SAGINAW, MI — Insurance provider UnitedHealthcare’s contract with Covenant HealthCare will soon end, rendering the health care provider out of network for UHC members.
Covenant Spokeswoman Kristin Knoll on Thursday, Dec. 12, confirmed an existing contract between the health care provider and insurance provider will end on Dec. 31 because of the two parties’ “inability to reach an agreement.”
“Covenant remains committed to caring for the community. It is our understanding that UHC will not consider the majority of services provided by Covenant after December 31 as ‘in-network’ and may result in additional out-of-pocket costs to patients and/or coverage denials. This is outside of the control of Covenant,” a statement from Covenant reads.
“We encourage anyone with questions specific to their UHC coverage to call UHC and/or reference the communication they received from UHC. For those who wish to maintain Covenant HealthCare as their provider of choice, there are a wide-array of other health plan options available to people in our area that consider Covenant in-network.”
In addition, “The ending date for the contract between UHC and Covenant physicians is still in negotiations. Discussions are underway to determine a date that reduces the impact on patients,” Covenant officials said.
A UnitedHealthcare spokesperson on Thursday confirmed Covenant will be out of network for UHC members enrolled in employer-sponsored, individual, Medicare Advantage and Dual Special Needs health plans effective Jan. 1, but Covenant will remain in network for UHC’s Medicaid members. Covenant’s physician groups are not affected by this contract termination and will continue to participate in UHC’s network, according to UHC officials.
UHC has more than 800,000 members in Michigan, less than 1,000 of whom will be affected by this change. Members were notified via letters in mid-November, according to UHC officials.
“We’ve been in active negotiations with Covenant HealthCare for over a year in an effort to work through some changes they requested to our current contract,” a UHC spokesperson said in a statement.
“After reaching agreement on those changes, Covenant then demanded increases in their rates, which would drive up the cost of care for the customers and members we serve in the Saginaw area. Our priority is ensuring our members have access to care that is both high quality and affordable, and we’re committed to supporting our members in the transition of their care to other hospitals that will participate in our network in 2020.”
UHC officials said continuity of care may be available to patients who are undergoing treatment at Covenant, providing continued in-network benefits for a period of time. Members may call the number on their health plan ID card to see if they qualify or to inquire about finding alternative hospitals in the area UHC has a relationship with, such as Ascension St. Mary’s.