This is a developing story, check back for updates.
UF Health patients who use UnitedHealthcare could lose their coverage starting Sept. 1.
The two companies have been in contract negotiations for the past several months, and UF Health, which operates 12 hospitals and more than 140 primary care clinics across the state, said it is still waiting for United to respond with a “fair and sustainable proposal.”
This includes streamlining the billing process and reducing administrative requirements, UF Health said in a statement to The Alligator.
“Insurance companies like UnitedHealthcare are reporting billions of dollars in record profits, while health systems like UF Health are struggling to meet their mission of serving patients and communities while shouldering rising costs,” the statement said.
The University of Florida Health Department said that if the situation does not change by the end of August, thousands of patients across Florida will experience “unnecessary disruptions” to their access to ongoing care.
In a website announcement updated Aug. 28, United argued that UF Health is demanding a rate increase of more than 25% in the first year of the commercial agreement.
The insurers also allege that UF Health repeatedly “refused” to finalize the terms of agreements with Medicaid recipients amid negotiations over commercial rates.
“Given UF Health's continued demands for exorbitant fee increases that are neither acceptable nor affordable to the people we serve, we can only assume that UF Health intends to exit our network,” United said.
United, which provides coverage to 3.7 million Floridians at about 250 hospitals across the state, reported annual revenue of $371.6 billion in 2023, up 14.6% from the previous year.
Student Coverage
UF students who are insured by United through the university's Student Health Insurance Plan will be able to continue receiving care at all UF Health facilities without impact, regardless of the outcome, UF Health said.
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Students who have insurance through a parent can continue to receive care at the on-campus UF Student Health Center in Gainesville, but not at other UF Health facilities, the company said.
However, in a statement to The Alligator, United Airlines did not say whether students would be exempt from the loss of coverage.
Instead, a spokesperson said in an emailed statement that if no agreement is reached, all UF Health hospitals, facilities and physicians will be out of network for all private, Medicaid and Student Resource Plan users by September.
When the discrepancy was brought to UF Health's attention, the organization reiterated that students were not affected and suggested United may have omitted the exception from its statement because its contract with UF Health differs from its contract with UF Student Services, the latter of which pays a fee to insurance companies to coordinate students' health care.
About 5,000 to 7,000 students are currently enrolled in the United Student Resources plan, which students are required to purchase unless they can prove they already have comparable insurance, according to a UF public records request.
The cost of the United Student Resources Basic Annual Plan for University of Florida students is $3,135 for the 2024-2025 academic year, according to a policyholder application provided to the Alligator. The academic year plan is valid from Aug. 16, 2024, to Aug. 15, 2025.
Non-student insurance, including Medicare and Medicaid
Non-student patients who have insurance through their employer or are enrolled in a Medicaid plan will no longer be able to receive coverage at UF Health facilities in the state starting Sept. 1, according to United.
The only people losing their Medicare coverage are patients at UF Health St. John's, which became part of the UF Health system last year.
Of the 64,000 people age 65 or older living in St. Johns County, 96.7% are enrolled in Medicare, according to 2022 data from the U.S. Census Bureau.
The county's share of the elderly population and the share of those on Medicare are not that different from the state averages. Neither UF nor United would say why only St. Johns County patients would lose their Medicare coverage.
People with Medicare plans at other UF Health hospitals and health care facilities, including UF Health Gainesville, Jacksonville and The Villages Regional Hospital, can continue to receive care as usual.
UF Health psychiatric hospitals and UF Health Central Florida facilities will not be affected, and United said they will remain in the network regardless of the outcome of negotiations.
United said in a statement that it is proposing rates that ensure UF Health receives coverage on par with peer health systems and that health care remains affordable for consumers and businesses in North Florida.
“We urge the health care system to come to the table with a proposal that Florida families and local businesses can afford,” the statement said.
United argues on its website that UF Health's fee demands would increase health care costs for self-insured employees who pay for their own health care out of pocket.
Insurers claim that at 20 of these self-funded businesses, medical costs will rise by more than $200,000 a year, reducing funding given to employers to expand.
United said UF Health's proposal would also raise hospital fees for consumers. For example, under the health network's proposal, someone with 20% coinsurance could expect to pay an average of $1,000 more out of pocket than they currently do if they undergo a C-section at UF Health Jacksonville, the company said.
United Airlines has been battling health systems across the country over the past few months.
That includes North Carolina-based Duke Health, whose patients would lose their coverage at the end of October if the networks don't reach an agreement. HealthPartners, a Minnesota nonprofit provider, also will leave United's Medicare Advantage network starting next year.
In an online statement, United Airlines also answered frequently asked questions about the dispute with UF Health.
People undergoing treatment, such as pregnant people or newly diagnosed cancer patients, may be eligible for the Continuum of Care program even if UF Health and United don't reach an agreement, according to the website. Those patients have until Sept. 30 to apply.
Zoey Thomas can be reached at [email protected]. Follow @zoeythomas39 on X.
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Zoe Thomas
Zoe Thomas is a junior in media production and will be The Alligator's enterprise health reporter for the fall 2024 semester. She previously worked at the University and Metro desks. Her most prized assets are her espresso machine, Regal Unlimited movie tickets, and HOKA running shoes.
