Delaware insurance provider, hospital network involved in contract dispute

A contract dispute between United Health Care Community Plan and Nemours Health Systems could create a shake up to Delaware’s Medicaid and Children’s Health Insurance Programs.

Through the programs, 33,000 children in Delaware are covered through the United Healthcare Community Plan which partners with Nemours for pediatric care.

However, if the health insurance company and the hospital cannot come to an agreement by April 1, parents will have to decide whether to look for a new doctor outside of the Nemours network or switch insurance providers.

According to the Department of Health and Social Services, if negotiations are unsuccessful, recipients of Medicaid and CHIP services can switch to the Delaware Physicians Network Insurance provider which also partners with Nemours. They can also choose to keep their United Healthcare insurance and find new pediatric services.

“We know this kind of change will cause concern for the families we serve,” DHSS Secretary Rita Landgraf said. “Our first hope is that Nemours and United Healthcare can resolve their differences and no transition will be needed. But if a change is necessary, we are prepared to help Delaware children and their families served by Medicaid and CHIP in every way we can.”

The Medicaid’s Health Benefits Manager is available to assistant families with questions or concerns at 1-800-996-9969.

“Our utmost priority is making sure that there is no disruption in services for Delaware children served by our Medicaid and CHIP programs,” added Steve Groff, director of DHSS’ Division of Medicaid and Medical Assistance. “No family should have to worry about continuity of care, especially when their child is sick, injured or managing a chronic illness.”