Bloomington-based HealthPartners no longer will accept UnitedHealthcare’s Medicare Advantage plan at the end of the year, meaning some 30,000 senior patients will have to change medical providers or pick a different insurance plan.
HealthPartners says UnitedHealth has been denying insurance claims from the plan at a much higher rate — sometimes 10 times higher — than other insurers and forces unnecessary waits for medical care. Starting next year, HealthPartners won’t be making appointments with the insurer’s patients at all, even if they’re willing to pay much higher, out-of-network rates.
“It’s unusual for us to leave a health plan network. Unfortunately, after a year of negotiations, we’ve determined that we can no longer participate in the UnitedHealthcare Medicare Advantage network,” HealthPartners said in a letter to Medicare Advantage users.
UnitedHealthcare told the Pioneer Press they still hope to negotiate an agreement and that HealthPartners’ accusations are untrue.
“Unfortunately, HealthPartners seems intent on disrupting access to care for our Group Retiree members as part of its effort to secure significant rate increases that are not affordable or sustainable for our members,” spokesman Cole Manbeck said.
The affected patients, all either 65 or older or with a qualified disability, include around 2,300 retirees of St. Paul Public Schools.
“We are mostly in our 80s and healthcare is a big deal for us,” said John Brodrick, a retired teacher and school board member who survived quadruple bypass surgery. “I am worried about potentially not being accepted by HealthPartners as a member of UnitedHealth. … I don’t know if I’m going to have to find a new cardiologist on Jan. 1. These are all the questions that are up in the air right now.”
HealthPartners runs Regions Hospital in downtown St. Paul, the HealthPartners Clinic in the St. Paul Midway and Lakeview Hospital in Stillwater, among other Twin Cities hospitals, clinics and specialty centers.
St. Paul Public Schools said Friday that the district had no advance notice about the change.
“The district is working closely with the insurance providers to identify potential next steps. As soon as we have more information, the district will communicate with the impacted retirees about their options,” a district spokesperson said.
The HealthPartners letter suggests patients switch to a different insurance plan if they want to keep receiving care from HealthPartners. Medicare’s annual enrollment period runs Oct. 15 to Dec. 7.
Uncertainty for retirees
Brodrick said he still was on the school board a few years ago when UnitedHealth won the health contract for retirees with “a really low-ball bid,” and he made sure to ask if retirees would still be able to access HealthPartners services. “I was assured by the benefits department that was true,” he said Friday. “Whether that was written into the contract or not, I hope St. Paul Public Schools is looking into it. I was uneasy at the time, for a lot of different reasons.”
Retired teacher Roy Magnuson said part of the debacle dates to 2019, when the St. Paul Federation of Educators Local 28 switched insurers for active employees, dropping UnitedHealth in favor of a public employees insurance plan. As a result, other employee groups associated with the school district suddenly had less bargaining leverage with UnitedHealth.
The affected employees are retirees for whom the school district continues to pay part of their medical coverage.
“I’ve had three other people contact me,” Magnuson said Friday. “They’re old and they’ve stayed with their doctor. The contract was that UnitedHealth would honor out-of-network providers if the school district gave them the contract. The union pulled out on fairly short notice, which left all of the different bargaining units in a different spot.”
Brodrick on Friday called on the school district to take a firm, public position in the dispute between the two healthcare giants.
“The little guy always seems to get caught in the middle,” he said. “Healthcare is the elephant in the room of every home in America, but the big-wigs seem to rule.”
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