Updated August 1, 2025
We are engaged in active discussions with Prime Healthcare in Illinois with the goal of reaching an agreement that is affordable while ensuring continued network access to the health system
Our current contract with Prime Healthcare in Illinois remains in effect through Sept. 30, 2025 for people enrolled in our commercial, Medicare Advantage and Individual Family Plans (IFP).
In the event we are unable to reach an agreement, Prime’s hospitals, facilities and physicians in Illinois would be out of network for the following benefit plans, effective Oct. 1, 2025:
- UnitedHealthcare employer sponsored commercial plans
- UnitedHealthcare Medicare Advantage plans, including Group Retiree and Dual Special Needs Plans (DSNP)
- IFP
Our negotiation with Prime Healthcare impacts the following Illinois hospitals:
- Holy Family Medical Center – Des Plaines
- Mercy Medical Center – Aurora
- Saint Joseph Medical Center – Joliet
- Saint Joseph Hospital – Elgin
- Saint Francis Hospital – Evanston
- Resurrection Medical Center – Chicago
- Saint Mary of Nazareth Hospital – Chicago
- St. Mary’s Hospital – Kankakee
We continue to compromise and are proposing meaningful rate increases that allow Prime Healthcare in Illinois to continue to be reimbursed at market-competitive rates while balancing the affordability needs of consumers and employers.
Prime Healthcare in Illinois is seeking a 40% price hike for their hospitals, which would make them significantly higher cost compared to the market average in Illinois. Prime’s proposal is not affordable or realistic for the people and employers we serve.
Prime’s proposal would significantly drive-up health care costs by nearly $20 million, increasing premiums and out-of-pocket costs for the people we serve as well as the cost of doing business for employers.
Approximately $13 million of Prime Healthcare’s proposed price hikes for our commercial plans would be paid out of the operating budgets of self-insured employers.
Prime’s rate demands would directly drive-up health care costs for our self-insured customers given that these employers pay the cost of their employees’ medical bills themselves rather than relying on UnitedHealthcare to pay those claims. The majority of our commercial members in Illinois are enrolled in self-insured plans.
As the prices for health care continue to rise, employers have less money available to help grow their business through things like investments in new technologies or increase salaries for employees.
In the event Prime Healthcare leaves our network in Illinois, people enrolled in our Group Retiree PPO plans may still receive care from a Prime Healthcare physician as an out-of-network provider, if they are a Medicare-approved provider that accepts the plan. Their share of the cost will be the same as if they were part of the network.
UnitedHealthcare Group Retiree members are encouraged to speak with their physician to confirm they’ll continue to see them, regardless of their network status.
For additional information about our Group Retiree plan as well as information on how to find a provider in their area, UnitedHealthcare members should go to retiree.uhc.com.
If one of our members is in the middle of treatment with a Prime Healthcare physician in Illinois and they go out of network, they may qualify for continuity of care.
Continuity of care provides continued in-network benefits for a specified period of time after a hospital or physician leaves our network. A few examples of patients who may qualify include:
- Women who are pregnant.
- Patients with newly diagnosed or relapsed cancer, or those currently in active cancer treatment.
Members who have questions about continuity of care or alternative hospitals in their area should call the number on their health plan ID card. Members can also use the provider directory on our member website to search for alternative hospitals and doctors.
We remain committed to continued good-faith negotiation with the goal of reaching an agreement that’s sustainable for consumers and local employers.
We know the relationship people have with their health care providers is not only important; it’s personal. That is why our top priority is to renew our relationship with Prime Healthcare in Illinois so the people we serve have continued access to the hospitals they know and trust for their health care needs. We are committed to meeting with the health system as often as it takes to reach a new agreement.