United Healthcare
Our physicians, nurses, and all the members of your health care team here at UF Health care deeply about you, your family, your friends, and the communities we serve. We value all our patients and believe clear and open communication is vital to our relationship with you and essential to our mission to serve you as you make informed decisions about your health and well-being. As we continue our tradition of excellence in caring for our communities, we wanted to take a moment to provide you with information that is necessary and appropriate for the delivery of health care services.
FAQs
Does the letter I received dated September 1 mean I am no longer able to go to my UF Health St. Johns physician or hospital?
We value our patients who turn to us for their care and are earnestly negotiating in good faith with United Healthcare to remain an in-network participating provider. Uninterrupted and continuous care for our community is a priority for UF Health St. Johns. Unfortunately, as of September 1, 2024, UF Health St. Johns physicians, UF Health Flagler Hospital, and other facilities no longer have a participating provider agreement with United Healthcare for commercial, Medicare Advantage, and Medicaid Managed Care health plans. However, this does not affect community physicians and other providers not employed by UF Health St. Johns.
You can still access UF Health St. Johns for certain services such as emergency services.
If you have specific questions about whether you qualify for continued coverage and care, if you will have a higher copayment for services, or for any other information necessary or appropriate for the delivery of your health care services, please contact your health plan. Some numbers United Healthcare lists on their website include:
- Commercial health plan customer service line: 1-866-801-4409
- Medicare Advantage customer service line: 1-800-600-9007
- Medicaid Managed Care customer service line: 1-888-716-8787
Many health plans also list customer service numbers on member identification cards.
If I am receiving services from UF Health St. Johns, how long can I continue to do so for plans that no longer contract with UF Health St. Johns?
There may be some exceptions to continuity of care. Florida law provides certain time frames for continued coverage and care when medically necessary. Call your health plan for any questions about your benefits.
If you have specific questions about whether you qualify for continued coverage and care or for any other information necessary or appropriate for the delivery of your health care services, please contact your health plan.
When appropriate and upon request, your UF Health St. Johns provider may attempt to verify the terms of coverage with your health plan, should you continue to seek services at UF Health St. Johns.
Why is UF Health St. Johns no longer included in the United Healthcare network?
At a time when health care systems nationally are shouldering continual increases in labor, supply, and other expenses while continuing to care for patients, health plans such as United Healthcare are reporting billions in record earnings. We are seeking fair and reasonable rates for the quality and compassionate care that our physicians, nurses, and other members of the health care team at UF Health St. Johns provide to our community every day. United is paying the same rates they were before COVID-19. To make the situation worse, United imposes policies and protocols, unlike other Managed Medicaid payors, that result in reductions in reimbursement to UF Health. Some examples include complex and lengthy prior authorization processes, complicated billing and coding requirements, and claim denials/payment delays. We are working very hard and in good faith to reach an agreement that provides our hospitals and physicians fair and appropriate rates that will return UF Health St. Johns to the United network.
I am currently pregnant and planned to deliver at UF Health Flagler Hospital. Will I still be able to deliver at UF Health Flagler Hospital?
You may be entitled to certain continued coverage and care until completion of postpartum care under state law. If you have specific questions about whether you qualify for continued coverage and care, or for any other information necessary or appropriate for the delivery of your health care services, please contact the applicable health plan.
What if I have an emergency?
In the event of an emergency, patients can always access care in our emergency room regardless of whether a health plan has an agreement for services with UF Health St. Johns, and, except in rare circumstances, emergency services and care provided by UF Health St. Johns will be covered to the extent required by law. Except for certain instances regarding continuity of care, UF Health St. Johns will be seeking payment of the maximum amounts permissible under law for emergency services and care rendered to patients enrolled in plans in which UF Health is no longer a participating provider or facility as of the termination date.
You also have the right to receive care from another hospital or provider, if you choose to do so. Health plans often list a telephone number on the health plan’s enrollee identification card so they may be contacted directly about your choices. If you have specific questions regarding your health plan, please contact your health plan.
Your health plan telephone number also is typically found on your health insurance card.
Will I be billed for services?
Each case depends on your health benefits. You are able to see out-of-network providers if you prefer. Please check with your health plan to determine what your out-of-network copayment would be.
Your health plan telephone number also is typically found on your health insurance card.
Can you help me choose a new health plan physician or other provider?
No, unfortunately we cannot help you select another physician or other provider. That’s a decision only you can make. For any information necessary or appropriate for the delivery of your health care services, please contact your health plan.
Your health plan telephone number also is typically found on your health insurance card.
I have United Health Medicare supplemental insurance (e.g., AARP). Does this affect my access to UF Health hospitals or physicians?
Any patient who has a United supplemental plan secondary to a Medicare plan can be seen. It does not have any affect.
I have a United commercial supplemental plan, how are my services affected?
We do not know how United will adjudicate these claims; however, we will continue to see any patients with any United supplemental plan.
If I switch to another physician, will that physician or other provider be able to get my medical records?
Yes. Once you have selected a new physician or other provider, your new physician or other provider can request copies of your medical records from UF Health St. Johns with your permission.
If a health plan does not include UF Health St. Johns as a participating provider, will my access to UF Health’s physicians be impacted?
Please consult your health plan. Your provider may still be included in the United network if they are not employed by UF Health or your health plan may have out-of-network benefits.
How can I switch from my current health plan to another commercial health plan?
Only you can make this decision. Please contact your benefits manager.
How can I switch from my current health plan to another Medicaid Managed Care plan?
Only you can make this decision. Please contact your benefit counselor with any questions or call the Florida Medicaid Choice Counselor at 1-877-711-3662 (TTY/TTD 1-866-467-4970).
How can I switch from my current health plan to another Medicare Advantage plan?
If you have any questions about Medicare, or the Medicare Advantage program, contact the Centers for Medicare & Medicaid Services (“CMS”) at 1-800-MEDICARE (1-800-633-4227). TTY users please call 1-877-486-2048. You can also call CMS twenty-four (24) hours a day, seven (7) days a week, or visit the CMS website at www.medicare.gov. For assistance with Medicare/Medicaid coverage, call the toll-free telephone number: 1-866-76ACCESS (1-866-762-2237),
What if I am willing to pay for out-of-network expenses?
We understand you would like to pay for health care service(s) yourself. We want to make sure you are aware of the financial “out-of-pocket” obligation you may experience by doing this. We suggest you contact your payer so they can fully explain your out-of-pocket obligation, specifically your out-of-network benefits as well as out-of-pocket maximum that you could need to pay by seeing a provider outside of the United Healthcare network.
If you choose to pay using your out-of-network benefits, it is possible you may owe as much as your out-of-pocket maximum, depending upon the services you receive.
Accepted Insurance Plans
To view plans currently accepted by UF Health St. Johns, please click here.