Our commitment to you and your family’s health care needs
We know your relationship with your doctors is deeply personal and important, and we understand this is not easy. We want to keep SSM Health in our network and are fully committed to continued good-faith negotiation. However, we need SSM Health to provide a proposal that is affordable for you as well as all of the people and employers we serve.
As we continue our discussions, we also want to provide you with the following information regarding next steps should SSM Health leave our network, effective Jan. 1, 2026.
Should we not reach an agreement, our number one priority is providing you continued, uninterrupted access to the care you need
If you or a loved one is in active or ongoing treatment for a serious or complex condition with an SSM Health provider at the time they leave our network, you may qualify for continuity of care. Continuity of care provides continued in-network benefits for a period of time after a provider leaves our network.
Please call the number on your health plan ID card if you have questions about continuity of care, including whether you or a family member might be eligible. Our dedicated team of advocates is ready to support you and help answer any questions you might have.
You continue to have access to a large network of hospitals and physicians, should SSM Health choose to leave our network
We are fortunate to have a broad network of hospitals and physicians in the St. Louis area as well as throughout Missouri and Illinois that are readily able to provide top-quality care.
If you have questions or need assistance finding alternative providers in your area, please call the number on your health plan ID card. You can also use the provider directory at myuhc.com to search for alternative hospitals and physicians in your area.
Committed to keeping you informed
We understand this is difficult, and we promise to keep you informed every step of the way as we work hard to reach an agreement that is affordable while providing continued, uninterrupted network access to SSM Health.
We have prepared the following FAQs to help answer any questions you or your family might have regarding our negotiation as well as important information regarding next steps, should SSM Health leave our network.
Frequently asked questions
Our current contract with SSM Health remains in effect through Dec. 31, 2025. If we are unable to reach an agreement, SSM Health’s hospitals, facilities and its physicians will be out of network for the following plans, effective Jan. 1, 2026:
- UnitedHealthcare employer-sponsored commercial plans, including UMR and Surest
- UnitedHealthcare Community Plan (Medicaid)
People enrolled in Medicare Advantage plans, including Dual Special Needs Plan (DSNP), Group Retiree, and Medicare Supplement plans will continue to have network access to SSM Health on and after Jan. 1, 2026.
In the event we are unable to reach an agreement, SSM Health will be out of network for the following plans, effective Jan. 1, 2026:
- UnitedHealthcare employer-sponsored commercial plans, including UMR and Surest
- UnitedHealthcare Community Plan (Medicaid)
People enrolled in Medicare Advantage plans, including Dual Special Needs Plan (DSNP), Group Retiree and Medicare Supplement plans, will continue to have network access to SSM Health on and after Jan. 1, 2026.
Yes. People enrolled in all Medicare Advantage plans, including Dual Special Needs Plan (DSNP), Group Retiree and Medicare Supplement plans, will continue to have network access to SSM Health on and after Jan. 1, 2026. These plans are not impacted by our negotiation.
Yes. We are committed to utilizing the remaining time on our contract to reach an agreement that is affordable for people and employers while maintaining continued network access to SSM Health.
SSM Health issued a notice to end our contract and is seeking an approximate 14% price hike over two years for our commercial plans that is not affordable for the people and employers we serve. SSM Health’s proposal would drive up premiums and out-of-pocket expenses for our members as well as the cost of doing business for local companies.
We are proposing meaningful rate increases for our commercial plans that would continue to reimburse SSM Health at market-competitive rates.
SSM Health is also significantly more expensive than the average cost of all other providers in our Medicaid network in Missouri. SSM Health is reimbursed as much as 40% more than some providers in our Medicaid network in the state, depending on the provider type and location. Allowing our Medicaid contract to remain as is would result in approximately $15 million in additional health care costs over the next year on top of their already-high costs.
The states where we operate our Medicaid plans have asked us to support their efforts to provide quality health care coverage to their residents while also helping to contain rapidly rising health care costs. We take this responsibility seriously and are committed to being a good steward of taxpayer dollars.
SSM Health’s high costs are no longer sustainable. We are asking the health system to work toward a solution that is affordable while reimbursing the health system at market-competitive rates.
Continuity of care allows people who are in active or ongoing treatment for a serious or complex condition at the time a provider went out of network to continue receiving in-network benefits with their provider for 90 days after they leave our network.
Some examples of conditions eligible for continuity of care include but are not limited to:
- Patients who are pregnant
- People currently in active cancer treatment
UnitedHealthcare members should call the number on their health plan ID card if they need assistance or have questions regarding whether they are eligible and how to apply.
We know the care SSM Health provides is not only important but also personal to our members and their families. That’s why we’re working hard to reach an agreement that would provide continued, long-term network access to the health system.
However, in the event SSM Health leaves our network, we want you to know you continue to have access to a broad network of hospitals and physicians in the St. Louis area as well as throughout Missouri and Illinois readily able to provide high-quality care to our members. Some of the hospitals that continue to remain in our network in the area include but are not limited to:
- Alton Memorial Hospital
- Barnes-Jewish Hospital
- Barnes-Jewish St. Peter’s Hospital
- Barnes-Jewish West County Hospital
- Boone Hospital Center
- Capital Region Medical Center
- Christian Hospital NE NW
- Memorial Hospital in Belleville
- Mercy Hospital Lincoln
- Mercy Hospital South
- Mercy Hospital St. Louis
- Mercy Hospital Washington
- Missouri Baptist Medical Center
- Parkland Health Center
- Progress West Hospital
- Ranken Jordan Pediatric Hospital
- Shriner’s Hospital for Children - St. Louis
- St. Elizabeth Hospital
- St. Louis Children’s Hospital
- St. Luke’s Hospital
- Touchette Regional Hospital
- University Hospital & Clinics (MU Health Care)
If you or a family member has questions or needs assistance finding alternative providers in your area, please call the number on your health plan ID card. You can also use the provider directory at myuhc.com to search for alternative hospitals and physicians in your area.
UnitedHealthcare members should 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 the hospital participates in our network.