions about costs for office visits or scheduled procedures, please visit montefiore.org/information-about-charges or contact your physician’s office.

United Dropped Your In-Network Access to Montefiore on January 1, 2021.

Compass Patients: United has allowed our contract to expire at midnight December 31, 2020.

This means, as of January 1, 2021 United has dropped Montefiore physicians and hospitals from its network. You will always have in-network access to our emergency rooms. Regardless of our contract status with United, you should always visit the nearest emergency room if you experience a medical emergency.

How do I help restore my full in-network access to Montefiore in 2021?

You may have the opportunity to switch to an insurance company that will guarantee your in-network access to your Montefiore physicians and hospitals for the full 2021 benefit year. The new open enrollment period runs from February 15, 2021 until May 15, 2021. Switch by visiting https://nystateofhealth.ny.gov/.We participate with the following individual exchange plans: 

  • HealthFirst
  • Empire BCBS Health Plus
  • Emblem
  • MVP
  • Oscar

If you or a family member is pregnant or undergoing treatment for a chronic condition, you may qualify for Continuity of Care benefits. If you think you may be eligible, we encourage you to apply through United. Call the customer service number on the back of your United health insurance card to see if you qualify.

  • Let him know what it means for you to lose in-network access to MHS. You shouldn’t have to choose between continuing your care with your trusted Montefiore providers at higher out-of-pocket costs or finding a new provider.
  • Ask him to commit to resolving this issue quickly by offering MHS a fair and reasonable contract, one that doesn’t jeopardize our ability to provide the high-quality care you count on from your Montefiore providers for years to come.
  • Ask him if United will commit to paying for your care directly instead of sending you the check and sticking you in the middle of this.

What happened?

United was unwilling to reach an agreement with Montefiore Health System before our contract expired on December 31, 2020. We continue to do everything in our power to urge United back to the table to negotiate in good faith. We are committed to keeping you informed as we work to get United to make this right.

What is this about?

While Montefiore is one of the most cost-efficient, academic hospital systems in the nation, according to CMS data, we have been hit harder by the pandemic than any other hospital in the state. Our resources have been strained to nearly impossible limits. Meanwhile, United has enjoyed profits in the billions during same time, all while asking us to accept rates that are simply unsustainable. We are asking United for only reasonable single digit increases. As a non-profit health system, we rely on fair contracts from all insurance companies. That is all we are asking of United. Nothing more.

What happens now that United has dropped Montefiore from its network?

United continues to demand we accept unsustainable payments, which jeopardizes our ability to provide the high-quality care you count on from your Montefiore providers. We, at Montefiore, can’t put your care at risk. We are continuing to urge United back to the table to attempt to reach a meaningful agreement, but United’s actions may potentially cause you to have to pay more in out-of-pocket costs.

Montefiore Health System’s hospitals (Montefiore Medical Center, Montefiore Mount Vernon, Montefiore New Rochelle, Montefiore Nyack, Montefiore St. Luke’s Cornwall and White Plains) and its employed providers are out-of-network as of January 1, 2021 for patients with United commercial insurance.

Here are three things you can do if you want to help protect your in-network access to the Montefiore physicians and hospitals you trust:

Our Promise to You

We are dedicated to doing everything in our power to reach an agreement with United. We will continue provide updates, so you stay informed. Regardless of our status with any insurance payor, we will always provide every patient with the same high-quality care they deserve.

What I need to know today.

  • All Montefiore Health System physicians and hospitals are out of network as of January 1, 2021.
  • You will always have in-network access to our emergency rooms. Regardless of our contract status with United, you should always visit the nearest emergency room if you experience a medical emergency.

 

Your health and wellbeing remain our priority, along with restoring your in-network access to MHS hospitals and physicians.