Children’s Hospital of Philadelphia announced on May 22 that its Letter of Agreement with QualCare, Inc. will end on June 30, 2026. As a result, CHOP hospitals, physicians, Home Care, and Specialty Pharmacy will no longer be part of the QualCare network starting July 1, 2026.
Oscar Health members currently have access to the QualCare network and therefore to CHOP services. After the agreement ends in June next year, Oscar Health members will lose access to CHOP as an in-network provider.
Until June 30, care and coverage at CHOP remain unchanged for all patients covered by plans using the QualCare network. After this date, those seeking care at CHOP may need new authorizations or could face out-of-network costs depending on their insurance plan.
The hospital said it is committed to supporting families during this transition and providing clear guidance about how ongoing or scheduled care may be affected. According to information released by CHOP: “We know insurance changes can be confusing. CHOP is committed to supporting families through this transition and providing clear guidance to help you understand how your family’s care may be affected.” The hospital encourages families with questions about appointments or continued care after July 1 to contact Oscar Health Member Services.
Some exceptions are outlined for patients who began treatment before the contract’s end date; for example, those already receiving medically necessary ongoing treatment as of June 30 may qualify for continued coverage for up to four months after contract expiration if authorized by Oscar Health. Pregnant mothers under the Center for Fetal Diagnosis and Treatment before June 30 will continue obstetric care through pregnancy and six weeks postpartum if they were in their second or third trimester when notified about the contract termination.
CHOP remains an in-network provider with many other commercial insurance plans beyond QualCare. Patients are encouraged to check whether their plan still includes CHOP after July or visit the hospital’s website for more information.
