Information for Patients with UnitedHealthcare Community Plans Dual Complete Health Plans (Dual Special Needs)
Medicare DSNP/Dual Eligible Patients: Our contract expires at midnight March 31, 2021. Until April 1, 2021, you should continue to see your trusted Montefiore doctor(s) and seek care as needed at our hospitals and facilities as you normally would. If United is unwilling to work with us, we will be forced out of network for DNSP patients effective April 1, 2021.
You may receive a letter from United stating that you need to change your doctor(s) or hospital. This is not the case. We are currently in negotiations with United, but we want to make sure you are aware that we partner with many insurance plans that will let you to keep seeing your Montefiore doctors, whether United reaches an agreement, or not.
What is this about?
Montefiore puts every dollar we get into supporting high-quality patient care and life saving research. The COVID-19 pandemic hit us harder than any other hospital in the state. Our resources have been stretched to nearly impossible limits. During the same time, United has made billions of dollars in profits. United is still asking us to accept rates that are unsustainable. We are only asking United for single digit increases. As a non-profit health system, we need fair contracts from all insurance companies. That is all we are asking of United. Nothing more.
What you can do.
The best way to keep your Montefiore doctor(s) and hospitals is to change your health insurance plan by calling one of the insurance plans listed below.
You can make this change during the following Medicare Advantage Open Enrollment periods:
- January 1, 2021 – March 31, 2021 (A change you make during this time will go into effect the first day of the following month. For example, you make a change January 12th, your new plan would be effective February 1.)
- April 1, 2021 – June 30, 2021 (A change you make during this time will go into effect the first day of the following month. For example, you make a change April 12th, your new plan would be effective May 1.)
Montefiore Medical Center and White Plains Hospital participate in the following Medicare / Medicaid Dual Health Plans:
Healthfirst – 4 STARS
WellCare – 3.5 STARS
FidelisCare – Plan is new – no data
EmpireBCBS – 3 STARS
EmblemHealth – 3 STARS
ElderPlan – 3.5 STARS
Centers Plan for Healthy Living – 3.5 STARS
**Below Plans are ONLY for Montefiore Medical Center Patients residing in the Bronx**
AgeWell New York – 2.5 STARS
RiverSpring / ElderServe – Plan is new – no data
Hamaspik Choice – Plan is new – no data
The Centers for Medicare & Medicaid Services provides star ratings to help patients compare the quality of plans. Health Plans may earn a maximum of 5 stars based on their Quality Performance.
Why should you think about changing health plans during Open Enrollment?
United’s contract with Montefiore expires at midnight on March 31, 2021, and if they are unwilling to reach an agreement, United may charge you more for getting care at Montefiore.
What happens now that United has dropped Montefiore from its network?
United’s actions may require you pay higher out-of-pocket costs when receiving care with your doctors and the following Montefiore hospitals:
- Montefiore Medical Center
- Montefiore Mount Vernon
- Montefiore New Rochelle
- Montefiore Nyack
- Montefiore St. Luke’s Cornwall
- White Plains Hospital
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.
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.
Your health is our only business, and we apologize for any inconvenience this might cause. We know how important it is to continue seeing the Montefiore doctors you know and trust.