It’s been 13 years since Marget got her kidney transplant.

Since moving to Maryland she’s been going to Johns Hopkins Medicine for her care.

While she only sees her transplant team once per year, the immune suppressants she’s on cause other issues necessitating other specialists like a cardiologist, an endocrinologist, a skin care specialist and others.

We are using Marget’s middle name to protect her medical privacy.

Things were smooth sailing for her medical care at Johns Hopkins with her general practitioner coordinating the handful of doctors, her multiple tests and labs to ensure she’s staying healthy.

But months ago, she started getting letters from her insurance company, UnitedHealthcare, saying that negotiations between Hopkins and United weren’t going well.

“My husband went and saw HR at his employer, and she said, ‘Oh, these kind of things happen. It's almost always resolved,’” Marget said. “Well, you know, it keeps going, and suddenly it is not resolved.”

On Aug. 25, Hopkins went out of network for UHC members and the two stopped negotiations this month.

While those patients can still go to Hopkins for care, out-of-network costs can be exorbitant.

That’s left about 60,000 people in Maryland, D.C. and Virginia out-of-network for Hopkins care.

UnitedHealthcare says it will give patients a continuation of care waiver if they are in active or ongoing treatment, but only for 90 days and after United approves it within 30 days of the contract ending, which is Sept. 25.

“The way that we're supposed to have this done is by literally, a fax, like through a telephone,” Marget said. “The very next day, I received confirmation from my providers at Johns Hopkins that, yes, we have faxed in these forms. United is saying it could take 15 days. It's been like 13. Where are the faxes? How do I know the faxes have been received? There's no confirmation.”

Marget is one example of the frustration some United customers have experienced has the company detransitions from Hopkins.

United says any member that was already approved for transplant services at Johns Hopkins at the time they went out of network will continue to have in-network access for those services at Johns Hopkins.

However, Marget still hasn’t gotten that confirmation.

She said she’s extremely stressed.

“It's highly specialized care,” she said. “You can't just go to a local nephrologist and hope this works out. I really need people who can manage my level. I'm never free, so it is stressful for my personal care, but also it's financially stressful and I feel like I'm forced into this on very short notice.”

Gene Ransom, the president of the Maryland State Medical Society, said he’s heard similar stories to Marget’s.

“I've heard from patients and it’s a major problem,” Ransom said. “Anybody who is in continuous care should really request from United an exception to be treated in-network for the rest of this insurance year. And if any of those are denied, and I've talked to several patients where they have been denied, you should immediately file a complaint with the Maryland Insurance Administration.”

Johns Hopkins and UHC’s dispute stemmed from UHC’s high claims denial rates.

“UnitedHealthcare refused to agree to reasonable contract language, instead insisting that we agree to terms that would make it difficult for us to provide patient care,” said Kim Hoppe, vice president of public relations. “UnitedHealthcare had the opportunity to listen to our concerns in a meaningful way and prioritize what matters most: ensuring patients get the care they need, when they need it, without excessive delays or denials. Unfortunately, they chose profits over patients. We decided to make patients aware of this stalemate now, to provide our patients and their employers the time they need to explore alternative insurance options during the upcoming open enrollment season.”

UHC is pointing the finger at JHM.

“Johns Hopkins informed us today it is walking away from our negotiation because we will not agree to language that allows it to refuse treatment for any member with an employer-based plan it does not want to do business with. Johns Hopkins’ demands are unacceptable,” said Joseph Ochipinti, UnitedHealthcare CEO, Mid-Atlantic region.

JHM wanted concessions for UHC that show the company will stop high volume denials and bureaucratic foot dragging that causes patients to wait for treatments.

According to a recent study, UHC is the worst company for claims denials on public plans, rejecting about a third of all claims.