Important Information for Patients with UnitedHealthcare Plans
Rutherford Regional Health System is committed to providing comprehensive, quality healthcare to our communities, and we believe that our patients and community members deserve access to affordable, quality care close to home.
We have been working to establish a new and fair agreement with UnitedHealthcare since last year and negotiating in good faith over the past several months to ensure our hospital and providers can continue providing high quality care and cost-effective services for UnitedHealthcare’s beneficiaries.
We are disappointed UnitedHealthcare has been unwilling to acknowledge our rising costs and pay fair rates for our services, despite continuing to raise the rates they charge their customers.
Since no significant process has been made, our hospital and its affiliated providers and practices will no longer be in network with UnitedHealthcare once the current contracts end. This includes:
- UnitedHealthcare employer-sponsored commercial plans, including UMR, starting May 1, 2025
- UnitedHealthcare Medicare Advantage plans starting June 1, 2025
- UnitedHealthcare Individual Exchange plans starting November 1, 2025
We are deeply concerned about the impact and disruption UnitedHealthcare’s actions will have on patients, providers and employers in our area and continue to work towards a solution that allows everyone to have easy and affordable access to the healthcare provider of their choice.
We appreciate that our patients and community members may have additional questions about this matter and have developed Frequently Asked Questions below.
If you are a UnitedHealthcare beneficiary and have additional questions about your plan or coverage, please call the number on the back of your insurance card.
Frequently Asked Questions
- What is happening?
We are in the process of negotiating with UnitedHealthcare to develop new and fair agreements that allow our hospital and providers to continue providing high quality care and cost-effective services for UnitedHealthcare’s beneficiaries. Unfortunately, no significant process has been made as UnitedHealthcare has been unwilling to pay its fair share for our services.
When the current contract ends, our hospital and its affiliated providers and practices will no longer be in network for:
- UnitedHealthcare employer-sponsored commercial plans, including UMR, starting May 1, 2025
- UnitedHealthcare Medicare Advantage plans starting June 1, 2025
- UnitedHealthcare Individual Exchange plans starting November 1, 2025
- Why is this happening?
UnitedHealthcare has been unwilling to acknowledge the rising costs for delivering care and refuses to pay fair rates for our services, despite raising the rates they charge their customers.
- I have a UnitedHealthcare commercial plan. How does this impact me?
Nothing changes at this time. We continue to negotiate in good faith to develop a new and fair agreement that preserves your access to our hospital, its services and providers.
If a new agreement is not reached and the current contract expires on April 30, you may encourage your employer to consider an alternative plan that is in network with our hospital and clinics.
If you have an appointment or procedure scheduled on or after May 1, please contact us to see if it can be rescheduled before the termination date.
If you are pregnant, receiving treatment for a special condition or have a procedure scheduled after April 30, you may qualify for Continuity of Care. Call the number on the back of your UnitedHealthcare insurance card to speak to a representative.
To understand your specific plan benefits, contact UnitedHealthcare by calling the number on your insurance card.
- I have a UnitedHealthcare Medicare Advantage plan. How does this impact me?
Nothing changes at this time. We continue to negotiate in good faith to develop a new and fair agreement that preserves your access to our hospital, its services and providers.
If a new agreement is not reached and the current contract expires on May 31, you may want to choose an alternative Medicare Advantage plan that is in network with our hospital and clinics. These include:
- Aetna (HMO, PPO and SNP plans)
- Blue Cross Blue Shield of North Carolina (HMO and PPO plans)
- Cigna Healthcare (HMO, PPO and SNP plans)
- Devoted Health (HMO and PPO plans)
- Humana (HMO, PPO SNP plans)
- Wellcare (HMO, PPO SNP plans)
If you have an appointment or procedure scheduled on or after June 1, please contact us to see if it can be rescheduled before the termination date.
If you are receiving treatment for a special condition or have a procedure scheduled after May 31, you may qualify for Continuity of Care. Call the number on the back of your UnitedHealthcare insurance card to speak to a representative.
To understand your specific plan benefits, contact UnitedHealthcare by calling the number on your insurance card.
- I am a UnitedHealthcare beneficiary and wish to continue receiving in-network access to Rutherford Regional Health System's services and providers. What should I do?
You may want to consider the following:
- Call UnitedHealthcare. Using the number on the back of your insurance card, call and let UnitedHealthcare know how important it is for you to have continued in-network access to your local hospital.
- If you have a commercial plan, speak with your HR or benefits manager at work. Ask them about alternative or secondary coverage options that will ensure in-network access to your local hospital and its providers.
- If you have a Medicare Advantage plan, choose an alternative plan that is in-network with our hospital and clinics.
- What plans are in-network with Rutherford Regional Health System?
The following Medicare Advantage plans are in network with our hospital and providers:
- Aetna (HMO, PPO and SNP plans)
- Blue Cross Blue Shield of North Carolina (HMO and PPO plans)
- Cigna Healthcare (HMO, PPO and SNP plans)
- Devoted Health (HMO and PPO plans)
- Humana (HMO, PPO SNP plans)
- Wellcare (HMO, PPO SNP plans)