Important information

For patients with UnitedHealthcare Insurance Plans

While we continue in good faith to try to negotiate a new and fair agreement with UnitedHealthcare, we remain far apart. Please refer to the information provided below for further details.

UNC Health has been negotiating with UnitedHealthcare for a new agreement to provide ongoing care for our patients who are insured by UnitedHealthcare.

Our mission is to improve the health and well-being of North Carolinians and others whom we serve. Yet our mission is threatened by the weight of inflation and the complicated rules UnitedHealthcare makes us follow. Meanwhile, UnitedHealthcare has had double-digit increases in their revenue, billions more than they expected. To continue to fulfill our mission, UNC Health needs a fair and equitable partnership with all payors, including UnitedHealthcare.

For more than 70 years, North Carolinians have relied on UNC Health for their healthcare needs. More than 1.6 million patients from all 100 counties put their trust in our clinics, hospitals and physicians. Access to our large network of providers and facilities is necessary for the health and well-being of every North Carolinian.

Yet we cannot do it all on our own. We need a new, fair and reasonable contract with UnitedHealthcare to ensure you will not have a disruption in your care.

Visit this site to find answers to your questions about our negotiations with UnitedHealthcare. If you do not find answers to your questions in the FAQs below, please call our patient assistance line at 1-833-917-1224, or email unchealthfornc@unchealth.unc.edu.

Click here to read our patient letter.

As a result, we have informed UnitedHealthcare that without a new, fair and reasonable contract, all UNC Health facilities and physician practices (except those noted) will be out-of-network with UnitedHealthcare Group, Individual, and Medicare Advantage plans beginning April 1, 2024.

The following UNC Health facilities and physician practices will remain in-network for all UnitedHealthcare products:

  • UNC Health Southeastern
  • UNC Health Appalachian
  • UNC Health Blue Ridge
  • Prime Surgical Suites

UNC Health will remain in-network with UnitedHealthcare’s North Carolina Medicaid plans.

UnitedHealthcare needs to be part of the solution in keeping local care sustainable. We are working tirelessly to combat rising costs due to inflation, while continuing to improve your experience. Yet we cannot do it all on our own. We need a new, fair and reasonable contract with UnitedHealthcare to ensure we can continue to be there for you.

We’ve built this site to help you find answers to your questions about our negotiations with UnitedHealthcare. If you do not find the answers to your questions, please call our patient assistance line at 1-833-917-1224, or email unchealthfornc@unchealth.unc.edu.

Continuity of Care

Certain patients, including those who are hospitalized, pregnant, or undergoing an active course of treatment before the contract end date, may qualify for Continuity of Care through UnitedHealthcare after April 1, 2024. If you think you may qualify, call the phone number on the back of your UnitedHealthcare health insurance card today to speak to a representative. For more information on how to apply for continuity of care, please visit the Understanding Transition of Care and Continuity of Care webpage.

For your convenience, we are making pre-filled forms available for the hospital of your choice.

Frequently Asked Questions

UNC Health has been negotiating with UnitedHealthcare for a new agreement that will allow us to maintain the level of care, scope of access, and quality of service that UNC Health provides for patients throughout local communities. Unfortunately, UnitedHealthcare is not negotiating a new contract in good faith and is refusing to pay its fair share. The agreement between UNC Health and United Healthcare will end on April 1, 2024.

UnitedHealthcare routinely creates barriers that prevent UNC Health from receiving reimbursement for the medically necessary care UNC Health provides, including issuing frequent denials, engaging in prolonged appeals, and downgrading patient diagnoses, in an attempt to pay less or not at all. These administrative barriers cause unnecessary anxiety for UNC Health patients and caregivers at a time when the sole focus should be on getting healthy. When they do pay, the reimbursement rates do not meet the rising costs of providing care. For these reasons, UNC Health seeks an improved relationship with UnitedHealthcare, asking that they show appreciation for the UNC Health partnership and acknowledge the administrative burden they place on UNC Health providers.

We still believe UNC Health and UnitedHealthcare can forge an equitable partnership that goes beyond dollars and cents or financial gain. Ultimately, a renewed fair partnership will create healthier communities.

Should UNC Health not reach a new fair agreement with UnitedHealthcare, UNC Health will no longer participate in UnitedHealthcare’s network beginning April 1, 2024. UnitedHealthcare has been told that the Provider Agreements with UNC Health won’t continue past that date under the current terms.

Yes, you can change your Medicare Advantage health insurance plan. Open enrollment for Medicare Advantage plans goes through March 31, 2024. UNC Health is proud to be in-network with many other Medicare Advantage plans, and we encourage you to explore alternate options that would preserve your in-network access to UNC Health providers.

All UnitedHealthcare products, except for Medicaid, are affected. This includes UnitedHealthcare commercial (PPO and HMO plans), Individual Exchange Plan, and Medicare Advantage products. UNC Health recommends you contact UnitedHealthcare directly to ask about your specific plan and questions related to your needs. Use the number on the back of your insurance card to call UnitedHealthcare.

Medicare supplement plans are not a Medicare Advantage product. This means they do not require a contract, and therefore, these plans are NOT affected.

If you have both Medicare Advantage and Medicaid, UNC Health will bill Medicaid if your UnitedHealthcare Medicare Advantage plan goes out of network.

UnitedHealthcare is a for-profit organization that profited more than $22 billion in 2023 alone. Those profits, amassed from the rising premiums they charge their members each year and through administrative burdens placed on providers, including claim denials and reimbursement rates that do not keep pace with inflation, are used to line shareholder pockets. United should be ashamed of their tactics of denying medically necessary care, refusing to pay fair rates and changing operating policies.

Conversely, UNC Health is a not-for-profit health system and any profits our system generates are reinvested in serving patients across North Carolina and the Southeast. UNC Health provides high-quality care and value to all of our patients, regardless of their ability to pay. We are hopeful United will do the right thing for their members and our patients.

UNC Health has been working to negotiating a new and fair agreement with UnitedHealthcare and will continue to do so. We take very seriously the potential disruption this may cause you and your family, and we are doing everything in our power to avoid that outcome. We have had meetings with UnitedHealthcare that seem productive- though we have failed to reach consensus. We are committed to negotiating in good faith to reach a mutually acceptable agreement with UnitedHealthcare before April 1 to ensure continued in-network access to care.

The Optum network contracts are separate agreements that are not part of this negotiation. If we do not have a new agreement in place with UnitedHealthcare by April 1, and we go out of network, Optum benefit plans will not be affected.

All UNC Health facilities and physician practices (except those noted) will be out of network with UnitedHealthcare Group, Individual, and Medicare Advantage plans beginning April 1, 2024.

The following UNC Health facilities and physician practices will remain in network for all UnitedHealthcare products:

  • UNC Health Southeastern
  • UNC Health Appalachian
  • UNC Health Blue Ridge
  • Prime Surgical Suites

 

UNC Health will remain in network with UnitedHealthcare’s North Carolina Medicaid plans.

For now, nothing changes. You should continue to visit UNC Health hospitals, facilities, and providers as usual. UNC Health routinely negotiates with health insurance providers, and we are working in good faith to reach a new agreement before our current contracts expire. However, you may want to consider alternative plans that include UNC Health in your network for all of 2024 during this open enrollment period.

Each health insurance plan handles out-of-network benefits differently. For the most accurate information, specific to your plan benefits, contact UnitedHealthcare by calling the number on the back of your insurance card.

Generally, health insurance plans that offer out-of-network benefits will cover a percentage of the cost of care. Usually, that percentage is less than the normal in-network benefit coverage. As with in-network coverage, you would be responsible for paying the balance of the bill.

If your plan does not offer out-of-network benefits, you would be responsible for the full cost of the care you or your family member receives.

While our negotiations with UnitedHealthcare continue, you can take these steps to protect your access to in-network care with UNC Health:

  • Call UnitedHealthcare. Using the number on the back of your insurance card, call and let UnitedHealthcare know how vital it is to have in-network access to UNC Health.
  • Contact your broker. If you have a Medicare Advantage or Exchange plan, you may have chosen the plan through a broker. Ask your broker about coverage options that will allow you to maintain in-network access to UNC Health and their network of healthcare providers for all of 2024.
  • Speak with your HR or benefits manager at work. If you have coverage through your employer, ask your Human Resources or benefits manager about alternative or secondary coverage options that will ensure in-network access to UNC Health facilities and providers.

Certain patients, including those who are hospitalized, pregnant, or undergoing an active course of treatment before the contract end date, may qualify for Continuity of Care through UnitedHealthcare after April 1, 2024. If you think you may qualify, call the phone number on the back of your UnitedHealthcare health insurance card today to speak to a representative. For more information on how to apply for continuity of care, please visit the Understanding Transition of Care and Continuity of Care webpage.

The agreement between UNC Health and UnitedHealthcare will end on April 1, 2024. United has been told that the Provider Agreement with UNC Health won’t continue past that date under the current terms. Unless you can obtain a Continuity of Care exception through UnitedHealthcare, services provided after this date will be considered out of network, and your out-of-pocket costs may be greater.

The agreement between UNC Health and UnitedHealthcare will end on April 1, 2024. United has been told that the Provider Agreement with UNC Health won’t continue past that date under the current terms. UNC Health is committed to doing anything we can to schedule your visits in advance of April 1, 2024 and we appreciate your flexibility to do so. Impacted patients will be informed upon scheduling that unless you can obtain a Continuity of Care exception through UnitedHealthcare, services provided after this date will be considered out of network, and your out-of-pocket costs may be greater.

If you experience a medical emergency, you should always visit the nearest emergency department.

UNC Health is hopeful to reach an agreement with United Healthcare that would maintain your in-network access to UNC Health facilities and providers in 2024. However, there are many other health plans we will be in network with if you are interested in exploring other options. Please visit UNCHealth.org/coverage to learn more.

Medicare Supplemental plans are not a Medicare Advantage product, and therefore, these plans are not affected. UNC Health recommends you contact UnitedHealthcare directly for additional questions related to your plan and coverage. Please use the number on the back of your insurance card to call UnitedHealthcare.

UNC Health will keep our patients informed as our negotiations continue. For additional information, please call 1-833-917-1224, email unchealthfornc@unchealth.unc.edu, or visit UNCHealthforNC.com to find up-to-date negotiation information and address any additional questions or concerns.