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United Healthcare Managed Care Notice

Information for patient families covered by United Healthcare insurance

If United Healthcare is your current insurance carrier for you or your child, we want to let you know about a possible change to our agreement with United Healthcare. It is typical for hospitals and health insurance companies to update their agreements every few years. We have been talking to United Healthcare for several months about a new agreement. These talks often go right to the deadline, which is May 10, 2017.

We hope to reach a new agreement with United Healthcare before May 10th. But, in case these conversations are not successful, we want to give you as much notice as possible and share important information to help you plan for your or your child’s care if our network status changes. So, if United Healthcare no longer includes Johns Hopkins All Children’s or our physician providers covered on your insurance plan as of May 10, it’s our understanding that you could be impacted in the following ways:

  • If you or your child is already an inpatient at Johns Hopkins All Children’s Hospital on May 10, the hospital stay and physician services will be covered as in-network for up to 6 months until you or your child is discharged or your insurance company makes the decision that you or your child should be transferred (or discharged to) another provider.
  • If you or your child is in active treatment for a chronic or acute health condition and comes here for doctor visits, outpatient procedures and/or rehab services, the visits will be covered as in-network for up to 6 months.
  • If you or your child is done with treatment and needs our services later on, our scheduling team members will be happy to share with you your options, including our financial assistance policy and self-pay discounts.
  • If you or your child is scheduled for a new appointment as a new patient on or after May 10, the visit will be considered an out of network visit. We urge you not to cancel the appointment now because the negotiation may be successful and it could be difficult to quickly reschedule the appointment.

We understand you may have questions and we have set up a special telephone line with extended hours to assist you:  727-767-8284 or 1-800-456-4543, ext. 78284. Please call between 8:00 a.m. and 6:00 p.m. Monday through Friday to speak with one of our staff members. If you get voicemail, leave a message with your daytime contact information and we will return your call the next business day.

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Answers to More Questions

Why did I get a letter from Johns Hopkins All Children's Hospital regarding my United Healthcare insurance?

It’s normal business practice for hospitals and health insurers to renew/renegotiate their contracts every few years. We’ve been working on this with United Healthcare for a few months and are still in active discussion, hoping we can reach an agreement before the contract expires on May 10, 2017.

Insurers are required to let customers know 30 days before a plan change, so even though we’re still negotiating, United Healthcare needed to send out their notification letter saying that Johns Hopkins All Children’s Hospital and their physician providers could potentially will switch from in-network to out-of-network status.

The hospital also sent you a letter to help inform you about the potential impact and various options you have if the contract is not renewed by May 10, 2017.

What if I have an appointment scheduled before May 10?

If your appointment is scheduled prior to May 10th, your treatment will be covered. At your appointment we may schedule follow-up visits that will take place after May 10 as we fully anticipate finalizing a new agreement.

What if I have an appointment scheduled after May 10?

We will keep your appointment scheduled as planned.

We believe patients in active treatment for a chronic or acute health condition and receiving outpatient services (for example physician visits, rehab visits) will continue to be covered as in-network for up to 6 months under the Continuity of Care.

If anything changes that may impact your appointment and your benefits coverage we will contact you prior to the appointment.

We encourage you to contact United Healthcare directly to discuss specifics regarding your plan.

What if I need to schedule an appointment after May 10?

If your child needs our services in the future, our scheduling team will be happy to assist.

We believe patients in active treatment for a chronic or acute health condition and receiving outpatient services (for example physician visits, rehab visits) will continue to be covered as in-network for up to 6 months under the Continuity of Care.

If you are a former patient of Johns Hopkins All Children’s we can schedule your appointments.  Our financial clearance team will contact you as the visit draws closer to discuss your financial responsibility for the visit.

If anything changes that may impact your appointment and your benefits coverage we will contact you prior to the appointment.

We encourage you to contact United Healthcare directly to discuss specifics regarding your plan.

What will I owe for my visit change?

Your patient responsibility is specific to the services received and the terms defined by your insurance plan.  Please call us at 727-767-8284, we have a centralized patient estimation unit who can help you.

What providers are in my network that you would recommend?

We encourage you to call your insurance company to give you a list of in-network providers.

If there’s no in-network provider available, we’ll help you understand your options and we can talk to your insurance company about getting authorization for treatment here as “out-of-network.”

I want to keep coming to Johns Hopkins All Children's Hospital.  What can I do?

We anticipate having a new agreement in place prior to May 10.  The notices you received were to let you know that the negotiation process is underway.
 
We believe patients in active treatment for a chronic or acute health condition and receiving outpatient services (for example physician visits, rehab visits) will continue to be covered as in-network for up to 6 months under the Continuity of Care.
 
If we are unable to reach a new agreement by May 10th, we will send another communication to you.  The notice will also be posted on this page on our website (www.HopkinsAllChildrens.org/mcnotice).

If an agreement is not reached, Johns Hopkins All Children's Hospital may change from "in-network to "out of network".

You can then choose to use our services and apply for financial assistance or a self-pay discount.

We hope to reach a new agreement with United Healthcare before May 10th but please check back with us.

My child is / I currently am an inpatient at Johns Hopkins All Children's Hospital.  What will happen?

The hospital stay and physician services will be covered as an in-network for up to 6 months until you or your child is discharged or your insurance company makes the decision that you or your child should be transferred (or discharged to) another provider.

We anticipate reaching a new agreement prior to May 10.  If we are unable to reach an agreement, we will be happy to talk with you to discuss options and minimize any disruption in care.

Can I change my insurance?

If you have a choice of plans, you can usually change only during "open enrollment" unless you have a qualifying event such as birth, marriage, divorce or change of employment.

You will need to contact either your employer or insurance broker to discuss your options.

Who can I contact with concerns about my or my child’s coverage?

We encourage you to contact your insurance company with specific questions about coverage.