Home Content CategoryBoca Viewpoint Get the 411 on UHC at Boca Regional Before You Dial 911
Out of Network

Get the 411 on UHC at Boca Regional Before You Dial 911

by Joe Panella
UPDATE July 12 2019 10am: When calling the hospital, you can get the status by pressing 1. The message is still the same and can be heard here.

This is a follow-up to my previous article about the irony of Boca Raton Regional Hospital’s (BRRH) failure to renew its contract with United Healthcare (UHC). UHC is the nation’s largest health insurance carrier but as reported by WPTV, they may not be offering the same level of payment to hospitals as other carriers. For those who don’t know, Boca Regional Hospital is now ‘out-of-network’ for thousands of Boca residents with certain United Healthcare plans.  

TAKE NOTE Medical charges from being admitted into an out of network hospital could be financially devastating. Some UHC subscribers tell BocaFirst their plan has NO COVERAGE for out of network hospital care. But, the lack of a coverage at BRRH affects more than a hospital stay. Make sure you know your situation. At the end of this article are things you can do about it. Of the three local doctors I visit regularly, here is what I found out:

In-Office Care

In-office visits are still covered. It’s business as usual. The physicians’ agreement with UHC still stands.  Outpatient services will no longer be referred to Boca Regional.  Instead, UHC patients will be referred to non-BRRH facilities who are in-network with UHC.  So far, so good, although Boca Regional will suffer a loss of business for outpatient services.

In-Hospital Care

Not only is using a new hospital on the table, in an emergency, we’ll need new doctors on short notice. 

The most significant impact of the impasse is with in-hospital care, should we need to be admitted for a hospital stay. This, of course, is where the largest expenses are generated in our healthcare system – the kind of expenses that can bankrupt a family. Now that BRRH is no longer associated with UHC we will, by financial necessity, be required to be admitted to a non-BRRH facility somewhere outside of Boca. 

New Doctors or New Health Insurance?

Not only is using a new hospital on the table, we will need to find physicians with admitting privileges at the new hospital. Not so good, eh?  In an emergency, we’ll need new doctors on short notice.  BRRH and our current doctors will lose the big bucks associated with a hospital stay. UHC will lose my family (and, I assume others) as we switch to different healthcare insurance plans.  Everybody loses.

I’m stuck with my current plan

I called my employer, who sponsors a few different plans, and learned that this situation does not qualify as a “life event” that permits switching health insurance providers.  This means my employer and I will continue to pay premiums to UHC for six more months despite the BRRH – UHC goat rodeo.

Finally, I made my daily call to Boca Regional’s business office at 561-955-7100 option 1. Still no deal with UHC. Listen here

What can you do?

  1. Some doctors only have privileges at BRRH. Call each of your doctors. Know which ones can’t treat you elsewhere.  It’s important to know this now, so you can be prepared in case you need to be admitted for a hospital stay.
  2. Call United Healthcare. Two of our doctors encouraged me to call UHC and let them know how we feel about this. They said “many voices make a big difference”. Ask UHC to document your displeasure. The phone number you need is on the back of your insurance card.
  3. Maybe best of all, call your employer’s benefits team. They are the most interested in how satisfied you are with the health care plans they offer. They need to know Hospitals are rejecting their insurance carrier. My employer Benefits Administrator took the matter seriously and assured me they would be in touch with UHC.  Your employer’s voice is much bigger than yours; more and bigger voices might break the impasse!
  4. Contact Baptist Health of South Florida with the email and phone numbers here. They inherited this situation from the outgoing CEO and Trustees but are the ones that can fix it.

Stay tuned, since things could (hopefully) change!


Answers to Questions by Cindy Krischer Goodman

Watch the WPTV Report by Arthur Mondale on the impasse between Boca Regional and United Healthcare.

Related Posts