Providence Health in Oregon and Washington

Important information regarding our relationship with Providence Health for people enrolled in our Medicare Advantage plans in Oregon and Washington

Providence’s hospitals and providers in Oregon and Washington will no longer be in UnitedHealthcare’s network for people enrolled in the following plans, effective Jan. 1, 2027:

  • UnitedHealthcare Individual Medicare Advantage plans
  • Group Retiree plans
  • Chronic Special Needs Plans (C-SNP)

Our top priority is that people have uninterrupted access to the care they need. That is why we are notifying our members prior to the Medicare Annual Enrollment Period (AEP) to inform them Providence will be out of network so they can make an informed decision regarding their health care needs.

Letters are being mailed to impacted members enrolled in UnitedHealthcare Individual Medicare Advantage, Group Retiree, and C-SNP plans to inform them of this change.

UnitedHealthcare members enrolled in the following plans are not impacted:

  • Employer-sponsored commercial plans in Oregon and Washington
  • Dual Special Needs Plans (D-SNP) in Washington
  • Medicare Supplement plans

We remain engaged in good-faith negotiation with Providence to renew our network relationship for D-SNP plans in Washington. Our goal is to reach an agreement prior to January 1, 2027, that is affordable for consumers and employers while providing continued, uninterrupted network access to the health system’s hospitals and providers for people enrolled in these plans.

As a reminder, we recently renewed our network relationship with Providence for employer-sponsored commercial plans in Oregon and Washington, ensuring long-term network access to the health system for people enrolled in these plans.

Continued access to care

Our priority is to provide our members with access to the care they need through a robust network of providers.

We understand network changes can be difficult. That is why we are notifying our members prior to the Medicare Annual Enrollment Period (AEP) to inform them Providence Health’s hospitals and providers will be out of network for members enrolled in UnitedHealthcare Individual Medicare Advantage plans, Group Retiree plans, and Chronic Special Needs Plans (C-SNP), effective Jan. 1, 2027.

UnitedHealthcare Medicare Advantage members will continue to have access to a broad network of hospitals and physicians across Oregon and Washington.

For support finding in-network physicians and hospitals, members can call the customer care number on their health plan ID card or visit their plan’s website:

UnitedHealthcare members who are in active or ongoing treatment for a serious or complex condition with a Providence provider are eligible to continue care throughout the course of their treatment at in-network costs.

Continuity of care allows people in the middle of treatment at the time a provider leaves our network to continue accessing care with their provider for a period of time.

Some examples of people who qualify and are eligible for continuity of care include but are not limited to:

  • People in active treatment for cancer
  • Individuals in ongoing treatment for transplant services

For information regarding how to apply and whether they might be eligible for continuity of care, members should call the number on their health plan ID card.

In the event of an emergency, UnitedHealthcare members should go to the nearest hospital and will be covered at the in-network benefit level, regardless of whether the hospital participates in our network.

Facts you should know

Our responsibility is to ensure members continue to have access to high-quality care while keeping coverage affordable and sustainable

We routinely evaluate our provider networks and negotiate contracts with health systems and physicians. These discussions are guided by our goal of delivering the greatest value to members by balancing access, quality and affordability.

As health care costs continue to rise, we must make decisions that help maintain the long-term viability of benefits and access.

Medicare Advantage plans across the country are faced with increasing medical costs, higher utilization and continued pressures on program funding.

As we balance access and affordability, every network decision at UnitedHealthcare is evaluated through the lens of what is best for our members.

We are committed to providing seniors access to high-quality care while protecting them from unnecessary cost increases and helping preserve the affordability of their coverage. 

Frequently asked questions

We have created the following FAQs to ensure you and your family have the information needed regarding next steps as well as details to help meet your health care needs.

No. Providence Health’s hospitals and providers in Oregon and Washington will no longer be in UnitedHealthcare’s network for people enrolled in the following plans, effective Jan. 1, 2027:

  • UnitedHealthcare Individual Medicare Advantage plans
  • Group Retiree plans
  • Chronic Special Needs Plans (C-SNP)

Our top priority is that people have uninterrupted access to the care they need. That is why we are notifying our members prior to the Medicare Annual Enrollment Period (AEP) to inform them Providence will be out of network so they can make an informed decision regarding their health care needs.

UnitedHealthcare members enrolled in the following plans are not impacted by this change:

  • Employer-sponsored commercial plans in Oregon and Washington
  • Dual Special Needs Plans (D-SNP) in Washington
  • Medicare Supplement plans

We remain engaged in good-faith negotiation with Providence to renew our network relationship for D-SNP plans in Washington. Our goal is to reach an agreement prior to January 1, 2027, that is affordable for consumers and employers while providing continued, uninterrupted network access to the health system’s hospitals and providers for people enrolled in these plans.

As a reminder, we recently renewed our network relationship with Providence for employer-sponsored commercial plans in Oregon and Washington, ensuring long-term network access to the health system for people enrolled in these plans.

Providence Health’s hospitals and providers in Oregon and Washington will no longer be in UnitedHealthcare’s network for members enrolled in the following plans, effective Jan. 1, 2027:

  • UnitedHealthcare Individual Medicare Advantage plans
  • Group Retiree plans
  • Chronic Special Needs Plans (C-SNP)

UnitedHealthcare members enrolled in the following plans are not impacted:

  • Employer-sponsored commercial plans in Oregon and Washington
  • Dual Special Needs Plans (D-SNP) in Washington
  • Medicare Supplement plans

We remain engaged in good-faith negotiation with Providence to renew our network relationship for D-SNP plans in Washington. Our goal is to reach an agreement prior to January 1, 2027, that is affordable for consumers and employers while providing continued, uninterrupted network access to the health system’s hospitals and providers for people enrolled in these plans.

As a reminder, we recently renewed our network relationship with Providence for employer-sponsored commercial plans in Oregon and Washington, ensuring long-term network access to the health system for people enrolled in these plans.

The following Providence hospitals are impacted by this change and will no longer be in UnitedHealthcare’s network for members enrolled in UnitedHealthcare Individual Medicare Advantage plans, Group Retiree plans, and Chronic Special Needs Plans (C-SNP), effective Jan. 1, 2027:

Oregon

  • Providence Hood River Memorial Hospital
  • Providence Medford Hospital & Medical Center
  • Providence Milwaukie Hospital
  • Providence Newberg Medical Center
  • Providence Portland Medical Center
  • Providence Seaside Hospital
  • Providence St Vincent Medical Center
  • Providence Willamette Falls Medical Center

Washington

  • Kadlec Regional Medical Center
  • Providence Centralia Hospital
  • Providence Holy Family Hospital
  • Providence Mt Carmel Hospital
  • Providence Regional Medical Center Everett
  • Providence Sacred Heart Medical Center
  • Providence St Joseph Hospital
  • Providence St Mary Medical Center
  • Providence St Peter Hospital
  • Swedish Edmonds
  • Swedish Health Services
  • Swedish Medical Center
  • Swedish Medical Center Cherry Hill
  • Swedish Medical Center Issaquah

No. UnitedHealthcare members enrolled in the following plans are not impacted by this change:

  • Employer-sponsored commercial plans in Oregon and Washington
  • Dual Special Needs Plans (D-SNP) in Washington
  • Medicare Supplement plans

We recently renewed our network relationship with Providence for employer-sponsored commercial plans in Oregon and Washington, ensuring long-term network access to the health system for people enrolled in these plans.

We remain engaged in good-faith negotiation with Providence to renew our network relationship for D-SNP plans in Washington.

Our goal is to reach an agreement prior to January 1, 2027, that is affordable for consumers and employers while providing continued, uninterrupted network access to the health system’s hospitals and providers for people enrolled in these plans.

No. This does not impact Medicare Supplement plans. People enrolled in a Medicare Supplement plan can continue to receive care at Providence on and after Jan. 1, 2027.

Our top priority is that you have uninterrupted access to the care you need. That is why we are notifying our members prior to the Medicare Annual Enrollment Period (AEP) to inform them Providence will be out of network, effective Jan. 1, 2027.

UnitedHealthcare members who are in active or ongoing treatment for a serious or complex condition with a Providence provider are eligible to continue care throughout the course of their treatment at in-network costs.

Continuity of care allows people in the middle of treatment at the time a provider leaves our network to continue accessing care with their provider for a period of time.

Some examples of people who qualify and are eligible for continuity of care include but are not limited to:

  • People in active treatment for cancer
  • Individuals in ongoing treatment for transplant services

For information regarding how to apply and whether they might be eligible for continuity of care, members should call the number on their health plan ID card.

In the event of an emergency, UnitedHealthcare members should go to the nearest hospital and will be covered at the in-network benefit level, regardless of whether the hospital participates in our network.

Our priority is to provide the people we serve access to the care they need through a robust network of hospitals and providers.

We understand that network changes can be difficult. That is why we are notifying our members prior to the Medicare Annual Enrollment Period (AEP) to inform them Providence Health hospitals and providers in Oregon and Washington will be out of network for members enrolled in Individual Medicare Advantage, Group Retiree, and C-SNP plans effective Jan. 1, 2027. 

The members we are privileged to serve will continue to have ample access to in-network care from a broad network of hospitals and physicians across Oregon and Washington, including but not limited to, the following:

Oregon

  • Oregon Health & Science University
  • Williamette Valley Medical Center
  • Adventist Health Portland
  • Tuality Healthcare

Washington

  • Multicare Health System
  • Virginia Mason Franciscan Health
  • UW Medicine
  • EvergreenHealth Monroe
  • EvergreenHealth Kirkland

People enrolled in our Group Retiree plans may receive care from an out-of-network provider, if the provider is a Medicare participating provider which accepts the plan.

If people have a Group Retiree PPO plan, their share of the cost is typically the same as if the provider was part of the network.

Members enrolled in our Group Retiree plans are encouraged to speak with the provider to confirm they will provide care, regardless of their network status.

For support finding in-network hospitals, members can call the customer care number on their health plan ID card or visit their plan’s website: retiree.uhc.com

Members should always go to the nearest hospital in the event of an emergency. Their care will be covered at the in-network benefit level, regardless of whether a hospital participates in our network.