Wellmont drops some United Healthcare Medicare Plans

POSTED: 12:06 PM Sep 06 2013   UPDATED: 9:00 PM Sep 06 2013
KINGSPORT, Tenn. -

Wellmont Health System announced Friday morning the Kingsport-based healthcare company failed to reach a new contract with some United Healthcare's Medicare Plans.

We’ve learned patients covered by four United Healthcare plans face the potential of paying higher hospital costs and having limited access to doctor’s offices.

All Wellmont Health System facilities will become out of network for United Healthcare patients October 1, 2013.

The plans are AARP Medicare Complete Essential, AARP Medicare Complete Plan 2, AARP Medicare Complete Plus Plan 1 and United Healthcare Dual Complete.

Patients who would like to retain in-network rates at Wellmont hospitals can switch from one of the United Healthcare plans to BlueCross BlueShield of Tennessee Blue Advantage, Humana, Windsor Health Plan or the federal government’s traditional Medicare program.

Alice Pope, Wellmont’s chief financial officer, said United Healthcare proposed terms in a new contract that will not allow Wellmont to be sufficiently reimbursed for costs incurred for care in its hospitals.

“Wellmont has negotiated in good faith in an effort to reach agreement on a new contract without a disruption for our patients,” Pope said. “Unfortunately, the result is an unacceptable contract proposal from United Healthcare that does not come close to matching the reasonable amount other insurance carriers pay our health system.”

Wellmont officials say patients who choose to remain with one of the United Healthcare plans will still be able to access Wellmont facilities for emergency services at in-network rates.

Physicians who are in network and practice at Wellmont hospitals can request that this status be granted to their patients.

UnitedHealthCare issued a statement in response to Wellmont's rejections saying, "Wellmont Health System is demanding a significant increase in payments for its services to UnitedHealthcare members. This is something that our customers in Northeast Tennessee simply cannot afford. We are making every effort to inform the people of Tennessee and help them understand their options, and prevent disruptions in their care."

Wellmont’s decision does not affect contracts Wellmont Medical Associates and the Wellmont CVA Heart Institute have with United Healthcare.

Patients who have questions may call a Wellmont representative at 800-844-2136.