UnitedHealthcare Medicare Advantage coverage update
Important information regarding UnitedHealthcare Medicare Advantage insurance
We want to make you aware of an important change coming soon to your UnitedHealthcare Medicare Advantage insurance coverage.
Beginning October 1, 2026, NKC Health will be out-of-network with UnitedHealthcare Medicare Advantage (UHC MA) plans (including AARP/Optum).
What does this mean for you?
- These changes will not impact your care at NKC Health until October 1, 2026, and you can continue to see your NKC Health providers as usual until then.
- Understand your plan and out-of-network benefits by calling the number on the back of your insurance card. Some plans may include out-of-network benefits that allow you to continue accessing your care at NKC Health after October 1, 2026, and may still help pay for care, even if it is out-of-network. Your coverage and costs will depend on your specific plan.
- Group Medicare Advantage plans - Employer-sponsored plans often have open access and cover care at out-of-network facilities. Patients with these plans may continue to be seen at NKC Health after October 1, 2026, but should still contact UHC to understand any out-of-pocket differences.
- PPO plans – These plans may be selected during a Medicare enrollment period and may have out-of-network benefits. Your cost sharing is often higher with out-of-network providers and may require prior authorization from your plan to continue care at NKC Health. You should contact your plan to understand your cost sharing and prior authorization requirements for care at NKC Health after October 1, 2026.
- HMO – POS plans – These plans are selected during a Medicare enrollment period and typically do not have out-of-network benefits. If you have this type of plan and seek care at NKC Health after October 1, 2026, you may be responsible for the entire bill. We recommend understanding your options for switching plans during Medicare’s annual enrollment period beginning on October 15, 2026 to continue receiving care at NKC Health.
- UnitedHealthcare Dual Complete – The Dual Eligible Special Needs Plans typically do not have out-of-network benefits. This plan will not be scheduled at NKC Health after October 1, 2026.
- Consider submitting a Continuity of Care (CoC) request to UHC if you have a qualifying condition which would allow you to continue treatment for 90 days at in-network benefits. All CoC requests should be sent to UHC and UHC is solely responsible for approving them.
Emergency care will always be available to you, regardless of our payer contract status.
What can you do to maintain access to NKC Health in 2027?
Talk to your broker about your options during the annual enrollment period (AEP) starting October 15. Switching to a Medicare Advantage plan we accept, or traditional Medicare can help you avoid higher out-of-pocket costs and ensure continued access to your preferred providers. NKC Health will accept the following plans in 2027:
- Medicare
- Humana Medicare Advantage
- Medicare Supplemental Plans
If you have additional questions, please contact (816) 691-1340.
This change was made with significant consideration and evaluation. By partnering with select Medicare Advantage plans, we can ensure that the plans we partner with truly support better outcomes, reduce unnecessary barriers and align with our mission of exceptional care.
A growing number of people in our communities are reaching Medicare age, making it even more important than ever that we have a sustainable, coordinated approach that allows us to provide the safe, seamless and personal care our patients deserve and that our clinicians want to deliver. By focusing on a smaller number of Medicare Advantage partners, we will be better positioned to meet the needs of our patients. Our partner plans share our commitment to providing an exceptional, personalized experience for our patients and rewarding providers who help patients improve their health, manage their chronic diseases and live healthier lives.
These changes will not impact your care at NKC Health until October 1, 2026, and you can continue to see your NKC Health providers as usual until then.
Understand your plan and out-of-network benefits by calling the number on the back of your insurance card.
No. As the number of Medicare beneficiaries participating in Medicare Advantage plans increases — alongside the growing variety of MA plans and products offered — healthcare providers nationwide face challenges. Medicare Advantage was once considered a reliable coverage option. Over time, denials, pre-authorization requirements, and administrative delays have created obstacles for patients. NKC Health continually evaluates all Medicare Advantage plans to ensure alignment with its mission of providing patients access to exceptional care.
This change was made with significant thought and consideration. By partnering with select Medicare Advantage plans, we can ensure that the plans we partner with truly support better outcomes, reduce unnecessary barriers, and align with our mission of exceptional care.
Changes should be made during the Medicare annual enrollment period, which is October 15 – December 7, 2026. These changes will be effective January 1, 2027.
Out-of-network refers to a healthcare provider who does not have a contract with a particular health insurance plan. If you use an out-of-network provider you will likely have higher out-of-pocket costs or have limited coverage, depending on your plan.
Original or traditional Medicare is healthcare operated and funded by the federal government. It is a health insurance program for ages 65 or older, or for younger people with certain medical conditions or disabilities that qualify under government rules. Typically, traditional Medicare pays for 80% of covered healthcare costs and patients pay the remaining 20%. Traditional Medicare does not cover most prescription drug costs or vision, dental, hearing, or long-term nursing home health needs.
Medicare Advantage plans are Medicare-approved plans from private companies offering an alternative to traditional Medicare for health and drug coverage. Medicare Advantage plans include Medicare-covered services and may include benefits not covered by Medicare, such as dental, vision, hearing, and alternative care. Medicare Advantage plans work to limit out-of-pocket costs while providing access to other essential health and wellness benefits.
Choosing a Medicare Advantage plan is a personal decision, and each patient needs to assess their unique health needs. To explore Medicare Advantage insurance options that are in-network for NKC Health:
- Talk to your broker about your options during the annual enrollment period (AEP) starting October 15th. Switching to an in-network Medicare Advantage plan or traditional Medicare will help you avoid higher out-of-pocket costs and ensure continued access to your preferred providers. NKC Health will be in-network with the following plans in 2026:
- Medicare
- Humana Medicare Advantage
- Medicare Supplement Plans
Yes. NKC Health will always be available to address emergency healthcare needs regardless of insurance.
Yes. You can call (816) 691-1340 if you have questions about the UHC MA change.