Expiration of Johns Hopkins, UnitedHealthcare insurance agreement impacts Maryland-area patients

An insurance coverage agreement between Johns Hopkins and UnitedHealthcare expired Monday, impacting nearly 60,000 patients in the Maryland area.

Effective immediately, Johns Hopkins facilities in Maryland, Virginia and Washington, D.C. are considered out-of-network for patients with employer-sponsored, Individual Family Plans, Medicare Advantage plans, and Medicaid plans through UnitedHealthcare.  

For months, the two organizations have been negotiating a contract that would have kept patients covered. 

Failing to reach an agreement

UnitedHealthcare repeatedly claimed that Johns Hopkins was seeking to implement terms that would have negatively impacted patients. 

"Despite our repeated efforts to compromise, Johns Hopkins Medicine maintained its demands for contractual provisions that would harm employers as well as our members," UnitedHealthcare said in a statement Monday. 

Johns Hopkins said it will continue to work with UnitedHealthcare with the goal of resuming in-network status "as soon as possible." 

"Johns Hopkins has been working with United for over eight months to update important pieces of our contract to prioritize patient protections and improve access to care," Johns Hopkins said in a statement Monday. "Despite our best efforts, we have been unable to reach an agreement with United that puts patients ahead of profits."

What it means for patients

According to Johns Hopkins, the end of the contract means that UnitedHealthcare will not cover care that patients receive from Johns Hopkins providers or hospitals. Patients will have to pay out-of-network costs if they wish to see a Johns Hopkins provider. 

The end of the contract will not impact facilities in Florida. 

Patients who are enrolled in the Veterans Affairs Community Care Network (VACCN) will not see any impacts, according to UnitedHealthcare. 

Patients can check with UnitedHealthcare to understand what care will be covered by calling the number on the back of their insurance card. 

Some patients who are undergoing active or long-term treatments can apply for continuity of care through UnitedHealthcare.

Find more information here.  

Cancer survivor feels the impact

Some patients who are receiving long-term or continuing care may be the most impacted.

Jaime Imhoff, an independent patient advocate, says she knows the burden of having major medical procedures and dealing with insurance. She is a cancer survivor and a double transplant recipient.

"If I had to be in the situation that they're in right now, I don't think I would be here today talking to you," Imhoff said. "There's an entire year that you have to go to that you're married to the hospital that you're transplanted at, and literally no other system will take you. You're stuck not knowing what to do."

Some patients may be eligible to keep their benefits while undergoing care.

"One patient was told that they're only going to receive 90 days of care. Another patient said that they are not going to receive any care whatsoever, even though they are a transplant, have to go see these specialty doctors," Imhoff says.

Hopkins has promised to keep negotiating. Imhoff says she believes the responsibility falls on UnitedHealthcare to make a deal.

"I am tending to lean towards more responsibility on United taking care of its members. It's paying individuals that are counting on United for healthcare. I think the burden lies on them," Imhoff added.

Imhoff recommends knowing your options, talking with your providers directly, and having your own medical records in hand.

It's worth noting that if you are receiving certain specialty care, you may still be able to receive care at Hopkins. Call UnitedHealthcare to determine if the care you're receiving is still approved.