Important Information for Harmony Health Plan Patients
CHICAGO, Illinois - Effective June 1, 2017, Harmony Health Plan has terminated its contract with the St. James PHO. As a result, thousands of patients are required to choose another primary care provider (PCP) within the Harmony network, effective immediately.
Harmony’s decision to cancel its St. James PHO contract may, very likely, require patients to find a new provider outside the local community. The following frequently asked questions may be helpful:
Q: When will Harmony Health Plan’s contract terminate?
A: Harmony Health Plan terminated its contract with the St. James PHO effective June 1, 2017. The termination is the result of Harmony’s sending a termination notice to the PHO. As a result of Harmony’s cancelation, providers within the St. James PHO are now considered out-of-network. To verify, please call Harmony at 1-800-608-8158 (TTY: 1-877-650-0952). Q: Is St. James PHO in contract discussions with Harmony to be restored to the network? Our patients are our primary concern and we have attempted to have St. James PHO remain in-network. Unfortunately, Harmony has refused to negotiate our contract.
Q: How can I get more information or change my provider?
Patients with questions regarding Harmony’s contract termination or those seeking a new primary care provider should:
- Call Harmony customer service at 1-800-608-8158 (TTY: 1-877-650-0952), Mon-Fri, 8am-5pm, or
- Search for a new primary care provider at www.wellcare.com/Illinois
Q: I am receiving active treatment with a St. James PHO physician. How will my current situation be transitioned?
You must contact Harmony Customer Service at 1-800-608-8158 (TTY: 1-877-650-0952) to discuss the transition of care.
If you are in a treatment plan, you may be able to see your PCP beyond the June 1, 2017 termination date if you:
- See the PCP regularly for certain treatment
- Are in the hospital getting care from Harmony after May 31, 2017, OR
- Are disabled or have a life-threatening illness OR
- Are in your 3rd trimester of pregnancy (patient may ask to keep her PCP until her baby is born and follow-up care is done)
You must contact Harmony to discuss transition of care.