Updated June 30, 2023
An update regarding our contract with St. Joseph’s Health in New York
Despite repeated efforts to reach a compromise, we were unable to renew our contract with St. Joseph’s Health. As a result, St. Joseph’s Health Hospital, facilities and its physicians are now out of network for our employer-sponsored and individual plans, including Oxford, as well as our Medicare Advantage and Medicaid plans, as of July 1, 2023.
However, the dates our members will no longer have network access to St. Joseph’s hospital, facilities and physicians varies depending on the type of plan members are enrolled in due to New York cooling off requirements and other factors.
Please see the following chart that displays the first day members enrolled in the following benefit plans will no longer have network access to St. Joseph’s hospital and the health system’s physicians.
| Benefit plan | Hospital | Physician |
|---|---|---|
Commercial (fully insured) |
9/1/2023 |
7/1/2023 |
Commercial (ASO) |
7/1/2023 |
7/1/2023 |
Medicare Advantage, including DSNP |
7/1/2023 |
7/1/2023 |
Medicaid |
9/1/2023 |
8/1/2023 |
Our goal was to reach an agreement that ensured uninterrupted access to St. Joseph’s Health at rates that were affordable for the people and employers we serve. Unfortunately, St. Joseph’s Health refused to move off its demand for a near double-digit price hike in just one year and rejected our proposal to extend our current contract, which would have allowed UnitedHealthcare members network access to the health system while we continued our negotiation.
While we remain committed to continued discussions with St. Joseph’s Health, our focus now is on ensuring the people we serve have access to the care they need through either continuity of care or a smooth transition to a new provider.
We have created the following FAQs to ensure you and your family have the information needed regarding next steps as well as details to help meet your health care needs
FAQs
Our contract with St. Joseph Health has expired as of July 1. However, the dates our members will no longer have network access to St. Joseph’s hospital and physicians varies depending on the type of plan you are enrolled in due to New York cooling off requirements and other factors.
Please see the following chart that displays the first day members enrolled in the following benefit plans will no longer have network access to St. Joseph’s hospital and physicians.
| Benefit plan | Hospital | Physician |
|---|---|---|
Commercial (fully insured) |
9/1/2023 |
7/1/2023 |
Commercial (ASO) |
7/1/2023 |
7/1/2023 |
Medicare Advantage, including DSNP |
7/1/2023 |
7/1/2023 |
Medicaid |
9/1/2023 |
8/1/2023 |
People enrolled in our Group Retiree PPO plan may still receive care from a St. Joseph’s Health physician or facility as an out-of-network provider, if they are a Medicare-approved provider that accepts the plan. Their share of the cost will be the same as if they were part of the network.
UnitedHealthcare Group Retiree members are encouraged to speak with their physician to confirm they’ll continue to see them, regardless of their network status.
For additional information about our Group Retiree plan as well as information on how to find a provider in their area, UnitedHealthcare members should go to www.retiree.uhc.com.
This negotiation impacts people enrolled in employer-sponsored and individual plans, including Oxford, as well as our Medicare Advantage and Medicaid plans, including our Dual Special Needs Plan (DSNP).
We remain open to continued negotiation with St. Joseph’s Health. We urge the health system to provide a proposal that’s affordable for the people and employers we serve so we can restore network access to St. Joseph’s hospital, facilities and its physicians.
St. Joseph’s is seeking a near double-digit price hike in just one year for our employer-sponsored and individual plans, which is not affordable for the people and employers we serve.
We are proposing rates that help us maintain our ability to continue offering competitive health plans in the Syracuse market while also helping ensure New Yorkers and employers are paying fair, equitable prices when they receive care from St. Joseph’s facilities and its physicians.
Our goal has always been to reach an agreement that is affordable and keeps the New Yorkers we serve out of the middle of our negotiation. That is why we proposed to St. Joseph’s that we extend our current contract to allow for additional time to negotiate. St. Joseph’s refused, unnecessarily disrupting access to the health system for its patients and our members.
You and your family continue to have access to quality care in the area through our broad network of physicians and hospitals. Hospitals remaining in our network include but are not limited to:
- Crouse Health Hospital
- Upstate University Hospital
If you are in need of assistance finding alternative hospitals or physicians in your area that meet your health care needs, please call the number on your health plan ID card. You can also search for alternative hospitals and doctors at myuhc.com.
If you or someone in your family is in the middle of treatment at a St. Joseph’s hospital, facility or with a St. Joseph’s physician, you may qualify for continuity of care. Continuity of care provides continued in-network benefits for a specified period of time after a hospital leaves our network. A few examples of patients who may qualify include:
- Women who are pregnant through six weeks post-delivery.
- Patients with newly diagnosed or relapsed cancer, or those currently in active cancer treatment.
If you have questions about continuity of care or alternative hospitals in your area, please call the number on your health plan ID card.
In the event of an emergency, you should always go to the nearest hospital. Your services will be covered at the in-network benefit level, regardless of whether the hospital participates in UnitedHealthcare’s network.