Houston Methodist says UnitedHealth members can still use 'out-of-network benefits'

Houston Methodist is advertising to patients with UnitedHealthcare coverage that even though the insurer ended its contract with the hospital system, they can still access care with their "out-of-network benefits," according to the Houston Chronicle.

Consumer advocates acknowledge that the ads are accurate, but questioned if the ads provided enough clarity on just how much higher out-of-network costs are — in some cases, two to three times more than in-network charges.

As of Jan. 1, Houston Methodist's seven hospitals and outpatient clinics are no longer considered in-network facilities for UnitedHealthcare commercial and Medicare Advantage policyholders, affecting about 100,000 policyholders. UnitedHealthcare and Houston Methodist were unable to agree on reimbursement rates before a Dec. 31 contract deadline.

In a statement to the Houston Chronicle, a spokesperson for Houston Methodist said: "If a patient is treated out-of-network, their out-of-pocket costs will be more. But we will be clear about those costs up front and work with individuals if necessary on the out-of-pocket amounts." The spokesperson added the ads aim to fill an information gap the health system thinks UnitedHealthcare has left in the wake of the split, arguing patients haven't been fully educated on their options.

UnitedHealthcare criticized this characterization, calling it "meritless" because all information about network status can be found by calling the insurer or going to its website. UnitedHealthcare said Houston Methodist's ads encourage their members to continue using the facilities but fail "to mention that doing so could result in significantly higher out-of-pocket costs."

Read the full report here.

More articles on healthcare finance:
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St. Louis hospital delays payroll after filing for bankruptcy
Verity to close Los Angeles hospital

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