• If you are a patient with an existing relationship with a UVM Health provider, please talk with your provider and your insurance company about your ongoing care needs.
• We will continue to see you for emergency services, regardless of your insurance coverage.
• If you are a new patient, please work with your insurance company to find an in-network provider to meet your care needs.
• If UVM Health is out-of-network with your insurance plan, additional requirements may apply before you will be able to schedule an appointment. You may need to pay out-of-pocket at the time of service, and you may be responsible for coordinating with your insurance company to submit claims for reimbursement and obtain any required approvals.
• If you have a unique need that you believe can only be delivered at UVM Health, talk with your provider and insurance company.

We accept original Medicare (parts A and B). If you select a Medicare Advantage plan or private insurance, please contact your insurance provider to confirm in-network coverage for UVM Health.

At this time, UVM Health accepts the following Medicare Advantage plans. Please note that these insurers may have certain plans that do not include UVM Health hospitals and providers (e.g., WellCare) or do not cover all services offered by UVM Health (e.g., mental health). It’s best to confirm coverage with your insurance company before choosing a Medicare Advantage plan or scheduling an appointment.

*Fidelis Medicare Advantage plans are standardly labelled “WellCare by Fidelis”, which is in-network with the partners listed above; whereas if the plan doesn’t include the “Fidelis” label, then it is likely out-of-network and not accepted by UVM Health hospitals and providers.

**UVM Health Advantage is open for membership to residents of certain counties in New York. The plans are accepted by all UVM Health hospitals and providers.

January 1, 2025. Beginning January 1, 2025, there may be additional requirements before a patient with a benefit plan for which UVM Health is out-of-network can schedule an appointment.

• Alice Hyde Medical Center (including The Alice Center)
• Central Vermont Medical Center (including Woodridge Rehabilitation and Nursing)
• Champlain Valley Physicians Hospital (including CVPH Skilled Nursing Facility)
• Elizabethtown Community Hospital
• Porter Medical Center (including Helen Porter Rehabilitation and Nursing)
• University of Vermont Medical Center

• Talk to your employer (or former employer if you’re a retiree) if you receive health insurance benefits through them.
• Medicare.gov has resources for individuals seeking to sign up for Medicare, as well as resources for exploring Medicare Advantage: Your health plan options | Medicare.
• Vermont Health Connect can help with VT Medicaid and commercial plans through the Qualified Health Plan, call customer support at 855-899-9600 or visit Vermont Health Connect.
• New York State of Health, New York’s website for the marketplace: New York State of Health | Health Plan Marketplace for Individual and Small Business Health Insurance (ny.gov)

• If you’re in the middle of active treatment, we will continue your treatment plan until it is complete, or until a time when it is clinically or financially appropriate for you to transition to an in-network provider.
• We will maintain appointments that are currently scheduled through March 31, 2025. If you’d like to reschedule with a provider in your network, please contact your insurance company to identify an in-network provider.
• Absent special circumstances, we will not schedule any routine or preventive procedures or appointments for new patients with benefit plans for which UVM Health is out-of-network after January 1, 2025.
• If you have a unique need that you believe can only be delivered at UVM Health, talk with your provider and insurance company.

• Health care providers enter insurance networks for various reasons, including the benefit of direct payment and the ability to more easily request things like prior approval, etc.
• Payments from insurance companies with which we do not contract are generally lower, do not cover the cost of providing care, and usually involve greater out-of-pocket costs for the patient.
• Insurance companies with which we are out-of-network do not always authorize care their members need, and managing these administrative processes can be difficult and costly.
• UVM Health is operating with increasingly limited budgets over time and we accumulate a significant amount of debt each year due to providing care to patients without in-network benefits.
• In order to provide access to care for our community, we need to ensure services remain available. To do that, we require adequate reimbursement for the services.