As of April 26, Lehigh Valley Health Network (LVHN) is out of network for most UnitedHealthcare commercial health plans, the result of a contract dispute that has dragged on for more than two years and now leaves thousands of local patients facing higher out-of-pocket costs or a change in providers.
The split is the second stage of a breakdown between the region’s largest health system, now part of Jefferson Health, and one of the nation’s largest insurers. LVHN’s UnitedHealthcare Medicare Advantage contract already ended on January 26, and the commercial contract followed on April 26. The two organizations blame each other for the impasse, and patients are caught in the middle.
Which Plans Are Affected
The change does not hit every UnitedHealthcare member the same way. The plans most affected are commercial, employer-sponsored and individual UnitedHealthcare coverage, along with Medicare Advantage.
Commercial plans (employer-sponsored and individual): Out of network at LVHN as of April 26. PPO members may still have out-of-network benefits but at higher cost-sharing, while HMO and EPO plans typically offer limited or no out-of-network coverage.
Medicare Advantage: Out of network since January 26. PPO plans retain out-of-network benefits at higher cost; HMO plans generally have no out-of-network coverage.
Some members are not affected. LVHN says UnitedHealthcare Medicaid and CHIP members may continue receiving care without interruption, and veterans covered through the UnitedHealthcare VA Community Care Network retain access to LVHN providers.
How Many Patients Are Involved
By the network’s own October 2025 estimate, roughly 70,000 LVHN patients carry UnitedHealthcare coverage across the region. Not all of them lose in-network access, Medicaid, CHIP and VA Community Care Network members keep it, and more recent reporting has put the number actually affected at around 50,000. LVHN and Jefferson Health have more broadly described the move as affecting “thousands” of patients at hospitals and offices across the area.
The figures span both the Medicare Advantage population, which lost in-network access first and, by local reporting, numbered more than 20,000 patients, and the commercial population affected as of April 26. Patients unsure of which category they fall into should check their plan documents or call the member services number on their UnitedHealthcare ID card.
Lehigh Valley Health Network is now part of Jefferson Health, the system negotiating with UnitedHealthcare.
Why the Two Sides Couldn’t Agree
At its core, the dispute is about money, specifically, how much UnitedHealthcare pays LVHN for care. The two sides describe the same negotiation in sharply different terms.
LVHN, part of Jefferson Health, says UnitedHealthcare has paid below negotiated rates since 2021, leaving reimbursements roughly 40 percent lower than expected, and that its last contract proposal in December 2024 sought a price increase to correct course. Jefferson Health leaders have framed the current arrangement as untenable.
“We have worked tirelessly to reach a resolution with United, but they’re not interested in finding a fair solution for our patients,” Jefferson Health said in a statement. Dr. Edmund Pribitkin, a Jefferson Health executive, said of the existing payment model, “This model is not financially sustainable.”
UnitedHealthcare rejects that account. The insurer says LVHN’s proposals amounted to a steep price hike, characterizing the December 2024 ask as a nearly 30 percent first-year increase and, in other statements, a more than 20 percent increase, and that LVHN did not respond to its latest offer. UnitedHealthcare has called LVHN’s claims about reimbursement “misleading and potentially false” and urged the system back to the table.
“We ask Lehigh Valley to join us at the negotiating table and work toward an agreement that is affordable rather than using consumers as leverage,” UnitedHealthcare said.
What It Means for Patients
Going out of network does not mean LVHN will turn patients away, but it changes how, and whether, UnitedHealthcare pays for care delivered there.
Emergency care is still covered. Under federal law, emergency services must be covered regardless of network status. If you are admitted from the emergency department, your stay is covered until you are stabilized, after which a transfer to an in-network facility may be required.
Routine and scheduled care may cost more or may not be covered. Depending on your plan type, non-emergency visits, procedures and tests at LVHN may now be billed at out-of-network rates or denied.
Urgent care may not be covered at LVHN if in-network alternatives are nearby.
Options and Guidance for Members
Patients in the middle of treatment have the most to consider. Both organizations point to several avenues.
Continuity of Care: Members in active treatment, such as pregnancy, active cancer treatment, an ongoing hospitalization, or a scheduled non-elective surgery, may qualify to keep in-network cost-sharing at LVHN for a limited period, commonly up to 90 days. This is not automatic; members must apply through UnitedHealthcare, using the number on their ID card, as soon as possible.
Switch to an in-network provider: Patients who want to stay in network can transfer care to a UnitedHealthcare in-network health system in the region.
Check plan-specific benefits: PPO members may retain out-of-network benefits at a higher cost; HMO and EPO members generally do not.
Watch open enrollment: Those who want to keep LVHN in network may be able to choose a different plan or insurer during their next enrollment period.
LVHN and UnitedHealthcare have each posted dedicated information pages on the dispute, and both encourage affected members to call the customer service number on their insurance card with questions about coverage. While the contract has lapsed, health systems and insurers sometimes reach retroactive agreements that restore in-network status, so patients should keep records of any out-of-network bills incurred during the gap.
LVHN-UnitedHealthcare Dispute at a Glance
LVHN is out of network for most UnitedHealthcare commercial plans as of April 26, 2026.
UnitedHealthcare Medicare Advantage members lost in-network access earlier, on January 26, 2026.
Medicaid, CHIP and VA Community Care Network members are not affected and keep access to LVHN.
Reporting estimates roughly 70,000 UnitedHealthcare patients in the region are affected across plan types.
LVHN says UnitedHealthcare underpaid by about 40 percent since 2021; UnitedHealthcare says LVHN sought a roughly 20–30 percent price increase.
Emergency care remains covered under federal law regardless of network status.
Patients in active treatment may apply for Continuity of Care to keep in-network rates for up to about 90 days.
