Children’s Hospital of Philadelphia (CHOP) is currently a participating provider in the QualCare, Inc. network. However, CHOP’s Letter of Agreement with QualCare will end on June 30, 2026.
Oscar Health, Inc. has access to the QualCare network, including CHOP hospitals, physicians, Home Care and Specialty Pharmacy. When the agreement with QualCare ends, Oscar Health members will no longer have access to CHOP as a participating provider.
Care and coverage at CHOP are not affected before June 30, 2026. However, beginning July 1, 2026, CHOP hospitals, physicians, Home Care, and Specialty Pharmacy will no longer be “in network” with QualCare.
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.
Please review the frequently asked questions below for information about appointments, continued care and next steps.
Frequently Asked Questions
What is QualCare?
CHOP is currently a participating provider of QualCare, which is a healthcare network. As such, QualCare agrees to allow insurance companies to access their network of contracted providers.
What is happening?
CHOP is currently a participating provider of QualCare. However, the last day for participation is June 30, 2026. When the contract ends, CHOP hospitals, all CHOP physicians and CHOP Home Care will no longer be in the QualCare network effective July 1, 2026. If you have insurance coverage through Oscar Health – which uses the QualCare network – CHOP will be out of network effective July 1, 2026.
My child is scheduled for services at CHOP in June 2026. What should I do?
Nothing currently. Your child will still be able to access CHOP services on or before June 30, 2026.
My child is scheduled for surgery in June 2026. Will my child be able to receive follow-up care for that surgery?
Your child will be able to receive standard post-operative care and treatment related to surgery performed on or before June 30, 2026. Any additional unrelated services will need new authorization from Oscar Health.
My child is scheduled to see their CHOP specialist after June 30, 2026. What can I do?
If your child’s appointment is related to continuing care that began on or before June 30, 2026, Oscar Health is required by law to authorize the continuation of ongoing “medically necessary” treatment for up to 4 months after the contract expires (extending coverage until Oct. 31, 2026). CHOP will seek authorization for this service as we normally would.
If we run into difficulty, we will let you know and ask you to call Oscar Health Member Services at 855-672-2755. Please let them know that the care began on or before June 30, 2026.
If this is a new appointment with a specialist you have not yet seen at CHOP, please call Oscar Member Services at 855-672-2755 and request authorization to continue treatment with your CHOP physician. Your CHOP specialist may be able to assist you in getting this authorization for follow-up appointments scheduled on or after July 1, 2026.
Can we still see our CHOP primary care doctor?
You may continue to see your CHOP Care Network primary care doctor on or before June 30, 2026. However, beginning July 1, 2026, you will need to select a new primary care doctor. If your child has an illness which is being treated on an ongoing basis by your primary care doctor, you will be able to continue with your primary care doctor for about 60 days. Call Oscar Health Member Services at 855-672-2755 for more information.
I am a pregnant mom who has been under the care of CHOP’s Center for Fetal Diagnosis and Treatment on or before June 30, 2026. How will my insurance coverage affect me and my baby?
Oscar Health is required to continue covering your obstetric care at CHOP. CHOP will provide care through your pregnancy and six weeks of postpartum care if you were in your second or third trimester of pregnancy when you received notice from QualCare about the contract termination with CHOP. Your baby will be covered by Oscar Health through their discharge from CHOP. You will need to request continued coverage from Oscar Health for office appointments scheduled on or after July 1, 2026.
My child has a follow-up appointment scheduled in June with a CHOP specialist (for example, a cardiologist). Can my child still see the doctor?
Yes.
My child has a follow-up appointment scheduled in July with a CHOP medical specialist (e.g., pulmonologist). Can my child still see the doctor?
Yes, as an existing CHOP patient, your child may see their doctor with continued coverage from Oscar Health. If authorization is granted prior to July 1, 2026, you may continue your child’s treatment or care. For post-operative care, you can continue to see your specialist for 6 months, and for a year for Oncology care.
My child is scheduled for a first visit with a CHOP surgeon (e.g., an orthopedic surgeon) in July. Can we keep this appointment?
For new patients to CHOP on or after July 1, 2026: An authorization from Oscar Health is needed before we can confirm your appointment or any follow-up care by CHOP.
Is CHOP in-network with other commercial insurance plans?
Yes. CHOP is an in-network provider with many commercial insurance plans. Please visit our Does CHOP Take My Insurance? page for a complete list.
As a patient, what are my rights?
For information about your rights as a member, please call Oscar Health’s Member Services at 855-672-2755 (option 2) or visit the Oscar Health website.
My child is scheduled for Behavioral Health Services at CHOP. Can we continue to come to CHOP?
Yes. Prior to June 30, 2026, you may continue to receive behavioral health services for up to a year – with authorization – after termination of Oscar Health coverage with CHOP.
For behavioral health services on or after July 1, 2026, pre-authorization from Oscar Health is needed before we can confirm your appointment or any follow-up care by CHOP.
My child receives services from CHOP Home Care. Can we continue to receive home care services from CHOP?
Oscar Health patients currently under the care of CHOP Home Care will be able to continue to receive services from CHOP Home Care through June 30, 2026. Beginning July 1, 2026, if you choose to remain with Oscar Health, you will need to select a new Home Care provider. Call Oscar Health Member Services at 855-672-2755 to learn about your options.
My child receives medications through CHOP Specialty Pharmacy. Can we continue to receive the medications from CHOP Specialty Pharmacy?
Oscar Health patients receiving Specialty Pharmacy medications can continue to receive medications through CHOP Specialty Pharmacy through June 30, 2026. Beginning July 1, 2026, if you choose to remain with Oscar Health, you will need to select a different Specialty Pharmacy.
Children’s Hospital of Philadelphia (CHOP) is currently a participating provider in the QualCare, Inc. network. However, CHOP’s Letter of Agreement with QualCare will end on June 30, 2026.
Oscar Health, Inc. has access to the QualCare network, including CHOP hospitals, physicians, Home Care and Specialty Pharmacy. When the agreement with QualCare ends, Oscar Health members will no longer have access to CHOP as a participating provider.
Care and coverage at CHOP are not affected before June 30, 2026. However, beginning July 1, 2026, CHOP hospitals, physicians, Home Care, and Specialty Pharmacy will no longer be “in network” with QualCare.
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.
Please review the frequently asked questions below for information about appointments, continued care and next steps.
Frequently Asked Questions
What is QualCare?
CHOP is currently a participating provider of QualCare, which is a healthcare network. As such, QualCare agrees to allow insurance companies to access their network of contracted providers.
What is happening?
CHOP is currently a participating provider of QualCare. However, the last day for participation is June 30, 2026. When the contract ends, CHOP hospitals, all CHOP physicians and CHOP Home Care will no longer be in the QualCare network effective July 1, 2026. If you have insurance coverage through Oscar Health – which uses the QualCare network – CHOP will be out of network effective July 1, 2026.
My child is scheduled for services at CHOP in June 2026. What should I do?
Nothing currently. Your child will still be able to access CHOP services on or before June 30, 2026.
My child is scheduled for surgery in June 2026. Will my child be able to receive follow-up care for that surgery?
Your child will be able to receive standard post-operative care and treatment related to surgery performed on or before June 30, 2026. Any additional unrelated services will need new authorization from Oscar Health.
My child is scheduled to see their CHOP specialist after June 30, 2026. What can I do?
If your child’s appointment is related to continuing care that began on or before June 30, 2026, Oscar Health is required by law to authorize the continuation of ongoing “medically necessary” treatment for up to 4 months after the contract expires (extending coverage until Oct. 31, 2026). CHOP will seek authorization for this service as we normally would.
If we run into difficulty, we will let you know and ask you to call Oscar Health Member Services at 855-672-2755. Please let them know that the care began on or before June 30, 2026.
If this is a new appointment with a specialist you have not yet seen at CHOP, please call Oscar Member Services at 855-672-2755 and request authorization to continue treatment with your CHOP physician. Your CHOP specialist may be able to assist you in getting this authorization for follow-up appointments scheduled on or after July 1, 2026.
Can we still see our CHOP primary care doctor?
You may continue to see your CHOP Care Network primary care doctor on or before June 30, 2026. However, beginning July 1, 2026, you will need to select a new primary care doctor. If your child has an illness which is being treated on an ongoing basis by your primary care doctor, you will be able to continue with your primary care doctor for about 60 days. Call Oscar Health Member Services at 855-672-2755 for more information.
I am a pregnant mom who has been under the care of CHOP’s Center for Fetal Diagnosis and Treatment on or before June 30, 2026. How will my insurance coverage affect me and my baby?
Oscar Health is required to continue covering your obstetric care at CHOP. CHOP will provide care through your pregnancy and six weeks of postpartum care if you were in your second or third trimester of pregnancy when you received notice from QualCare about the contract termination with CHOP. Your baby will be covered by Oscar Health through their discharge from CHOP. You will need to request continued coverage from Oscar Health for office appointments scheduled on or after July 1, 2026.
My child has a follow-up appointment scheduled in June with a CHOP specialist (for example, a cardiologist). Can my child still see the doctor?
Yes.
My child has a follow-up appointment scheduled in July with a CHOP medical specialist (e.g., pulmonologist). Can my child still see the doctor?
Yes, as an existing CHOP patient, your child may see their doctor with continued coverage from Oscar Health. If authorization is granted prior to July 1, 2026, you may continue your child’s treatment or care. For post-operative care, you can continue to see your specialist for 6 months, and for a year for Oncology care.
My child is scheduled for a first visit with a CHOP surgeon (e.g., an orthopedic surgeon) in July. Can we keep this appointment?
For new patients to CHOP on or after July 1, 2026: An authorization from Oscar Health is needed before we can confirm your appointment or any follow-up care by CHOP.
Is CHOP in-network with other commercial insurance plans?
Yes. CHOP is an in-network provider with many commercial insurance plans. Please visit our Does CHOP Take My Insurance? page for a complete list.
As a patient, what are my rights?
For information about your rights as a member, please call Oscar Health’s Member Services at 855-672-2755 (option 2) or visit the Oscar Health website.
My child is scheduled for Behavioral Health Services at CHOP. Can we continue to come to CHOP?
Yes. Prior to June 30, 2026, you may continue to receive behavioral health services for up to a year – with authorization – after termination of Oscar Health coverage with CHOP.
For behavioral health services on or after July 1, 2026, pre-authorization from Oscar Health is needed before we can confirm your appointment or any follow-up care by CHOP.
My child receives services from CHOP Home Care. Can we continue to receive home care services from CHOP?
Oscar Health patients currently under the care of CHOP Home Care will be able to continue to receive services from CHOP Home Care through June 30, 2026. Beginning July 1, 2026, if you choose to remain with Oscar Health, you will need to select a new Home Care provider. Call Oscar Health Member Services at 855-672-2755 to learn about your options.
My child receives medications through CHOP Specialty Pharmacy. Can we continue to receive the medications from CHOP Specialty Pharmacy?
Oscar Health patients receiving Specialty Pharmacy medications can continue to receive medications through CHOP Specialty Pharmacy through June 30, 2026. Beginning July 1, 2026, if you choose to remain with Oscar Health, you will need to select a different Specialty Pharmacy.
Contact Billing and Insurance
Pre-visit financial counseling hotline, 267-426-1467
Questions about your bill, 1-800-283-3055
Contact us online
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Recommended reading
Does CHOP take my insurance?
If you are not sure if your child's visit will be covered, call your insurance company to find out about your plan, referrals, authorizations, copays and more.
Does CHOP take my mental health insurance?
The Department of Child & Adolescent Psychiatry and Behavioral Science (DCAPBS) at Children's Hospital of Philadelphia has agreements with the insurance plans on this page.
Family Health Coverage Program
The Department of Family Health Coverage Programs helps uninsured and underinsured families enroll in financial assistance programs.