UnitedHealthcare Medicare Advantage Plan Update

Beginning Jan. 1, 2025, Essentia Health will no longer accept UnitedHealthcare Medicare Advantage plan insurance.

What This Means for You

As part of this change, if you are insured by UnitedHealthcare’s Medicare Advantage plan, we will not schedule any appointments for you after Dec. 31, 2024.

Like other health care organizations, Essentia has been reviewing Medicare Advantage plans to make sure they have your best interest in mind. We found UnitedHealthcare’s Medicare Advantage plan delays and denies care at twice the rate of other Medicare providers. This causes delays in getting the care you need and deserve. It can be both frustrating and stressful.

Next Steps

We know that the relationships you have with members of your care team are important to you. We would like to continue caring for you. We hope that you will consider switching to another Medicare plan in which Essentia Health is listed as an in-network care provider.

Medicare Open Enrollment

The best time to switch to a Medicare plan that covers care provided at Essentia Health is during the annual Medicare Open Enrollment period, Oct. 15, 2024 - Dec. 7, 2024.

Medicare Plans Covered

Medicare plans that cover care provided at Essentia Health include:

  • Medica
  • Essentia Care
  • UCare
  • Blue Cross Blue Shield of Minnesota
  • Blue Cross Blue Shield of North Dakota
  • HealthPartners
  • Security Health
  • Traditional Medicare

 Frequent questions and answers

  • Why won’t Essentia Health be an in-network provider for UnitedHealthcare’s Medicare Advantage plan in 2025?
    We believe that you deserve prompt access to the care that you need. We have found that UnitedHealthcare requires too many prior authorizations and denies care too often. Too many prior authorizations and denials cause hardships for our patients.
  • What UnitedHealthcare plans are affected by this change?

    Patients covered by these UHC insurance plans are affected by this change:

    • UnitedHealthcare Medicare Advantage plan
    • UnitedHealthcare Wisconsin Dual Complete
    • UnitedHealthcare Optumcare UHC Medicare
    • UnitedHealthcare AARP Medicare Complete
    • UnitedHealthcare Minnesota Dual Complete
  • I have a Medicare Supplement (Medigap) or a part D plan through UnitedHealthcare. Will my insurance still be accepted in 2025?

    Yes. This change does not affect patients who have UnitedHealthcare’s Medicare Supplement (Medigap) or part D insurance, because all Medicare Supplement and part D plans rely on traditional Medicare as the primary bill payer when you need care.

  • If I choose to stay with UnitedHealthcare’s Medicare Advantage plan, how long do I have to seek care at Essentia Health before my health insurance coverage ends? 
    Essentia will continue to be considered in-network until Dec. 31, 2024. As a part of this change, if you are covered by UnitedHealthcare’s Medicare Advantage plan, Essentia Health will no longer schedule appointments for you that occur after Dec. 31, 2024.
  • What happens to appointments that I have already scheduled in 2025?
    At the end of the year, we will contact patients who have not switched to a Medicare plan that includes Essentia Health in its network. If you have not changed plans, we will cancel any appointments that are scheduled after Dec. 31, 2024.
  • I plan to continue to seek care at Essentia Health in 2025, what do I need to do to make sure my care and/or procedures are still covered? 
    We know that your relationships with your physicians and advanced practice providers are important to you. If you are covered by UnitedHealthcare, we hope you will find a different Medicare plan that has Essentia Health in its network. These include Medica, EssentiaCare, UCare, Blue Cross Blue Shield of Minnesota and North Dakota, HealthPartners, Security Health, traditional Medicare and Medicare supplemental plans.

    You may choose to work with an insurance broker, visit www.Medicare.gov or call 1-800-MEDICARE, (1-800-633-4227) for assistance.
  • Continuity of Care
    A small number of patients with certain conditions will be able to schedule appointments and receive care at Essentia for a limited time beyond Dec. 31, 2024 for continuity of care. Please see the chart for conditions and timelines.
    Covered Service Continuity of Care Period beyond Dec. 31, 2024

    Inpatient covered services

    30 days or until discharge, whichever comes first

    Non-surgical cancer treatment

    30 days or a complete cycle of radiation or chemotherapy, whichever is greater

    End stage kidney disease and dialysis

    30 days

    Symptomatic patients with AIDS undergoing active treatment

    30 days
    If you do not make changes in your Medicare coverage, we will continue to care for you in our hospital emergency rooms. Patient care is our top priority in emergency situations, and this will not change.
  • If I decide to choose a new provider for my Medicare plan, when should I do this? 
    The best time to make changes in your Medicare plan is during Medicare open enrollment. For 2025, the Medicare open enrollment will be Oct. 15, 2024, through Dec. 7, 2024. Changes made during open enrollment take effect on Jan. 1, 2025. 
  • Who can help me change my Medicare plan? 

    There are three ways that you can shop and compare Medicare plans:

    • If you’ve worked with an insurance broker or advisor in the past, they may be able to help you. You can also find a new Medicare broker.
    • If you want to review plan options on your own, medicare.gov may be helpful. You may also call 1-800-MEDICARE (1-800-633-4227).
    • If you have insurance coverage through a group retirement plan, reach out to your former employer for more information.
  • Which Medical plans cover care at Essentia Health?
    Insurance providers that include Essentia Health in their Medicare plan network include Medica, UCare, Essentia Care, Blue Cross Blue Shield of Minnesota and North Dakota, HealthPartners, Security Health, traditional Medicare and Medicare supplemental plans. 
  • What are the differences between traditional Medicare and Medicare Advantage plans? I thought I could go to any provider with my Medicare plan.
    With traditional Medicare, you can see any provider who accepts Medicare.

    Medicare Advantage plans usually have a network of specific doctors, clinics and hospitals that have contracted with your insurance company to provide care. These plans often offer extra coverage and benefits that traditional Medicare does not cover.

    Learn more about Medicare Advantage plans: https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf

     

Need Help Choosing a New Medicare Insurance Plan?

Contact a local insurance broker

Compare plans at www. Medicare.gov or call 1-800-MEDICARE (1-800-633-4227)

State Resources:

Minnesota Senior Linkage Line:
1-800-333-2433
https://mn.gov/senior-linkage-line/

North Dakota State Health Insurance Counseling Program (SHIC):
1-888-575-6611
https://www.insurance.nd.gov/shic-medicare

Wisconsin State Health Insurance Assistance Program (SHIP):
1-800-242-1060
https://www.dhs.wisconsin.gov/benefit-specialists/medicare-counseling.htm

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