Goodsurance
ES

Carriers & the market

When your hospital leaves your plan

A growing number of hospital systems are ending Medicare Advantage contracts, which can move a hospital out of network mid year. Knowing how networks work protects you before and during enrollment.

By the Goodsurance editorial teamJune 30, 2026

One contract fight makes local news; the pattern behind it is national. Across 2026, a growing list of hospital systems have ended or declined to renew contracts with Medicare Advantage plans, telling reporters the same two reasons over and over: too many care requests delayed or denied through prior authorization, and payments that arrive slowly. A current example is the standoff between NewYork-Presbyterian and UnitedHealthcare, whose latest deadline lands today; if no deal is signed, that hospital becomes out of network for many of the insurer's Advantage members. The reason this matters to anyone, anywhere, is structural. A Medicare Advantage plan is only as good as its network of hospitals and doctors, and that network is not locked in for the life of your enrollment. When a contract lapses, a hospital or large medical group can move out of network in the middle of the year. A few facts soften the blow and are worth carrying into any such dispute. Medicare Supplement plans, including AARP branded ones, are not affected, because Original Medicare has no network. Continuity of care rules often let a patient in an active course of treatment keep seeing their team for a transition period. And if your hospital is in a public contract fight with your plan, the move is the same: call the number on your card, confirm whether your doctors and facilities are still in network, and ask specifically about continuity of care for anything already underway. Before the Annual Enrollment Period this fall, it is worth checking that the hospital and doctors you count on are in your plan's network for next year.

More hospitals are leaving Medicare Advantage networks. A plan is only as good as its network, and networks can change mid year.

In plain words

When one hospital and one insurer fight over a contract, it makes the local news. But this is happening in many places. In 2026, more and more hospital systems have ended their deals with Medicare Advantage plans. They give the same reasons: too many care requests are delayed or denied, and payments come too slowly. Right now, NewYork-Presbyterian and UnitedHealthcare are in such a fight, with a deadline today. Why care if you do not live there? Because it can happen with your plan too. A Medicare Advantage plan is only as good as its list of hospitals and doctors. That list can change in the middle of the year if a contract ends. A few things help. People with a Medigap plan, including AARP ones, are not affected. If you are already getting treatment, special rules often let you keep your team for a while. And if your hospital is fighting with your plan, call the number on your card. Ask if your doctors are still covered. Ask if you can keep your current care. Before you shop this fall, check that your hospital and doctors are in your plan for next year.

Source: Becker's Hospital Review
Read at the source →

More news

Other stories on what is moving in Medicare.

Carriers & the market

Medicare Advantage Star Ratings Litigation Widens to at Least 10 Insurers as Open Enrollment Continues

Jefferson Health Plans, a university-affiliated plan in Pennsylvania, became among the latest to challenge CMS's 2027 rating methodology in court, joining a legal pileup that now spans plans of every size and type.

November 10, 2026

Carriers & the market

Humana Says 2027 Open Enrollment Is Ahead of Plan and Expects Medicare Advantage Membership to Grow

Weeks after non-renewal notices went out to members in dozens of exited markets, Humana told investors that early annual enrollment period data show better-than-expected retention and new sales, pointing to 2027 membership growth.

November 9, 2026

Carriers & the market

CVS Health Plans to Split Into Two Companies, Keeping Aetna and Caremark Together

The corporate parent of one of the largest Medicare Advantage insurers announced it will separate its insurance and pharmacy benefits arm from its retail drugstores by 2028, reversing roughly a decade of vertical integration.

November 5, 2026

Carriers & the market

Fairview Health Services Sued UnitedHealthcare for Listing It as In-Network in 2027 Medicare Advantage Plans After Exiting the Contract

A Minneapolis health system says UnitedHealthcare's open enrollment materials pointed current members to a provider directory that still included Fairview even after the system ended its contract. The case raises questions about directory accuracy during the annual enrollment window.

November 4, 2026

Carriers & the market

NewYork-Presbyterian and UnitedHealthcare Reach Another Extension, Keeping Medicare Advantage In Network Through November 30

The October 31 deadline passed without a permanent deal, but both sides agreed to extend in-network coverage one more month. With open enrollment running through December 7, New York-area beneficiaries who use NYP should watch whether a permanent agreement lands before year-end.

October 30, 2026

Carriers & the market

CVS Health Becomes Fifth Insurer to Sue CMS Over 2027 Medicare Advantage Star Ratings

CVS Health filed a federal lawsuit Monday challenging the methodology behind its 2027 Medicare Advantage star ratings, joining at least four other insurers in court after CMS released quality scores on October 8.

October 29, 2026