A Medicare Advantage PPO card sits on top of a Medicare card, in this file photo. AP/Jenny Kane
Posted on 09/09/2026 9:37:51 PM PDT by SeekAndFind
Twenty-nine health systems are dropping Medicare Advantage plans in 2026, citing prior authorization denials, reimbursement issues, and deal renegotiations.
A Medicare Advantage PPO card sits on top of a Medicare card, in this file photo. AP/Jenny Kane
The number of terminated contracts this year is down from 40 in 2025 and 32 in 2024, Becker's Hospital Review reported on Sept. 4.
Naples Comprehensive Health, one of America's top 50 hospitals, will go out of network with Centene's Wellcare and Health Care Service Corporation's HealthSpring Medicare Advantage plans, effective in 2027.
"This change allows us to ensure that the plans we partner with truly support quality care, reduce unnecessary administrative barriers, and align with our commitment to delivering the best possible experience for our patients," the hospital said in a statement.
The Epoch Times requested comments from Wellcare and HealthSpring but did not receive a response by the time of publication.
Lee Health in Fort Myers, Florida; Fairview Health Services in Minneapolis, University of Miami Health System; and CarolinaEast Medical Center in New Bern, North Carolina, are terminating contracts with the UnitedHealthcare Medicare Advantage plan at the end of 2026, according to corporate statements.
If unable to reach a new agreement, NewYork-Presbyterian Hospital will be leaving UnitedHealthcare on Oct. 1, according to a hospital statement.
A UnitedHealthcare spokesperson told The Epoch Times, "We are actively negotiating with most of these providers to renew our network relationship," except for the University of Miami Health System.
"These discussions are similar to the thousands of provider contract negotiations we conduct each year, the vast majority of which result in renewed agreements that support continued access to quality, affordable care for the people we serve," the spokesperson said.
Lee Health wrote to its patients saying that a central concern "is the impact that UnitedHealthcare's authorization, review, and denial processes can have on timely access to medically necessary care."
UnitedHealth denied 17 percent of Medicare Advantage prior authorization requests in 2025, the highest rate compared to its competitors, according to KFF, a healthcare research group.
Roughly 60 percent of those denials were overturned upon appeal.
On average, insurers denied 12 percent of standard prior authorization requests for Medicare Advantage, 14 percent for traditional Medicare claims, and 18 percent for Obamacare, according to KFF.
Prior authorization requests were overturned on appeal more often in Medicare Advantage (67 percent) compared to Medicaid (47 percent) and Obamacare (43 percent).
Additionally, UnitedHealthcare owes Lee Health more than $100 million in disputed and underpaid claims, according to a hospital statement.
Fairview also pointed to care denials, payment issues, and frequent coverage changes as reasons to leave UnitedHealthcare plans in its public statement.
CarolinaEast Medical Center (New Bern, N.C.) did not provide reasons for leaving Medicare Advantage plans.
However, UnitedHealthcare will stop requiring prior authorization for more than 1,700 procedure codes, which is about 30 percent of the total for its commercial, Medicare Advantage, Medicaid, and Affordable Care Act plans, according to a September announcement from the company.
"We know the time you spend managing prior authorizations, paperwork, and reimbursements is time you'd rather spend with your patients," the company said in the memo to providers.
"Removing these prior authorization requirements is part of our effort to help reduce administrative work, remove barriers that can delay care and give you more time to focus on patient care," the memo reads.
UnitedHealth, Humana, and Aetna, the three largest Medicare Advantage carriers, reduced the number of counties they serve in 2026 due to low financial margins, according to analysis from ATI Advisory, a healthcare strategy group.
This marks a new phase in the Medicare Advantage market in which growth is driven less by geographical expansion and more by focusing on more lucrative markets, according to ATI.
Most counties offer a zero-dollar premium Medicare Advantage plan in 2026, according to ATI Advisory.
As of May, more than 50 percent of Medicare beneficiaries - about 36 million Americans - have enrolled in Medicare Advantage, according to Centers for Medicare and Medicaid Services.
Medicare Advantage enrollment is concentrated among large carriers. UnitedHealthcare, Humana, and Aetna together account for nearly 60 percent of market share, according to KFF.
The Medicare Advantage market share held by UnitedHealthcare dropped to 26 percent in 2026, down from 29 percent in 2025, according to a June analysis from KFF.
Humana's market share increased to 20 percent in 2026, up from 17 percent.
Medicare Advantage plans account for 80 percent, 33 percent, and 12 percent of revenue for Humana, Aetna, and UnitedHealthcare, respectively.
"[Centers for Medicare and Medicaid Services]' vision for Medicare Advantage and Part D is clear: a great choice for seniors and a smart deal for taxpayers," said Chris Klomp, director of Medicare and Chief Counselor of the U.S. Department of Health and Human Services.
"The Rate Announcement improves payment accuracy and strengthens competition based on quality - not on coding practices - helping put the program on a more sustainable path for the long term."
Federal payments to Medicare Advantage plans would increase 2.48 percent in 2027, according to the Centers for Medicare and Medicaid Services. But the increase is still below insurers' expectations for 2027.
"All insurers are likely to cut back on benefits, but Humana will be cutting back the most," said Kevin Gade, chief operating officer at Bahl and Gaynor.
Members with higher medical needs might have to seek other plans, Gade said.
So, who are the systems?
I ain’t signing up for spam to read their crap.
So, who are the systems?
I ain’t signing up for spam to read their crap.
Legalese but interesting.
We have a Medicare advisor we talk to about the coming year’s known and possible needs. Largest expenditure was a Corneal Transplant. On Humana for that reason. Lousy job, I’m legally blind in that eye now.
Advisor scurrying around already to check possibilities for next year. . She did tell me to go back to opthalmologist and INSIST they do some repairs. I doubt that it’s possiblel but will do.
I think the woods are full of Medicare advisors. Look in phone book, ask around if you think someone on your side decoding legalese would help.
Oh come on. Be a sport. All you have to do is opt out for them using your information. It’s easy.
/s
Advantage plans are so bad you can’t even get one in Alaska because no one will take them.
Seems like the Advantage is never
an actual benefit to the consumer
[UnitedHealth denied 17 percent of Medicare Advantage prior authorization requests in 2025, the highest rate compared to its competitors]
Well shoot. Shoulda gone to Mega Lo Mart.
exactly advantage to who, we know who
Yeah
At the first of last year, the main hospital in my area and all its affiliated specialist groups stopped taking my husband’s Medicare Advantage insurance. After Obamacare that same hospital had bought up the majority of specialist groups in the area so that took a lot of doctors off the list of physicians my hubby could see.
The government requires you to get on one of you these insurance plans and then you end up limited as to what care you can get. It’s only going to get worse. Obamacare is such a major failure and the left (and their adoring media) refuse to admit it. McCain should have been kicked out of the GOP party for his little stunt in refusing to vote for repealing that disaster!
There is no advantage to Advantage & the Affordable Health Care Act did not make healthcare affordable.
Something tells me we may have been lied to. 🧐
My advantage is local and has been wonderful to me. I love it. However my medical bgroup where I have been for the past 35 years is dropping them so I need to go with whomever they recommend.
Since the large hospital system and the big blue are a relative monopoly here... we will see.
Thank you for posting this.
More reasons not to sign up for advantage plans.
I’ll stick with the barebones A and B that are forced upon me.
Remember, John Roberts said the little fagot’s plan wasn’t a tax.
link
I know a guy with Medicare Advantage. He told me how great it is. I told him to get back with me when he needs some serious medical work done.
With one exception, everyone else we know who had a Medicare Advantage plan has dumped it.
AI sourced to KFF...
“Coverage and Availability
Plan Choices: Rural counties average fewer Medicare Advantage plans than urban areas, though availability varies.
Enrollment Trends: Private plan enrollment has grown rapidly in rural communities, covering roughly 40% to 52% of rural beneficiaries depending on how remote the county is.
Traditional Medicare: More than half of beneficiaries in the most remote rural counties still choose Traditional Medicare for broader nationwide access.”
Remote.
Riiiiiight.
Less to do with remote and more to do with HCPs don’t want to live there.
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