Since Mount Sinai Hospitals system could not come to an agreement with both United Healthcare and Oxford Health Plans over reimbursement rates, Mount Sinai Hospitals are now considered out-of-network for patients covered under United health plans and Oxford health plans through employer-sponsored and individual market plans – beginning March 1st 2024. It’s important to note that United Healthcare owns Oxford Health Plan. By March 22nd , all Mount Sinai hospitals and a few affiliated outpatient care facilities will be out-of-network for patients insured by UnitedHealthcare.
United Healthcare has been trying to negotiate a contractual agreement with new in-network benefits, as Mount Sinai is pursuing pay raises for their medical staff and alleges United Healthcare of underpaying the network 30% less than other academic centers. Granted, pay raises equates to increased costs, negotiations have failed to “result in a new UnitedHealthcare in-network benefits agreement”. This rift between the Mount Sinai network and Oxford Health Plans, alongside United Healthcare, will hit patients the hardest - making the process of replacing medical professionals that make up their health team difficult, and in certain instances, unachievable.
UnitedHealthcare is required by law to continue coverage to treat and prevent a disruption of life-saving care and are required by law to continue coverage for patients who go to Mount Sinai emergency rooms.
If not dealing with an emergency, check with your insurance company to make sure your medical treatment is covered and to check if your medical providers are in-network.
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