UnitedHealthcare and Legacy Health: what to do with that letter

If UnitedHealthcare mailed you something about Legacy Health, you are not the only one in Clark County holding it.

People have been reading me that letter over the phone for two weeks. Most of them want to know one thing. Do I have to do something right now? Here is what the letter is about, what has not changed, and the one date that matters.

Three facts, in plain English

1. What this is

UnitedHealthcare and Legacy Health are negotiating a new contract. The argument is about how much UnitedHealthcare pays Legacy. That is it. No hospital is closing. Legacy Salmon Creek is open. Your doctor is still your doctor.

2. What has not changed

Nothing has changed today. Your plan works the way it worked last month. If you have an appointment at Legacy in September, it is in network. Until October 1, in network status stays as it is today.

3. The date that matters

September 30, 2026 is the deadline. If the two sides do not reach an agreement by then, Legacy goes out of network for UnitedHealthcare members on October 1, 2026.

UnitedHealthcare's page says that would apply to employer and individual commercial plans, Medicare Advantage plans including Group Retiree and Dual Special Needs Plans, and Community Plan of Washington (Medicaid) plans.

Why a letter like this goes out

Legacy sent UnitedHealthcare a notice of contract termination. That sounds final. It is not. Here is how Legacy explains it in their own release, and I am quoting them rather than putting my words in their mouth:

“The notice of termination allows both parties to continue negotiations without the Legacy-UnitedHealthcare contract automatically renewing with the old financial terms.”

So the notice is the thing that keeps them talking instead of locking in last year's rates. Legacy says UnitedHealthcare's reimbursements have not kept pace with the real cost of care, and they are asking for an increase over the next two years. UnitedHealthcare says it is proposing market competitive rate increases and is trying to hold down premiums and out of pocket costs.

I am not going to tell you who is right. Read both and decide for yourself:

• UnitedHealthcare's Legacy Health negotiation page (their page says updated August 10, 2026)
• Legacy Health's news release (dated August 17, 2026)

Vancouver has already sat through one of these

This is not new ground for Salmon Creek. In 2024, Legacy and Regence went down to the wire and reached a deal hours before the contract expired, as The Columbian reported at the time. Salmon Creek patients stayed in network.

They fought again this year, and that one did lapse. Legacy went out of network for Regence members on April 1, 2026. Then Legacy announced a new contract on May 6, 2026, billed retroactive to April 1.

I bring that up because you have seen this movie, not because it predicts anything. Regence is not UnitedHealthcare. A deal one year does not guarantee a deal the next.

Nationally in 2026, several large UnitedHealthcare hospital fights settled at or near the deadline, including BayCare in Florida and Corewell Health in Michigan, and at least one did not, with Lehigh Valley Health Network in Pennsylvania going out of network in April. Often. Not always.

What I would do this week

If you are in active treatment right now, call me and we read your plan's rules together. UnitedHealthcare's page says members in the middle of treatment may qualify for continuity of care and should call the number on their ID card to find out. I am not going to guess at whether that is you. We will read it side by side.

What if October 1 comes and there is no deal

Then it costs you more to go to Legacy. Legacy's own release says patients may have to pay more money out of pocket for Legacy services. Nobody is turned away at the door. The bill changes.

Emergency care is the exception both sides state plainly. If it is an emergency, go to the nearest hospital. UnitedHealthcare's page says those services are covered at the in network benefit level regardless of whether the hospital is in the network. Legacy's release also carves out emergency care.

Other hospitals here stay in network. UnitedHealthcare's page names PeaceHealth St John Medical Center, OHSU, and Adventist Health among others in the Portland and Vancouver area. That does not make changing hospitals easy. It does mean you have somewhere to go.

One narrow note. If you are on a Group Retiree Medicare Advantage PPO through a former employer, UnitedHealthcare's page says you may still be able to see a Legacy provider out of network at the same cost share, if that provider is Medicare approved and accepts the plan. Confirm that with your plan before you count on it.

And if a plan change turns out to be the right move for you, the normal window is the Annual Enrollment Period, which opens October 15 for 2027 coverage. This contract fight does not create a mid year enrollment period. If you need a change, that is a conversation with your actual plan and your actual doctors in front of us. It is not something a webpage can decide.

If you have a Medicare Supplement

This works differently for you. Original Medicare does not have a network the way a Medicare Advantage plan does, so a contract fight between a carrier and a hospital is not the same event. Here is the catch. A lot of people are not certain which one they carry, and the card is the only way to know. Call anyway and we will look at your card together. I am not telling you to buy a Supplement. That is a separate decision with its own rules and its own timing.