Information for Patients with Oxford or United Commercial 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.

Unfortunately, right now, the only way to guarantee in-network access to your trusted doctors and hospitals is to switch insurance coverage. We understand your choices of coverage is up to your employer. Many patients may have more options than they believe.

Contact your HR department and let them know the importance of keeping your in-network access to your Montefiore Health System hospital and providers. Ask them about your options to protect your access, including offering a second option for coverage. Many patients have requested a template to use to reach out to their HR/Benefits Manager. You can find a downloadable template here

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.

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 Montefiore.org/information-about-charges or contact your physician’s office.

United dropped Montefiore on January 1, 2021

Commercial 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.

Some commercially insured patients may have in-network benefits for HOSPITAL SERVICES only until March 1, 2021. Please check with your employer or call the number on the back of your health insurance card to confirm if you are eligible.

How did this 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 only asking United for 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.

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.

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 do I need to know?

  • All Montefiore Health System physicians and hospitals are out of network as of January 1, 2021. Some United commercial patients (fully insured) may be eligible for HOSPITAL covered services on an in-network basis for an additional 60 days until midnight March 1, 2021. Please call United Member Services today to find out if you are eligible for this extension.
  • 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.