Important Information for Wellstar Patients with UnitedHealthcare Insurance
Wellstar Health System's Primary Commercial Contract with UnitedHealthcare Has Lapsed as of October 3, 2021. Wellstar Medicare Advantage Contracts with UnitedHealthcare Extended through December 31, 2021.
As of October 3, 2021, UnitedHealthcare is telling its commercial members they no longer have access to in-network care and services from Wellstar hospitals and physicians.
At Wellstar, our patients are at the center of everything we do. For several years, Wellstar has been working to renegotiate a contract with UnitedHealthcare that would result in reimbursements for Wellstar hospital and physician services similar to those from other health insurance providers. Unfortunately, UnitedHealthcare has allowed the negotiations to fail.Wellstar had provided our written consent for UnitedHealthcare to access Wellstar physicians and hospitals through the MultiPlan agreement. Shortly after we shared that update, MultiPlan notified us that it received notice from UnitedHealthcare, that they (UnitedHealthcare) will no longer access any and all locations of Wellstar as network providers in the MultiPlan Network.
We understand how important it is to have full access to the local, high-quality providers and hospitals you know and trust, and we continue to work on reaching a new primary commercial agreement that prioritizes patient care.
To find out how you may be impacted, read the section below under the healthcare plan that applies to you.
Wellstar understands the disruption this may cause for our patients, and we continue to pursue a fair agreement to resolve the issue. We appreciate that you have trusted us with your healthcare, and we want to be there for you.
We will provide updates on our progress in contract negotiations in the coming weeks on this webpage. We have also compiled information that may be helpful to you on this page, including Frequently Asked Questions.
Wellstar was able to negotiate an extension for the UnitedHealthcare Medicare Advantage contract through December 31, 2021. Read more about the extension and specific actions you may need to take in the "Find Out How You May Be Impacted" section below.
Wellstar was able to negotiate an extension for State Health Benefit Plan UnitedHealthcare Medicare Advantage (for Retirees) members to have in-network access to Wellstar through December 31, 2021. While the cost share for these members is the same for both in and out-of-network services, we encourage members to choose other Medicare Advantage options during Open Enrollment to ensure in-network access to Wellstar in 2022. Read more in the “Find Out How You May Be Impacted” section below.
AARP Medicare Supplement from UnitedHealthcare plans are NOT impacted by this contractual expiration. Read more in the "Find Out How You May Be Impacted" section below.
Find out how you may be impacted
- If you have an upcoming appointment with Wellstar after October 3, contact UnitedHealthcare to understand your out-of-network benefit options before contacting your provider to re-schedule or to discuss other options.
- Speak with your employer to make sure that you understand your health insurance options or if there are other health plans available during your company’s next Open Enrollment period that offer in-network services from Wellstar.
Patients with UnitedHealthcare Medicare Advantage
UnitedHealthcare Medicare Advantage members with an existing relationship with a Wellstar provider will have coverage through the end of the year and are encouraged to select a new Medicare Advantage health plan during the upcoming Open Enrollment period (October 15 - December 7, 2021) that includes in-network access to Wellstar providers.
To change your plan selection to include your Wellstar physicians and hospitals during the Open Enrollment process, you can either:
- Contact your insurance broker (if you have one) and they can assist you in making a change.
- Easily find a broker by calling 1-866-552-4464 and selecting Option 4 (Mygeorgiacares.org) to speak with someone about Medicare plans to assist you in making a change.
- Visit Medicare.gov and log in or create an account and follow the prompts to select a new plan
Patients with State Health Benefit Plan UnitedHealthcare Medicare Advantage (for Retirees)
For our patients, we have been able to negotiate an extension of our contract with UnitedHealthcare, and Wellstar will remain in-network through December 31, 2021. Even if a further contract extension for this product does not occur for 2022, you will be able to continue to use your trusted Wellstar physicians and hospitals under your out-of-network benefit, with no additional cost to you. Wellstar physicians and hospitals WILL NOT be listed as in-network providers. We understand this could create anxiety and recommend you consider choosing one of the other Medicare Advantage options available to you during Open Enrollment that includes Wellstar physicians and hospitals as in-network providers.
Patients with AARP Medicare Supplement from UnitedHealthcare
The contract negotiations do not affect patients with the AARP Medicare Supplement from UnitedHealthcare. If you have this plan, you will continue to have full access to the Wellstar doctors and hospitals you know and trust.
Patients who are Veterans Utilizing the Veteran's Affairs Community Care Network
We recognize and honor U.S. Veterans for their service and sacrifices, and are privileged to be a trusted healthcare partner. Veterans with UnitedHealthcare insurance continue to have full access to the Wellstar doctors and hospitals they know and trust. Wellstar has secured a separate agreement with Optum which allows in-network access for Veterans utilizing the Veteran’s Affairs Community Care Network. Effective immediately Veterans can access care through referrals in the usual manner and process, working with Veteran’s Affairs staff to get referrals and guidance for new Wellstar appointments.
Prioritizing Patient Care
We value our relationship with you. Wellstar’s doctors, nurses and entire team have been working harder than ever over the last 20 months to meet the healthcare needs of Georgians during the COVID-19 crisis. Wellstar consistently earns recognition from national organizations that set standards for the care we provide. This includes recognition for world-class cardiology, cancer and neurological care.
UnitedHealthcare Members at Risk of Losing In-Network Access
In contrast, UnitedHealthcare and its parent company, UnitedHealth Group, reported a record $22 billion profit last year—during a global pandemic. It’s disappointing that—even during these difficult times—UnitedHealthcare and its parent company continue to choose profits over patients. It’s no surprise that UnitedHealthcare is the least trusted private insurer in the country according to The 2020 Trust Index from ReviveHealth.
See how UnitedHealthcare and its parent company, UnitedHealth Group, are focused on profits, not patients as demonstrated by their skyrocketing profits2020 UNH Form 10-K
2017 UNH Form 10-K
What will patients lose without Wellstar in the UnitedHealthcare network?
Wellstar provides access to compassionate, high-quality care through our: 11 hospitals; over 300 Wellstar Medical Group medical office locations; nine cancer centers; 74 rehabilitation centers; three hospice facilities; one retirement village; 34 imaging centers; 17 urgent care locations; and five health parks. Unfortunately, UnitedHealthcare has allowed the negotiations to fail. As of October 3, 2021, UnitedHealthcare is telling its commercial members they no longer have access to in-network access to one of the largest and most integrated healthcare systems in the state of Georgia.
Participating Health Plans
The following is a list of major health plans that Wellstar Health System participates in. Wellstar is simply asking UnitedHealthcare to reimburse us fairly, similar to other insurance companies such as Anthem/Blue Cross Blue Shield, Cigna and Humana.
*If you do not see your health plan listed, please contact (770) 956-STAR Monday-Friday to see if your plan is included.
- Alliant Health Plans, Inc.
- Anthem/Blue Cross Blue Shield of Georgia
- Beech Street
- Health One Alliance
- Multi Plan
- Prime Health Services
- Private Healthcare Systems (PHCS)
- Three Rivers
Medicare Advantage Plans
- Anthem/Blue Cross Blue Shield of Georgia
- CareSource DSNP — Medicare/Medicaid eligible
- Cigna Medicare (Healthspring)
- Clear Spring Health (formerly EON Health Plan)
- Clover Health, LLC
- Humana Choice and Regional
- Humana Gold Choice
- Peach State (Allwell)
- Positive Healthcare Partners
- Pruitt Health Premier
- Sonder Health Plans
- WellCare - All Medicare Advantage Plans