Samaritan Health Services has terminated its contract with United Healthcare.
This means on Jan. 9, 2024, Samaritan Health Services hospitals will be considered out of network under United Healthcare insurance plans. Samaritan physician and provider services will become out of network on Nov. 1, 2024.
After these dates, community members insured by United Healthcare can still choose to see Samaritan providers and seek care at a Samaritan facility, but it may be at a greater cost based on their plan’s coverage.
Community members can rest assured that if they visit a Samaritan hospital for emergency services, they are protected by the federal No Surprises Act, which requires services be provided at the in-network rate for those with health insurance through an employer (including a federal employees health benefits plan), the federal health insurance marketplace, a state-based marketplace or other individual market coverage.
Samaritan patients who are currently insured through United Healthcare can speak to their workplace benefits administrator or their broker, if they are on a Medicare Advantage plan, if they would like to explore other insurance options.
Samaritan remains a participant in a variety of health plans, which are all listed online at samhealth.org/InsuranceBilling.
Patients can call Samaritan’s Regional Billing Office Customer Service at 800-640-5339 with any questions.
Frequently Asked Questions
Q: I received a letter about Samaritan terminating its contract with United Healthcare. What does this mean?
Samaritan Health Services sent a notice of final termination to United Healthcare. This means that Samaritan hospitals will no longer be considered in network effective Jan. 9, 2024, and on Nov. 1, 2024, for physician and provider services. If you want to continue to seek care with a Samaritan clinician or facility, you will likely have higher out-of-pocket fees.
Q: Why did Samaritan Health Services terminate their agreement with United Healthcare?
Samaritan Health Services periodically reviews its contracts and relationships with health insurance companies. Through this review, we have determined that United Healthcare’s processing of requests and claims has made it difficult for Samaritan to provide timely access to the appropriate care to United’s members. This, along with other factors, is not in alignment with our mission of building healthier communities together.
Q. Is United Healthcare supplement insurance affected by this termination?
No. United Healthcare supplement insurance, also known as a Medigap policy, is not impacted. Supplement insurance is not subject to a contract. Learn more about Medigap coverage on the Centers for Medicare & Medicaid Services website.
Q: Can I still use a Samaritan Pharmacy for prescription medications?
Yes. Pharmacy benefits are not part of the hospital or physician and provider services contracts.
Q: What health plans affiliated with United Healthcare are affected by this contract termination?
- AARP- United Healthcare Medicare Advantage.
- All Savers.
- Deseret Mutual Benefit Administrators/Missionary Medical.
- Government Employees Health Association (GEHA).
- Golden Rule.
- National Tele Communications Association (NTCSA), The Rural Broadband Associates.
- United Healthcare.
- United Healthcare Student Resources.
- United Medical Resource (UMR).
- United Medical Resource/World Trade Center.
- United Behavioral Health.
- United Healthcare Medicare Advantage.
- United Healthcare Medicare Optum.
- United Healthcare Shared Services/Harvard Pilgrim.
- United Healthcare Shared Services/Select Health.
- United Healthcare Shared Services/Deseret Mutual Benefit Administrators.
Q: What insurance plans does Samaritan contract with?
Samaritan Health Services remains a participant in a variety of health plans, which are all listed on our website at samhealth.org/InsuranceBilling
Q: What happens if I choose to stay with United Healthcare?
If you choose to stay with United Healthcare, you will be required to pay out-of-network rates when you seek care with Samaritan physicians, providers and facilities. The one exception is when you seek emergency care. In accordance with the federal No Surprises Act, emergency services must be provided as in network for those covered by health insurance through an employer (including a federal employees health benefits plan), the federal health insurance marketplace, a state-based marketplace or other individual market coverage.
Q: How do I change my plan?
If you are enrolled in a plan through your employer or a Medicare Advantage plan, you have the opportunity to explore plans and select the one that is right for you during open enrollment.
Open enrollment varies by employer, please contact your employer for details about your open enrollment period and plan offerings.
For Medicare Advantage plans, medicare.gov/plan-compare or call 800-MEDICARE to assess your needs and available plans. Another resource is Senior Health Benefits Assistance, also known as SHIBA, which has certified counselors who provide local and confidential one-on-one help for Oregonians who have questions about Medicare.
The Medicare open enrollment period is Oct. 15 to Dec. 7 each year for Medicare Advantage. For any change you make during open enrollment, coverage will start in January 2024.
Q: Are there financial assistance or payment options offered by Samaritan?
Yes. There are several payment options, including payment plans as well as financial assistance for those who qualify. Learn more at samhealth.org/FinancialAssistance.