UnitedHealthcare Negotiations

Important information for patients with UnitedHealthcare health insurance plans.

St. Peter’s Health Partners is working hard to reach a fair agreement with UnitedHealthcare that covers the true cost of the care we provide to patients.

Unfortunately, UnitedHealthcare has forced St. Peter’s Health Partners out of its network, effective July 1, 2024. This impacts patients who are covered by UnitedHealthcare employer sponsored commercial (excluding the New York State Empire Plan), Medicare Advantage, Medicaid and Essential Plan health plans. UnitedHealthcare has disrupted your access to St. Peter’s Health Partners hospitals, facilities, and physicians.

New York law provided continued access to our hospitals through August 31, 2024, for fully insured employer sponsored commercial, Medicaid and Essential Plan health plans. We agreed to extend in-network access to all St. Peter’s Health Partners providers and services for Medicaid and Essential Plan health plans through August 31. As of September 1, 2024, patients with employer sponsored commercial, Medicaid and Essential Plan health plans no longer have in-network access to St. Peter’s Health Partners providers and services. If you choose to continue care with St. Peter’s Health Partners providers or services while we remain out of UnitedHealthcare’s network, your out-of-pocket costs may increase.

St. Peter's Health Partners will continue participation in behavioral health coverage administered by Optum.

Why did UnitedHealthcare force St. Peter’s Health Partners out-of-network?

The payment we receive from UnitedHealthcare does not appropriately cover the true cost of the care we provide. We rely on fair reimbursement so we can sustain the high-quality care people depend on and need, but UnitedHealthcare frequently denies, delays, and underpays our hospitals and providers. We are asking for fair reimbursement, which UnitedHealthcare continues to deny us.

UnitedHealthcare has misrepresented our request for fair payment as a not-for-profit health system. In truth, we are seeking a multi-year agreement with less than 5% increases on average, so we can continue to invest in the medical innovations, technologies, and programs patients rely on. UnitedHealthcare claims to be concerned about lowering costs for members. However, it rakes in billions by choosing to increase member’s monthly out of pocket costs, deny claims and underpay health systems like ours and others across the country.

Continuity of Care

Some patients, including those who are pregnant or undergoing active treatment for a chronic condition, may qualify for extended in-network access through UnitedHealthcare's continuity of care program. Unfortunately, St. Peter’s Health Partners cannot qualify you under UnitedHealthcare's process. However, patients with Medicaid or Essential Plan health plans need to call their provider’s office to initiate the process.

UnitedHealthcare requires you to call the number on the back of your insurance card to see if you qualify. If you have a Medicaid or Essential Plan health plan you need to call your providers office to initiate the process.
UnitedHealthcare will provide additional instruction on how to enroll based on your health plan.
If UnitedHealthcare denies your Continuity of Care request and you are currently undergoing treatment at St. Peter’s Health Partners and are enrolled in a Medicare Advantage benefit plan, you can file a complaint with the Centers for Medicare and Medicaid Services by calling 800-985-3059.
If UnitedHealthcare denies your Continuity of Care request and you have insurance through your employer, contact your HR or benefits manager.
If UnitedHealthcare approves your Continuity of Care request, it must permit continued in-network access to your current health care provider for a certain period.

Your provider’s office can help you complete the continuity of care form from UnitedHealthcare.

We know how important it is for you and your family to continue receiving care from the trusted doctors, nurses, and staff at St. Peter’s Health Partners. We will continue to work to reach a fair agreement with UnitedHealthcare.

If you do not find the answers to your negotiation-related questions on this site, please contact us directly through our contact us page or call our patient line at 518-535-0400. This website will be updated as our negotiations continue, so please check back for the current information.

What You Can Do

Never delay care. Go to the closest emergency department. Emergency care is always in-network.
Apply for continuity of care immediately. Some patients, including those who are pregnant or undergoing active treatment for a chronic condition, may qualify for extended in-network access through UnitedHealthcare's continuity of care program. Unfortunately, St. Peter’s Health Partners cannot qualify you under UnitedHealthcare's process. However, patients with Medicaid or Essential Plan health plans need to call their provider’s office to initiate the process.
- UnitedHealthcare requires you to call the number on the back of your insurance card to see if you qualify. If you have a Medicaid or Essential Plan health plan you need to call your provider’s office to initiate the process.
- UnitedHealthcare will provide additional instruction on how to enroll based on your health plan.
- If UnitedHealthcare denies your Continuity of Care request and you are currently undergoing treatment at St. Peter’s Health Partners and are enrolled in a Medicare Advantage benefit plan, you can file a complaint with the Centers for Medicare and Medicaid Services by calling 800-985-3059.
- If UnitedHealthcare denies your Continuity of Care request and you have insurance through your employer, contact your HR or benefits manager.
- If UnitedHealthcare approves your Continuity of Care request, it must permit continued in-network access to your current health care provider for a certain period.
Call the number on the back of your insurance card and urge UnitedHealthcare to keep your in-network access to St. Peter's Health Partners and its doctors.
If you receive insurance through your employer, ask about other health plans that include St. Peter's Health Partners. Your employer may be able to provide you with secondary health plan coverage that includes access to your trusted caregivers.
If you have Medicare Advantage or bought a UnitedHealthcare plan from the ACA marketplace (also known as the Health Insurance Exchange), contact your health insurance agent/broker for options to switch plans. We work with many other health plans that will give you in-network access to St. Peter's Health Partners.
If you have UnitedHealthcare Medicaid or Essential Plan health plan, you may be able to choose other health care coverage that allows you to access St. Peter's Health Partners. Visit https://www.health.ny.gov/health_care/medicaid/members/ to see if you can change your plan. Additionally, patients enrolled in a Medicaid plan can call the state help line at 800-541-2831.
Dually-enrolled - Call 1-800-MEDICARE. Dually enrolled patients in a Medicare/Medicaid plan may also take action. Call 1-800-633-4227 to see if you are eligible to make a change in your plan.

You can find a complete list of plans St. Peter’s Health Partners is in-network with for the full 2024-2025 benefit year at sphp.com/for-patients/billing-information/accepted-insurance.

Frequently Asked Questions

UnitedHealthcare has forced St. Peter’s Health Partners hospitals, facilities, and providers out of network for patients covered by UnitedHealthcare employer sponsored commercial (excluding the New York State Empire Plan), Medicare Advantage, Medicaid and Essential Plan health plans, as of July 1, 2024. Below, we’ve provided in-depth information to help our patients understand how the disruption caused by UnitedHealthcare may impact them:

Q: What is happening?

A: St. Peter’s Health Partners has been working diligently to secure a new agreement with UnitedHealthcare that more appropriately covers the true cost of the care we provide to patients with UnitedHealthcare employer sponsored commercial (excluding the New York State Empire Plan), Medicare Advantage, Medicaid and Essential Plan health plans.

At this time, our existing agreement has expired. UnitedHealthcare has made the decision to force St. Peter’s Health Partners out of its network as of July 1, 2024. This means impacted patients may experience disruption when trying to access their trusted St. Peter’s Health Partners hospital or health care provider. UnitedHealthcare may also force you to pay more out-of-pocket for the health care services you receive through St. Peter’s Health Partners moving forward.

St. Peter's Health Partners will continue to participate in behavioral health coverage administered by Optum.

Q: Who is affected by the negotiation?

A: Patients who receive health insurance coverage through UnitedHealthcare employer sponsored commercial (excluding the New York State Empire Plan), Medicare Advantage, Medicaid and Essential Plan health plans are impacted. UnitedHealthcare no longer includes St. Peter’s Health Partners in your provider network, effective July 1, 2024.

New York law provided continued access to our hospitals through August 31, 2024, for fully insured employer sponsored commercial, Medicaid and Essential Plan health plans. We agreed to extend in-network access to all St. Peter’s Health Partners providers and services for Medicaid and Essential Plan health plans through August 31. As of September 1, 2024, patients with fully insured employer sponsored commercial, Medicaid and Essential Plan health plans no longer have in-network access to St. Peter’s Health Partners providers and services. If you choose to continue care with St. Peter’s Health Partners providers or services while we remain out of UnitedHealthcare’s network, your costs may increase.

St. Peter's Health Partners will continue to participate in behavioral health coverage administered by Optum.

Q: Which providers and facilities are impacted?

A: St. Peter’s Health Partners hospitals, facilities, and employed providers are impacted by these contract negotiations.

Medical Group Providers

St. Peter’s Health Partners Medical Associates
Samaritan Hospital Clinics and Providers
St. Peter's Hospital Clinics and Providers
Trinity Health Anesthesia Group of New York

Hospitals, Facilities & Services

St. Peter’s Hospital
Samaritan Hospital
Sunnyview Rehabilitation Hospital
Eddy Visiting Nurse & Rehabilitation Association
Empire Home Infusion Services including Northeast Home Medical Equipment
The Community Hospice

Q: Can I continue to see my St. Peter’s Health Partners health care provider?

A: Some patients, including those who are pregnant or undergoing active treatment for a chronic condition, may qualify for extended in-network access through UnitedHealthcare's continuity of care program. Unfortunately, St. Peter’s Health Partners cannot qualify you under UnitedHealthcare's process. However, patients with Medicaid or Essential Plan health plans need to call their provider’s office to initiate the process.

UnitedHealthcare requires you to call the number on the back of your insurance card to see if you qualify. If you have a Medicaid or Essential Plan health plan you need to call your provider’s office to initiate the process.
UnitedHealthcare will provide additional instruction on how to enroll based on your health plan.
If UnitedHealthcare denies your Continuity of Care request and you are currently undergoing treatment at St. Peter’s Health Partners and are enrolled in a Medicare Advantage benefit plan, you can file a complaint with the Centers for Medicare and Medicaid Services by calling 800-985-3059.
If UnitedHealthcare denies your Continuity of Care request and you have insurance through your employer, contact your HR or benefits manager.
If UnitedHealthcare approves your Continuity of Care request, it must permit continued in-network access to your current health care provider for a certain period.

Your provider’s office can support in filling out the continuity of care form from UnitedHealthcare.

Q: What is St. Peter’s Health Partners doing to reinstate its in-network status?

A: We will not give up trying to reach a fair agreement with UnitedHealthcare. We know how important it is for you and your family to continue receiving care from the trusted doctors, nurses, and staff at St. Peter’s Health Partners. Your voice can make a difference. Call UnitedHealthcare and tell them to focus on you, not just their own profits.

Q: I am an impacted patient. Can I still choose St. Peter’s Health Partners for my health care while you remain an out-of-network provider?

A: Yes, all impacted patients will continue to have access to St. Peter’s Health Partners facilities and providers during this period of disruption; however, if you choose to continue care at St. Peter’s Health Partners while we remain out of UnitedHealthcare’s network, your costs may increase based on the benefits included in your UnitedHealthcare plan. Impacted patients should contact UnitedHealthcare to determine their out-of-network benefits.

Q: If I’m not covered by a UnitedHealthcare health plan, does this impact my insurance too?

A: No, our out-of-network status only affects patients covered by a UnitedHealthcare health plan.

Q: What if I’m pregnant or receiving treatment for an ongoing condition at St. Peter’s Health Partners?

UnitedHealthcare requires you to call the number on the back of your insurance card to see if you qualify. If you have a Medicaid or Essential Plan health plan you need to call your provider’s office to initiate the process.
UnitedHealthcare will provide additional instruction on how to enroll based on your health plan.
If UnitedHealthcare denies your Continuity of Care request and you are currently undergoing treatment at St. Peter’s Health Partners and are enrolled in a Medicare Advantage benefit plan, you can file a complaint with the Centers for Medicare and Medicaid Services by calling 800-985-3059.
If UnitedHealthcare denies your Continuity of Care request and you have insurance through your employer, contact your HR or benefits manager.
If UnitedHealthcare approves your Continuity of Care request, it must permit continued in-network access to your current health care provider for a certain period.

Your provider’s office can help you complete the UnitedHealthcare continuity of care form.

Q: What if I’m in the hospital on/after July 1, 2024?

A: If you are already admitted to the hospital prior to July 1, 2024, you will be covered at in-network rates through the end of your inpatient stay.

Q: What if I have an upcoming procedure at St. Peter’s Health Partners on/after July 1, 2024?

A: We understand some patients may have appointments scheduled on or after July 1, 2024. If this is the case, you should call UnitedHealthcare at the number on the back of your health insurance care to determine whether they will cover your procedure through Continuity of Care provisions.

Please contact your provider’s office immediately for support in filling out the continuity of care form from UnitedHealthcare, or re-scheduling your procedure.

Q: What if I have a medical emergency on/after July 1, 2024?

A: You should always seek emergency care if you believe you are experiencing a medical emergency at the closest location to you. Regardless of our status with UnitedHealthcare, your care will be considered in-network when receiving emergency care.

Q: If my care is impacted, what should I do?

Never delay care. Go to the closest emergency department. Emergency care is always in-network.
Apply for continuity of care immediately. Some patients, including those who are pregnant or undergoing active treatment for a chronic condition, may qualify for extended in-network access through UnitedHealthcare's continuity of care program. Unfortunately, St. Peter’s Health Partners cannot qualify you under UnitedHealthcare's process. If you have a Medicaid or Essential Plan health plan you need to call your provider’s office to initiate the process.
UnitedHealthcare requires you to call the number on the back of your insurance card to see if you qualify. However, patients with Medicaid or Essential Plan health plans need to call their provider’s office to initiate the process.
UnitedHealthcare will provide additional instruction on how to enroll based on your health plan.
If UnitedHealthcare denies your Continuity of Care request and you are currently undergoing treatment at St. Peter’s Health Partners and are enrolled in a Medicare Advantage benefit plan, you can file a complaint with the Centers for Medicare and Medicaid Services by calling 800-985-3059.
If UnitedHealthcare denies your Continuity of Care request and you have insurance through your employer, contact your HR or benefits manager.
If UnitedHealthcare approves your Continuity of Care request, it must permit continued in-network access to your current health care provider for a certain period.

Your provider’s office can support in filling out the continuity of care form from UnitedHealthcare.

Call the number on the back of your insurance card and urge UnitedHealthcare to keep your in-network access to St. Peter's Health Partners and its doctors.
If you receive insurance through your employer, ask about other health plans that include St. Peter's Health Partners. Your employer may be able to provide you with secondary health plan coverage that includes access to your trusted caregivers.
If you have Medicare Advantage or bought a UnitedHealthcare plan from the ACA marketplace (also known as the Health Insurance Exchange), contact your health insurance agent/broker for options to switch plans. We work with many other health plans that will give you in-network access to St. Peter's Health Partners.
If you have UnitedHealthcare Medicaid or Essential Plan health plan, you may be able to choose other health care coverage that allows you to access St. Peter's Health Partners. Visit https://www.health.ny.gov/health_care/medicaid/members/ to see if you can change your plan. Additionally, patients enrolled in a Medicaid plan can call the state help line at 800-541-2831.
Dually-enrolled - Call 1-800-MEDICARE. Dually enrolled patients in a Medicare/Medicaid plan may also take action. Call 1-800-633-4227 to see if you are eligible to make a change in your plan.

Q: What if I have more questions?

A: Call us at 518-535-0400 to speak with someone directly or visit this page.

What You Can Do

Never delay care. You will always have in-network access to our emergency department. Regardless of our network status with UnitedHealthcare, you should always visit the closest emergency department if you experience a medical emergency.
Apply for continuity of care immediately. Some patients, including those who are pregnant or undergoing active treatment for a chronic condition, may qualify for extended in-network access through UnitedHealthcare's continuity of care program. Unfortunately, St. Peter’s Health Partners cannot qualify you under UnitedHealthcare's process.
- UnitedHealthcare requires you to call the number on the back of your insurance card to see if you qualify.
- UnitedHealthcare will provide additional instruction on how to enroll based on your health plan.
- If UnitedHealthcare denies your Continuity of Care request and you are currently undergoing treatment at St. Peter’s Health Partners and are enrolled in a Medicare Advantage benefit plan, you can file a complaint with the Center for Medicare and Medicaid Services by calling 800-985-3059.
- If UnitedHealthcare denies your Continuity of Care request and you have insurance through your employer, contact your HR or benefits manager.
- If UnitedHealthcare approves your Continuity of Care request, it must permit continued in-network access to your current health care provider for a certain period of time.
Call the number on the back of your insurance card and urge UnitedHealthcare to keep your in-network access to St. Peter's Health Partners and its doctors.
If you receive insurance through your employer, ask about other health plans that include St. Peter's Health Partners. Your employer may be able to provide you with secondary health plan coverage that includes access to your trusted caregivers.
If you have Medicare Advantage or bought a UnitedHealthcare plan from the ACA marketplace (also known as the Health Insurance Exchange), contact your health insurance agent/broker for options to switch plans. We work with many other health plans that will give you in-network access to St. Peter's Health Partners.
If you have UnitedHealthcare Medicaid or Essential Plan health plan, you may be able to choose other health care coverage that allows you to access St. Peter's Health Partners. Visit https://www.health.ny.gov/health_care/medicaid/members/ to see if you can change your plan. Additionally, patients enrolled in a Medicaid plan can call the state help line at 800-541-2831.
Dually-enrolled - Call 1-800-MEDICARE. Dually enrolled patients in a Medicare/Medicaid plan may also take action. Call 1-800-633-4227 to see if you are eligible to make a change in your plan.

You can find a complete list of plans St. Peter’s Health Partners is in-network with for the full 2024-2025 benefit year at sphp.com/for-patients/billing-information/accepted-insurance.

We believe Health Comes First 

We know how important it is for you and your family to receive care from the trusted doctors, nurses and staff at St. Peter’s Health Partners. As a not-for-profit, local care provider, we work tirelessly to care for our patients and communities. We also continue to reduce costs and implement efficiencies to ensure we can continue providing top-quality care to our patients. We are working hard to reach a fair agreement with UnitedHealthcare, but we need them to do the same—and put patients first. Our request to UnitedHealthcare is simple: to be paid fairly and in line with other providers in our market. We cannot maintain access to the care and services patients depend on and need without fair agreements from commercial health insurers who reimburse us for the cost of care.

Find out how St. Peter’s Health Partners invests in our community. Health insurers, including UnitedHealthcare, are posting record-breaking profits for shareholders, while we are expected to cover gaps. UnitedHealth Group, the parent company of UnitedHealthcare, made more than $22 billion in 2023 alone. St. Peter’s Health Partners cannot continue to do more with less. To learn more, visit Health Comes First.