Information Regarding UnitedHealthcare Medicare Advantage, Brown University Health Contract Negotiation
Brown University Health and UnitedHealthcare have publicly announced that, absent a breakthrough in contract negotiations, Brown University Health hospitals will no longer accept UnitedHealthcare Medicare Advantage plans as of July 1, 2025. In other words, unless Brown and UnitedHealthcare reach an agreement, Brown University Health hospitals will be “out of network” for individuals who are enrolled in UnitedHealthcare Medicare Advantage plans.
Since this information has been made public, the Attorney General’s Office has received a large number of inquiries from Rhode Islanders enrolled in UnitedHealthcare Medicare Advantage plans who are concerned about what this potential change means for them.
“Any sudden change in health insurance coverage can cause consumers to panic, and rightfully so,” said Attorney General Neronha. “My Office has recently received many inquiries from concerned Rhode Islanders about how this contract dispute will affect their coverage if a resolution is not reached between the parties. Today, we launched a new dedicated website that addresses questions about continuity of care, emergency and non-emergency coverage, and other important topics. Affordable, accessible health care is foundational to our quality of life, and we hope this resource equips Rhode Islanders with the information they need, should they need it.”
We prepared this Frequently Asked Questions document to provide some additional information to individuals worried about whether their care will be covered by their insurance plan. This information is based on publicly reported statements by the parties as of June 25, 2025 and publicly available Medicare resources. We will continue to monitor and will update this information if circumstances change.
Frequently Asked Questions
This contract dispute only affects UnitedHealthcare’s Medicare Advantage plans. People enrolled in other health insurance plans, including Original Medicare, Medicare Advantage plans offered by other insurance carriers, and UnitedHealthcare’s non-Medicare (commercial or Medicaid) offerings, will not be affected.
This contract dispute currently only affects Brown University Health hospitals in Rhode Island, not other physicians or providers within the Brown University Health system. The hospitals affected are: Rhode Island Hospital; Hasbro Children’s Hospital; Miriam Hospital; and Newport Hospital. Brown University Health physicians will remain in-network on or after July 1, 2025.
The contract is in effect through June 30, 2025, so if an agreement is not reached, Brown University Health hospitals will be out of network beginning July 1, 2025.
Yes. All plans must cover qualifying emergency services, even if those services are provided by an out-of-network hospital. Do not avoid seeking emergency care because of this change.
You will not owe more for qualifying emergency services provided at an out-of-network hospital. See 42 C.F.R. § 422.113(b)(1)(ii) (defining “emergency services”). You can review your plan documentation for a description of what is considered a medical emergency and what services will be considered emergency services.
While UnitedHealthcare Medicare Advantage enrollees can still seek and receive non-emergency care rendered by out-of-network hospitals, enrollees may be responsible for the full cost of services or face higher out-of-pocket expenses than for care rendered by in-network hospitals. In some cases, these costs can be substantial. See question #7 below for more information.
If you are a UnitedHealthcare Medicare Advantage enrollee and you are in the middle of receiving treatment at a Brown University Health hospital, you may be eligible for a “continuity of care” plan. Continuity of care (sometimes called “transitional care”) requirements may allow individuals who are undergoing a course of treatment to continue to see a provider (including a hospital) as in-network for a limited period of time after the provider leaves the network. Patients must generally request approval of a continuity of care plan from their insurer. Because approval can take time, it is best to start this process as soon as possible.
According to UnitedHealthcare, Medicare Advantage enrollees can apply for continuity of care at any time from now until July 30th. If you wish to request approval for a continuity of care plan, you should call the number on the back of your health plan ID card.
It depends on your plan and your particular medical needs. You may need to pay more for care at Brown University Health hospitals if a contract is not agreed to, but you may still have some coverage for care provided at these facilities. Patients should call UnitedHealthcare at 1-800-711-0646 to understand whether they will have to pay more for care at Brown University Health hospitals. The amount of coverage and any additional out-of-network costs will depend on each patient’s specific plan.
Your UnitedHealthcare Medicare Advantage plan may still offer some coverage for services at Brown University Health hospitals, even if no contract is reached. For example, Medicare Advantage plans are required to cover medically necessary services that are otherwise unavailable in-network at in-network cost sharing. See 42 C.F.R. § 422.112(a)(1)(iii). Additionally, under certain circumstances, Medicare Advantage plans are required under federal regulations to cover certain out-of-network services. See 42 C.F.R. § 422.100. However, the amount that you may be obligated to pay out-of-pocket may be higher than at in-network hospitals. To determine the extent of the coverage your UnitedHealthcare Medicare Advantage plan provides for out-of-network hospital services, refer to the “Evidence of Coverage” information provided by your plan and contact UnitedHealthcare at 1-800-711-0646. Coverage documentation can generally be located on your plan’s website.
Individuals can switch insurance during the annual Open Enrollment Period, which runs from October 15 to December 7, 2025. You can begin researching your coverage options now. Consumers with questions about changing their Medicare enrollment can contact 1-800-MEDICARE (1-800-633-4227) for help with your options. Individuals may also change their coverage after experiencing a qualifying event. See 42 CFR § 422.62(b). Additional information can be found at: https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/joining-a-plan
According to UnitedHealthcare, the following hospitals in Rhode Island will remain “in-network” for UnitedHealthcare Medicare Advantage:
- Care New England Hospitals
- Fatima Hospital
- Kent Hospital
- Landmark Medical Center
- Roger Williams Medical Center
- South County Hospital
- Westerly Hospital
- Women and Infants Hospital
There are additional resources available for patients who have questions or concerns. Both UnitedHealthcare and Brown University Health have established dedicated websites that contain responses to frequently asked questions. These can be found here:
https://www.uhc.com/brown
https://www.uhc.com/brown/faqs
https://www.brownhealth.org/unitedhealthcare-information
Rhode Islanders with specific questions about their coverage with UnitedHealthcare should contact the insurer directly at 1-800-711-0646.
The Rhode Island Parent Information Network (RIPIN) also offers free support to any Rhode Islander who needs help accessing health care or health insurance. Call 401-270-0101, or email callcenter@ripin.org. The RIPIN call center is available Monday through Friday, 8:00 a.m. to 5:00 p.m. EST.
The Rhode Island Office of the Attorney General will continue to monitor for future developments on this issue. If you are having trouble enforcing your rights under your plan or understanding your options, we can be reached at 401-274-4400 ext. 2514 or at healthcare@riag.ri.gov.