Johns Hopkins patients navigate next steps after UnitedHealthcare talks fail

Tens of thousands of patients are scrambling now that Johns Hopkins Medicine and UnitedHealthcare negotiations ended without a new contract.

Hopkins providers will remain out-of-network for UnitedHealthcare patients.

Several patients told WJZ on Tuesday that navigating the next steps has been stressful. For them, it's not just a matter of picking a new doctor -- it's picking a new set of people they can trust.

No longer in-network

Lisa Robinson initially was being consulted at the University of Maryland Medical Center for her liver transplant, but United ultimately led her to get the procedure done at Hopkins.

"When it actually came down to the nitty gritty that I was actually going to be put on the list and possibly receive a liver, [University of Maryland] received word [United] would not cover the procedure," Robinson said.

Robinson got her transplant on Aug. 6, and not long after that, she heard about the dispute between Hopkins and United.

But now that the two have no contract, she's figuring out how to keep up her post-transplant treatment. Robinson said she was initially recommended to stay with her Hopkins doctors for at least a year after her procedure.

She has since been approved for continued care through Nov. 11.

"Right now my kidneys are fighting with some of the drugs that are actually helping my liver, which is a normal process," Robinson said. "Because it is a normal process, [my doctors] have to constantly evaluate my numbers and change my medication."

Hopkins providers have been out-of-network for United patients since Aug. 25. Aside from Maryland, this also impacted patients in Washington, D.C., and Virginia.

Both Hopkins and United claim the disagreement isn't about money, but rather about provisions each side says harm patients.

Hopkins claims United wouldn't budge on pre-authorizations and care denials, which Hopkins said delayed care.

United, meanwhile, said Hopkins wanted a provision allowing exclusion of some employer plans.

Holding out hope

Sarah and Zack Smith have been going back and forth to Hopkins from York County, Pennsylvania, for more than a year due to a condition their son has.

There was even a point when the couple moved to Baltimore for five months when their son was in the NICU.

"I know that all of our doctors and everyone we'd interact with...wants a solution, but they can't do anything. We can't do anything. So, it's been extremely stressful," Sarah Smith said. "It kind of feels like a safety net is being taken away a little bit."

In a letter to patients, Hopkins said negotiations with United could resume in the future.

The Smiths are holding out hope.

"[If we stay at Hopkins] the bills could go from hundreds of dollars to thousands of dollars pretty quickly, I think," Zack Smith said. "Obviously, we can't delay too many appointments."

The Smiths are looking at switching providers, which is what United has recommended to them.

The other option they're eyeing is in Philadelphia, which would add another two hours round-trip for them.

United said it is prioritizing approving continued care at Hopkins for eligible patients.

Hopkins has recommended that patients explore alternative insurance options in the upcoming open enrollment season.