Important Update: Effective April 26, LVHN Out of Network for UnitedHealthcare Members
April 17, 2026
After more than two years of negotiations, Lehigh Valley Health Network (LVHN), now part of Jefferson Health, will be out of network with UnitedHealthcare for commercial plans effective April 26, 2026. This outcome was not our choice and does not reflect our commitment to providing accessible, high‑quality care for the communities we serve.
Throughout negotiations, Jefferson-LVHN made repeated good‑faith efforts to reach an agreement that reflects prior contractual expectations and the real costs of delivering care in the Lehigh Valley. UnitedHealthcare has declined to do so, creating uncertainty for patients and families. LVHN remains in network with nearly all other major insurers in the region and is prepared to resume discussions with UnitedHealthcare at any time to reach a fair and sustainable agreement that keeps patients connected to their care.
Patients may still have options including emergency coverage, Continuity of Care for active treatment, out-of-network benefits, or transferring care to an in-network provider such as Jefferson Health.
Important Notice for VA Members
Veterans covered through the UnitedHealthcare VA Community Care Network (VA CCN) may continue receiving care with their LVHN providers without interruption. This includes continued access even if the LVHN commercial contract with UnitedHealthcare ends on April 26, 2026. Veterans are not impacted by the commercial contract status and can continue to receive the care they need.
The ongoing contract dispute between UnitedHealthcare and Lehigh Valley Health Network, now part of Jefferson Health, is not an isolated disagreement. It is a symptom of a deeper problem — one that threatens access to care in communities that rely on...
You may have the option to continue your care at LVHN on an out-of-network basis; however, you may now be responsible for a higher percentage of the costs (if your plan offers out-of-network benefits) or for the full cost of care (paying out of pocket).
If you have a PPO plan with United, you have out-of-network benefits and can continue to see your doctor(s) at LVHN, but your cost sharing (copays, coinsurance, deductible) and out-of-pocket maximum will all be higher. This means that you will pay more out of pocket for physician visits and other services. You will need to contact United to understand how much higher your costs will be.
If you have an HMO plan with United, you will not have out-of-network benefits. You may elect to continue seeing your doctor(s) at LVHN, but you will now be responsible for the full cost of services.
If you have an HMO-POS (point of service) plan with United, you will have some limited out-of-network coverage. The benefits may be capped at a certain amount or may only be available for certain services. You will need to contact United for more information on the benefits for your specific plan.
Yes, in the event of an emergency, United is required by federal law to cover ambulance services. Coverage and cost sharing may vary depending on the type of ambulance service and your specific plan. United can tell you what your cost sharing will be for out-of-network ambulance services.
Yes, United is required by federal law to cover all emergently needed services, which will include visits to LVHN emergency departments. United can tell you what your cost sharing will be for out-of-network emergency services.
United is required by federal law to cover inpatient stays from an emergency admission until you are stable enough to be transferred. At that time, United may – but is not obligated – to continue covering your stay at LVHN. LVHN will request prior approval for payment from United in these situations. We will make every effort to avoid transferring United Medicare Advantage patients to sites of care, but the final decision regarding payment rests with United.
Urgent care visits may be covered. United is required under federal law to cover urgently needed services only when there is no in-network alternative available. If you need to be seen urgently, and your travel time to an LVHN ExpressCARE or JeffExpress Urgent Care is roughly the same as another urgent care facility that is in network, a visit to an LVHN ExpressCARE or JeffExpress Urgent Care might not be covered. United can provide more information regarding coverage in these circumstances, including what type of visit qualifies as urgently needed, and in-network alternatives.
You will not need any preapproval for emergency services. If you were admitted from the emergency room and have been stabilized, LVHN will request prior approval from United to avoid unnecessary transfers.
If you have a PPO or HMO-POS plan, you may need preapproval for certain services, including elective procedures. You should not need to obtain prior approval or a referral for office visits (including primary care and specialist visits), but you should confirm this with United. These visits may or may not be covered, depending on your plan.
If you have an HMO plan, you will not have out-of-network benefits and you will be responsible for the full cost of services, so United will not grant prior approval.
Medicare Coordination of Benefits rules will apply, and United may still pay. Contact United for more information.
You may be able to continue receiving care under a rule called “continuity of care” (CoC). Under CoC rules, United is required to continue covering ongoing, active treatments at in-network cost-sharing levels for up to 90 days, or in some cases longer, when you have a serious or complex medical condition(s). These conditions include, but are not limited to, pregnancy and active cancer treatment. Under CoC, United is only required to pay for treatment related to your specific condition(s) and not for unrelated care (such as routine exams and elective procedures). The length of any approved CoC period depends on your plan and circumstances and is generally measured from when UnitedHealthcare notifies you of the network change. CoC eligibility is not automatic and requires approval from UnitedHealth. Call the number on your health plan ID card for assistance with this application.
No. LVHN cannot determine eligibility for CoC or guarantee coverage. UnitedHealthcare makes all coverage determinations. LVHN can assist with providing medical records or clinical information if United requests it.
You may still contact UnitedHealthcare to ask whether your situation can be reviewed. Approval is not guaranteed, but United can explain whether a request may still be considered based on your circumstances.
Yes, you will be able to change your plan for any reason until March 31st, 2026, after which you will need a qualifying reason to change your insurance. For more information, contact United, call 1-800-MEDICARE, or check with your Medicare insurance agent, broker, or advisor.
Yes. Veterans who receive care through the UnitedHealthcare VA Community Care Network (VA CCN) may continue seeing their LVHN providers.
Even if the LVHN commercial agreement with United Healthcare terminates on April 26, 2026, Veterans covered under the VA CCN will not be impacted and may continue receiving care at LVHN facilities
Commercial FAQs
If Lehigh Valley Health Network’s (LVHN’s) commercial contract with UnitedHealthcare ends on April 26, 2026, LVHN hospitals and clinicians will be considered out of network for most UnitedHealthcare commercial plans as of that date. You may still receive care at LVHN, but coverage and costs for which you are responsible (“Costs”) will depend on your specific plan.
These FAQs apply to patients covered under UnitedHealthcare commercial (employer‑sponsored or individual) plans. Veterans covered through the UnitedHealthcare VA Community Care Network (VA CCN) are not affected and may continue receiving care at LVHN as usual. LVHN’s Medicare Advantage contract with UnitedHealthcare ended on January 26, 2026.
Yes. You may continue to receive care at LVHN. However, LVHN will be an out‑of‑network provider, and your Costs may be higher depending on your plan and whether you qualify for special transition protections such as Continuity of Care (“CoC”), discussed below.
Your Costs will depend on your specific plan design:
PPO plans may offer out‑of‑network benefits, but typically with higher deductibles, coinsurance, and out‑of‑pocket costs.
HMO or EPO plans often do not cover out‑of‑network care except in limited circumstances.
UnitedHealthcare can explain your specific benefits. Call the number on the back of your United ID card for details.
Yes. You should always go to the nearest emergency room in a medical emergency, including an LVHN emergency department. Emergency care is covered under federal law regardless of network status. UnitedHealthcare can explain what cost‑sharing applies under your plan.
UnitedHealthcare is required to cover emergency admissions and emergency services. Once you are medically stable, United may require transfer to an in‑network facility and is not obligated to continue covering your stay at LVHN. LVHN will work with UnitedHealthcare on authorization requests and safe discharge or transfer planning.
Urgent care visits may be covered, depending on your plan and whether a timely in‑network urgent care option is available. Coverage determinations and cost‑sharing are made by UnitedHealthcare. You should contact United to confirm whether an LVHN urgent care visit would be covered under your plan.
Yes. LVHN can assist with medical records, care coordination, and transition planning if you choose to transfer care to an in‑network provider.
You should contact UnitedHealthcare as soon as possible to understand your coverage options. LVHN staff can also help answer general questions and assist with scheduling decisions once you confirm coverage with United. You may qualify for Continuity of Care coverage that will permit you to temporarily continue treating with your LVHN provider.
CoC is a short‑term transition option that may allow certain patients who are in the middle of active treatment to continue receiving specific care at in‑network cost‑sharing levels for a limited period after LVHN becomes out of network. CoC:
Is not automatic
Must be requested by the member
Must be approved by UnitedHealthcare
Typically applies only to the qualifying condition, not all care
LVHN may assist patients with CoC requests upon written request by the patient.
You may qualify if you are in an active course of treatment that cannot safely be interrupted, such as:
Pregnancy
Ongoing inpatient or hospital care
Scheduled non‑elective surgery (including post‑operative care)
Active cancer treatment
Treatment for a serious or complex medical condition
UnitedHealthcare reviews requests case by case and makes the final decision as to whether you qualify.
The length of a CoC period depends on your plan and your medical condition. Typically, CoC lasts anywhere between 60-90 days, but may be longer in certain circumstances.
UnitedHealthcare will confirm the duration that applies to your plan.
The transition period is typically measured from the date UnitedHealthcare notifies you that LVHN is leaving the network, rather than the contract termination date itself. United can confirm the timing for your plan.
You must request it directly from UnitedHealthcare. Call the number on the back of your United ID card and ask about “Continuity of Care”. United may ask about:
Your diagnosis and treatment plan
Recent visits and upcoming appointments
Why a safe transition to an in‑network provider is not yet possible
Yes. Requests should be madeas soon as possible after you are notified of the network change. Waiting too long may affect eligibility. UnitedHealthcare will advise you of any applicable deadlines.
If CoC is not approved, you may choose to:
Continue care at LVHN using out‑of‑network benefits (if available under your plan)
Transition your care to a UnitedHealthcare in‑network provider
Ask UnitedHealthcare whether an exception or special arrangement may be available based on your situation
UnitedHealthcare can help you understand these options.
