Time is running out for UnitedHealthcare and Johns Hopkins to come to an agreement on a new contract. If they don’t, nearly 60,000 patients in D.C., Maryland and Virginia will be stuck out of network.
One D.C. couple is set to welcome their first child next month, but they found out this week that they may need to find a new provider at the last minute.
The couple, who asked News4 to conceal their identities to protect their privacy, called their journey a rollercoaster — they suffered two pregnancy losses last year, and now they can’t wait to meet their baby boy at the end of September.
“So you know he’s been in here doing his somersaults, so I think we’re just excited to finally get to meet him and see what he’s like,” the mom said. “I get emotional thinking about it,”
She said the first two trimesters were rough, and now at 33 weeks and counting until the due date, the lovebirds said they’ve had to put a pause on their nesting.
“All of a sudden I find out that the hospital is not going to take my insurance,” the mom said.
The 38-year-old said she was all set to deliver at Sibley Memorial Hospital next month, but Monday, she got a letter telling her they may need a new plan and provider fast.
“I was just like, first of all, just in shock,” she said. “I was like, wait a second, and then I’m just like, crap, we’re probably going to have to find a new provider.”
It’s a tall order this late in the game.
Turns out, the married couple are among tens of thousands in the dmv region who may be out of network at all Johns Hopkins hospitals at the end of the month due to stalled contract negotiations with UnitedHealthcare.
For seven months, the two have gone back and forth over things like reimbursement requirements and denials, pushing the deadline back several times.
Now, time is running out before the Aug. 25 deadline, which applies to all employer commercial sponsored plans, individual family plans, Medicare advantage plans and patients on Medicaid.
“My healthcare literacy is probably more than the average American, and if I’m having these issues, imagine somebody else,” the mom said.
Both sides shared statements Wednesday pointing fingers at each other.
“Unfortunately, UnitedHealthcare has chosen to slow down negotiations recently because we refused to accept their harmful practices that hurt patients,” a rep for Johns Hopkins said. “[…] Our patients deserve better than insurance company barriers standing between them and their care.”
While UnitedHealthcare said, “Our top priority is to reach an agreement that maintains continued, uninterrupted network access to Johns Hopkins. Our negotiation isn’t about money. […] However, Johns Hopkins is requiring contractual provisions that would negatively impact members and employers, allowing them to turn patients away at their discretion.”
“I had to call them three times, talked to three different people and got three different answers,” the mom said.
A rep for UnitedHealthcare said patients undergoing treatment for conditions like cancer and pregnant people are eligible to apply for continuity of care to pay at their in-network rate.
But the new mom says that doesn’t ease her mind.
“Babies are expensive,” she said.
If the two can’t come to an agreement by Aug. 25, Johns Hopkins hospitals and facilities will be out of network for those on UnitedHealthcare.
(Except for the headline, this story has not been edited by PostX News and is published from a syndicated feed.)
