United/Oxford - Montefiore Now out of Network

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We regret to inform you that, effective January 1, 2021, Montefiore Health System hospitals and physicians, located in the Bronx, New York and throughout the New York metropolitan area, are out-of-network for our employer-sponsored and individual plans, including Oxford, as well as our Medicaid plan.

While our agreement with Montefiore, which affects both UnitedHealthcare and Oxford commercial products, including Medicaid, ended December 31, 2020, the timing of when our members will lose in-network access will depend on the type of plan they’re enrolled in:

  • Montefiore’s physicians will be out-of-network for all employer-sponsored and individual plans, including Oxford, as well as our Medicaid plan, effective January 1, 2021.

  • Montefiore’s hospitals will be out-of-network for all self-insured commercial plans, effective January 1, 2021.

  • Our members enrolled in fully insured commercial plans as well as our Medicaid plan will continue to have in-network access to Montefiore’s hospitals until March 1, 2021.

Please keep in mind the following points:

  • In accordance with the two-month cooling-off period mandated by the State of New York, covered services received at a Montefiore Health System hospital will continue to be in-network until March 1, 2021 for members enrolled in fully insured commercial plans.

  • We will have Transitional Care (may also be referred to as Continuity of Care) guidelines in place so members eligible for Transitional Care and who have scheduled or ongoing medical treatments at a Montefiore Health system hospital will continue to get care as appropriate.

    There are many neighboring hospitals in our network that members can be referred to, including those listed below.



Neighboring Hospitals

County

Orange
Bronx
Orange
Rockland
Westchester
Westchester
Bronx
Bronx
Bronx
Orange
Bronx
Westchester
Westchester

Facility Name

Bon Secours Community Hospital
BronxCare Hospital Center
Garnet Health Medical Center
Good Samaritan Hospital of Suffern
New York Presbyterian Hudson Valley Hospital
New York Presbyterian Lawrence Hospital
NYC Health + Hospitals Jacobi
NYC Health + Hospitals Lincoln
NYC Health + Hospitals North Central Bronx
St. Anthony Community Hospital
St. Barnabas Hospital
St. John’s Riverside Hospital
Westchester Medical Center

 

We had sent letters to participants of UnitedHealthcare and Oxford self-insured commercial plans who have used the hospital in the recent past, informing them of our contract negotiations. We will also be mailing a similar letter to our fully insured members prior to January 15. In accordance with the two-month cooling-off period mandated by the State of New York, covered services received at a Montefiore Health System hospital will continue to be in-network until March 1, 2021 for fully insured members.

If you would like more information or have questions, please contact your sales representative. Members with questions should call us at the phone number on their health plan ID card.

Dexter Dible