Sunday at midnight was the deadline for a health insurance showdown that pits the area's largest health care provider, BayCare Health System, against insurance carrier UnitedHealthcare.

UnitedHealthcare’s online directory has already been updated and contact information for BayCare providers has been deleted.

The changes have affected more than 400,000 customers, who find themselves unsure of what to do next.

"(It's) important that you get together with your doctor and have them discuss what your options are,” said Rod Kamuf, a benefits consultant.

Kamuf suggests finding a doctor in-network. The easiest way head to the UnitedHealthcare website, punch in your zip code, and pick from the list.

How soon do you need to make the change? Kamuf said it depends on how urgent your medical needs are. If you can, he suggests pushing back upcoming appointments.

"It could resolve itself," he said. "A lot of times these contract issues do resolve themselves and that's what we're hoping for here."

If you have out-of-network coverage, you can stay with your BayCare provider but Kamuf warns that option comes with a price.

"It's going to cost you a lot more money because you're paying higher deductibles,” said Kamuf. “You're paying deductibles two times what your plan states.  You're out of pocket may be two or three times what your plan states."

Hundreds of thousands caught in the middle

One of the customers who is caught in the middle of the conflict is Winna Morrin of Palm Harbor. Doctors diagnosed her with breast cancer last year. After a double mastectomy and four reconstructive surgeries later, she has just one surgery left.

"I'm finally getting to the end of this nightmare and my last surgery is December 6th and it might not happen," said Morrin, who meets Monday with her doctor for her last appointment.

It might not happen now that negotiations have stalled between UnitedHealthcare and BayCare. 

In full page ads in the Tampa Bay Times, United said BayCare made unreasonable demands, while BayCare has said the claims are false. BayCare also said United owes them $11 million.

If the two are unable to work out a deal, BayCare won't be in United's provider network for Medicare Advantage, Medicaid and commercial products and doctors won't be part of United's commercial and Medicaid network.

Smaller health care providers also affected

And while the heavy hitters battle it out, smaller health care providers, like a sleep apnea center in Seminole, say they're already been hard hit.  That even before this contract dispute, they've received less money for the very same services rendered by BayCare.

Dr. Mark Majkowski of Bay Area Sleep Associates says many small providers haven't received increases in years but in the end, he firmly believes the United and BayCare will reach a deal.

"This is really the well-established insurance company dealing with the well-established provider and the people who end up paying for it, in addition to the members in terms of higher rates, it's the hard-working 90 percent of the health-care providers in Florida," said Dr. Majkowski.

As for patients, like Winna Morrin, the only thing she can do is wait patiently.

"We've come this far,” she said.  “Let's finish it."

She can only hope that the two come to a deal and she can have her sixth and final surgery.

BayCare patients who are insured by United can still go to BayCare's emergency rooms. Those who are mid-treatment should contact their provider to verify their coverage.

Statements

In a statement, UnitedHealthcare said its “disappointed that BayCare was unwilling to change its requested rate increase, and as a result they have terminated their contract with UnitedHealthcare. Our focus remains on serving the health care needs of our nearly half-million UnitedHealthcare members in the Tampa community and supporting their continued access to care at 21 other area hospitals.  The door remains open to further negotiations with BayCare and we hope the hospital system will return to active discussions with us.”

A list of alternative hospitals participating with UnitedHealthcare, Medicare Advantage, Medicaid (Community Plan and Evercare), and Florida Healthy Kids Networks include:

In Hillsborough:
Brandon Regional Hospital
Florida Hospital Carrollwood
Florida Hospital Tampa
H Lee Moffitt Cancer Center & Research Institute*
Memorial Hospital of Tampa
South Bay Hospital
Tampa General Hospital
Town and County Hospital

In Pasco:
Town and County Hospital
Town and County Hospital
Florida Hospital Zephyrhills
Regional Medical Center Bayonet Point

In Pinellas:
All Children’s Hospital*
Bayfront Medical Center
Edward White Hospital
Florida Hospital North Pinellas
Largo Medical Center
Largo Medical Center – Indian Rocks
Northside Hospital and Heart Institute
Palms of Pasadena Hospital
St. Petersburg General Hospital

*These hospitals are participating with all products with the exception of UHC Medicare Advantage plans.

BayCare released the following statement;

“BayCare’s hospitals, facilities, home care and laboratories are no longer participating in United’s provider network for commercial, Medicare Advantage and Medicaid products.  
 
Further, on Oct. 24, 2012, United terminated BayCare physician groups from participation in United’s commercial and Medicaid networks, effective Nov. 26, 2012.  BayCare’s employed physicians still participate with Medicare Advantage products.  BayCare’s employed physician groups include:  HealthPoint Medical Group, Morton Plant Mease Primary Care, Morton Plant Mease Specialists, Morton Plant Mease Immediate Care, St. Anthony’s Primary Care, St. Anthony’s Specialists and Suncoast Medical Clinic.
 
Patients can always go to any BayCare hospital or facility for an emergency medical condition and it will be covered regardless of our contract status.
 
United customers that have out-of-network benefits or qualify to be covered by a continuity of care provision may continue to access BayCare facilities and physicians for non-emergent services provided that United authorizes such services.  For coverage questions, members should contact United at the phone number listed on their insurance cards.  
 
BayCare is open to having meaningful discussions with United."