Last winter, Amber Wingler began receiving a series of increasingly urgent messages from a local hospital in Columbia, Missouri, telling her that her family's health care could soon be affected.
MU Health Care, where most of his family's doctors practice, has become embroiled in a contract dispute with Anthem, Wingler's health insurance company. The current contract was coming to an end.
Then, on March 31, the woman received an email warning her that the hospital would no longer be in Anthem's network the next day.
This news stunned her.
“I know they negotiate contracts all the time… but this seemed like a simple bureaucratic procedure that wouldn't affect us. I’ve never been excluded from an insurer’s network before,” he said. The moment could not have been more opportune.
Question: When a Missouri mother's insurance company couldn't reach an agreement with her hospital, most of her doctors suddenly found themselves out of network. She wondered how she could provide health care for her children or how she could find new doctors. “For a family of five… where to start?” — Amber Wingler, 42, from Columbia, Missouri.
Wingler's daughter, 8-year-old Cora, had been having intestinal problems for no apparent reason. Waiting lists for appointments with various pediatric specialists for diagnosis, from gastroenterology to occupational therapy, were long, ranging from weeks to more than a year.
(In a statement, MU Health Care spokesman Eric Maze said the health system is working to ensure children with the most urgent needs are seen as quickly as possible.)
Suddenly, Cora's visits to a specialist were outside her insurance network. At several hundred dollars apiece, the cost would quickly skyrocket. The only other pediatricians Wingler found were in St. Louis and Kansas City, more than 120 miles away.
So Wingler put off seeing her daughter's doctor for several months while she tried to decide what to do.
Across the country, contract disputes are common, with more than 650 hospitals involved in public disputes with insurers as of 2021.
Yes may become even more common as hospitals brace for roughly $1 billion in federal health care cuts as mandated law icon President Donald Trump signed the law into law in July.
Patients caught in a contract dispute have few realistic options.
“There is an old African proverb that says: “When two elephants fight, the grass gets crushed.” And unfortunately, in these situations, it's often the patients who are the bully,” said Caitlin Donovan, director of the Patient Advocacy Foundation, a nonprofit that helps people who have difficulty accessing health care.
If you're feeling overwhelmed by a contract dispute between a hospital and your insurance company, here's what you need to know to protect yourself financially:
1. “Out of network” means you'll likely pay more.
Insurers enter into contracts with hospitals and other health care providers to set the rates they will pay for various services. When they reach an agreement, the hospital and most of the providers working there become part of the insurer's network.
Most patients choose to use in-network providers because their insurance covers part, most, or even all of the bill, which can run into hundreds or thousands of dollars. If you go to an out-of-network provider, you may have to pay the entire bill.
If you decide to continue seeing your regular doctors, even if they are out of network, you can ask for a cash discount and hospital financial assistance program.
2. Disputes between hospitals and insurers are usually resolved.
Jason Buchsbaumhealth policy researcher at Brown University, surveyed 3,714 nonfederal hospitals in the U.S. and found that between June 2021 and May 2025, 18% had a public dispute with a health insurer.
About half of those hospitals eventually fell out of the insurer's network, according to Buchsbaum's preliminary data. However, most of these separations are resolved within one or two months, he added. Therefore, it is very likely that your doctors will become part of the network again, even after the separation.
3. You may qualify for an extension that will allow you to cut costs.
Some patients with serious or complex conditions They may qualify for an expansion of in-network coverage called continuity of care.
You can request this extension by calling your insurer, but the process can take a long time. Some hospitals have created resources to help patients apply.
Wingler went through the whole ordeal for her daughter, spending hours on the phone, filling out forms and sending faxes.
But he said he didn't have the time or energy to do that for everyone in his family.
“My son was in physical therapy,” she said. “But I’m so sorry son, you keep doing the exercises you’re supposed to do. I’m not going to fight for you to have cover when I’m already fighting for your sister,” he told himself.
It is also important to consider whether a medical emergency is required: in most emergency departments, hospitals They can't charge patients more tariffs of your network.
4. You may have to wait to change insurers.
You may be thinking about switching to an insurance company that covers your favorite doctors. But keep in mind that many people who choose health insurance plans during the annual open enrollment period become locked into their plan for the year. Contracts between insurers and hospitals do not necessarily coincide with your plan year.
Some life eventsfor example, getting married, having a child, or losing a job may allow you to change coverage outside of the annual open enrollment period, but your doctors leaving your insurance network do not count as a life event that allows you to do so.
5. Finding a new doctor can take a long time.
If the rift between your insurance company and the hospital seems permanent, you may want to consider finding a new list of doctors and other providers in your plan's network. Where to start? Your plan likely has an online tool to find network providers near where you live.
But keep in mind that changing doctors may mean waiting to move on to a new patient, and in some cases, having to move on.
6. Receipts should be saved.
Even if your insurance and hospital do not reach an agreement before your contract expires, there is a chance that you will reach a new agreement.
Some patients decide to postpone their appointment while they wait. Others show up for appointments and pay out of their own pockets. If this is your case, keep your receipts. When insurers and hospitals reach an agreement, it is usually applied retroactively, so appointments you paid for out of pocket may eventually be covered.
End of the test
Three months after the contract between Wingler's insurance company and the hospital expired, the two sides announced a new agreement. Wingler joined the throng of patients making appointments they had put on hold during the crisis.
In a statement, Jim Turner, a spokesman for Elevance Health, Anthem's parent company, wrote: “We approached the negotiations with an emphasis on fairness, transparency and respect for all affected.”
MU Health Care's Maze said, “We understand the importance of timely access to pediatric specialty care for families and deeply regret the frustration some parents have experienced trying to make an appointment after completing our contract negotiations with Anthem.”
Wingler was glad his family was able to see their doctors again, but his relief was tempered by his determination not to find himself in the same situation again.
“I think we'll be a little more cautious when open enrollment comes around,” Wingler said. “We never got around to reviewing our out-of-pocket coverage because we didn’t need it.”
