Delaware warns parents in Nemours v. United Healthcare dispute

Time is running out for United Healthcare and the Nemours Foundation to reach a deal on coverage for visits with pediatricians affiliated with A.I. duPont Children’s Hospital.

The current contract between Nemours and United Healthcare is scheduled to expire on April 1, and the two sides apparently have made little progress to reach a new deal. More than 30,000 children are covered by United Healthcare through Medicaid and the Children’s Health Insurance Program. The disagreement centers on the financial terms of a renewed contract.

While state leaders are hopeful a deal can be worked out, Lt. Gov. Matt Denn is warning parents who are covered by United to prepare in case a deal can’t be reached by the deadline.

“Because neither United Healthcare nor Nemours appears to be making serious efforts to resolve their differences – despite the best efforts of the state – it is also important that parents make plans to ensure that their children receive appropriate medical care after April 1,” said Denn. He explained that there is no grace period or extension of coverage if a deal is not made.

“Unless you take active steps in advance, services provided by Nemours will not be covered,” he said.

Denn said that parents of children who receive Medicaid or CHIP benefits administered by United Healthcare should call the state’s Medicaid Health Benefit Manager (1-800-996-9969) to switch their care manager. This must be done by March 15. 

Parents who receive health insurance benefits administered by United Healthcare through a private employer can talk to their company’s human resources or personnel department. 

Despite the apparent impasse, Denn is hopeful a deal can be reached. Denn said that he is willing to work with both parties, along with the Department of Health and Social Services, to get the issue resolved.

“It is in the best interests of both parties and of the children they serve to resolve this issue quickly so that the care for these children is not interrupted or terminated,” he said.