For several years United Healthcare has been synonymous with a big list of doctors. Many people chose a United plan because they could see doctors in many states. Here in Northern Nevada, United Healthcare covers doctors at both of our largest hospital groups. The first is with Renown and the second is with Northern Nevada Hospital / St. Mary’s Hospital. That may be ending at the end of April. Today negotiations continue between United Healthcare and Renown. If there is no agreement by the end of April Renown doctors could stop accepting United Healthcare. This makes a Renown and United Healthcare Split.
This isn’t the first time these contract negotiations have happened. In fact, these negotiations usually occur about once per year. They happen between every insurance company and physician group. In 2019 Anthem went through a similar process with Renown. Anthem reached an agreement with Renown and their contract continues through today.
To be clear, this change applies to United Healthcare’s small business plans. This does NOT apply to United Healthcare Medicare plans. For Medicare Supplement AND Advantage plans, there is no Renown and United Healthcare Split.
What Physicians Need
The physicians are working against the increasing cost of providing care. Especially here in Nevada, it’s becoming expensive to treat patients. More patients are coming in the door due to our increasing population. The number of doctors is not increasing as fast, leaving them understaffed and overworked. Additionally, many patients have put off preventative treatment due to COVID. Instead of getting a minor condition treated months ago, now it’s a major and expensive problem.
What United Healthcare Needs
All insurance companies are trying to keep their rates low. No one likes paying high rates to insurance companies. However, lowering the cost also lowers the number of doctors covered by the plan. For an extreme example, an insurance company could have insurance plans for $100 per month. But if it only covered one doctor, specialist, and hospital, very few would be able to use it. On the other hand, if it covered every doctor and hospital the monthly rate would be so high no one would be able to afford it. United Healthcare is trying to achieve a balance – keeping the rates low but covering enough doctors.
Why wasn’t I told?
Insurance companies are bad at communication. United Healthcare sent out a letter to some of its members in early April. Most members I’ve talked to didn’t receive the letter. I’ve included a sample of the letter here:
Important steps to make
First – please keep in mind that the Renown and United Healthcare Split hasn’t happened yet (as of the end of April). As more information comes forward I’ll be releasing it on YouTube. Please be sure to stay subscribed to our YouTube channel.
Second – If you have appointments in early May with a Renown doctor, I would recommend rescheduling it if possible. This includes lab work! Many people don’t realize lab work is sometimes charged on the date they process it.
If the contract ends
- Emergency services will still be available from Renown. This includes “emergency services” only, meaning a reasonable person must have believed it’s life-threatening.
- If you’re in the middle of receiving treatment there may be an option to continue to go to your Renown doctor for a short amount of time. This is also known as Continuity of Care. If you believe this may apply to you please contact United Healthcare.
- This only applies to Renown doctors. There are still hundreds of doctors covered by United Healthcare, in a wide variety of specialties. I understand good doctors are hard to come by, however, please try to work with United Healthcare and our office to find a doctor who will work with you.