If you’re on a UnitedHealthcare Medicare Advantage plan and get your care through Lee Health, there’s a change coming that could affect where you can go for care starting in 2027 — and the window to do something about it during this year’s enrollment period is closing fast.
What’s Actually Happening
Lee Health, Southwest Florida’s largest hospital system, is ending its contract with UnitedHealthcare effective December 31, 2026. Starting January 1, 2027, Lee Health’s hospitals and physician practices — including Lee Memorial Hospital, Cape Coral Hospital, Gulf Coast Medical Center, HealthPark Medical Center, and Golisano Children’s Hospital of Southwest Florida — will be out-of-network for UnitedHealthcare members, including those on UnitedHealthcare Medicare Advantage plans. Lee Health has said it does not currently see a path forward to restoring the relationship.
Why the Two Sides Are Splitting
According to Lee Health, the split comes down to years of disagreement over how UnitedHealthcare handles prior authorizations and claim denials, which the health system says delay patient care. Lee Health has pointed to more than $100 million in claims it considers disputed or underpaid, with roughly a third of its medical necessity denials tied specifically to UnitedHealthcare Medicare Advantage plans. UnitedHealthcare, for its part, has said Lee Health ended the relationship without advance notice. Whoever’s account you find more convincing, the practical result for patients is the same: starting in January 2027, Lee Health won’t be an in-network option for UnitedHealthcare members.
Why This Matters Now, Not in January
It’s tempting to file this away as a “next year” problem since the network change doesn’t take effect until January 1, 2027. But Medicare’s Annual Enrollment Period — the window when you can actually change your Medicare Advantage plan — runs October 15 through December 7, 2026, and any change you make takes effect January 1. In other words, the deadline to do something about this arrives weeks before the network change itself does. Wait until January to see how it plays out, and the enrollment window to switch will already be closed — leaving you out-of-network at Lee Health for the rest of the year.
What This Means If You’re a UnitedHealthcare Medicare Advantage Member
If you currently see Lee Health providers, or would want access to Lee Memorial, Cape Coral Hospital, Gulf Coast Medical Center, HealthPark, or Golisano Children’s in an emergency, you have a decision to make before December 7: stay on your current UnitedHealthcare Medicare Advantage plan and accept that Lee Health will be out-of-network starting in 2027, or switch to a different Medicare Advantage plan — or Original Medicare plus a Medicare Supplement — that keeps Lee Health in-network. Emergency care is generally still covered regardless of network status, but planned care, specialists, and ongoing treatment are a different story.
How Burke Insurance Group Can Help
This is exactly the kind of situation an independent agent is useful for. We’re not tied to UnitedHealthcare or any single carrier, so we can show you which Medicare Advantage plans in your area keep Lee Health in-network, or walk through whether Original Medicare plus a supplement makes more sense for your situation. There’s no cost to you for a consultation, and no obligation. Reach out before December 7 so you have time to make a change if you need one.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
