Many of the people who are insured with United Healthcare in Wasco County recently received a letter from Adventist Health Portland. The letter said that Adventist’s contract with United Healthcare is up on April 1, that both parties were working on a renewal, but that “At this point, we haven’t reached a fair agreement.”
In the health insurance industry, it’s common that companies will negotiate with various providers to come to a contract on reimbursement terms. Those that have a contract are called “in network” and those that don’t have contracts are called “out of network.”
That usually means the insureds have fewer benefits, higher co-pays and deductibles when dealing with out of network providers.
Wasco County residents who obtained their Medicare Advantage plans through Oregon PERS (Public Employees’ Retirement System) had their coverage switched from Pacific Source to United Healthcare on January 1, only to receive this letter a few weeks later.
The surprising news is that in this Medicare Advantage version of United Healthcare coverage, it makes no difference whether the provider is in or out of network. A check on the plans offered on the PERS site confirms it – at least for this year.
This may not be the case for people who get one of 10 plans offered by United Healthcare in Wasco County for individuals.
The United Healthcare website has several places to enter a Zip Code to see details of the plans offered in that area, but in two places that locked up the page, an in another, it said United Healthcare had no Medicare Advantage plans offered in Wasco County.
The toll-free number for United Healthcare is (888) 758-3897. It can be a long wait on hold after you pass the original telephone tree, so be prepared.