UnitedHealthcare

What Patients Need to Know

UnitedHealthcare has notified Valley Heath that it rejects Valley Health's proposal to renew its contract for group and individual UnitedHealthcare Medicare Advantage plans past the current contract termination date of September 30, 2026. UnitedHealthcare has started notifying its Medicare Advantage members of this decision.

This comes at a time when hospitals and health systems are facing growing financial pressures caused by inflation and reimbursement reductions, particularly to Medicaid. These changes force health systems like Valley Health to make difficult decisions in order to protect essential services and preserve access to care for the communities we serve.

No changes are in effect today. Patients should continue to keep their appointments and access care as they normally would through September 30, 2026.

UnitedHealthcare Community Plan (Medicaid) members are not impacted. Valley Health and UnitedHealthcare reached an agreement to extend their Medicaid contract.

Who This Impacts

UnitedHealthcare offers several types of insurance plans. The potential impact depends on the type of UnitedHealthcare coverage a patient has. The list below can assist in determining if your plan will be impacted.

Impacted Plans

  • Medicare Advantage (MA) plans — both individual and retiree Medicare Advantage plans will become out of network beginning October 1, 2026, as UnitedHealthcare has rejected Valley Health’s proposal to renew its contract.

Plans Not Impacted

  • Medicare Supplement plans — Medicare Supplement plans, also known as Medigap plans, are not impacted. People enrolled in a UnitedHealthcare Medicare Supplement plan can continue to receive care at Valley Health with no changes in their coverage or out of pocket costs.
  • Commercial plans — coverage through an employer or purchased directly through the health insurance marketplace is not impacted.
  • Medicaid plans — coverage continues for patients with these plans:
    • UnitedHealthcare Community Plan
    • Cardinal Care 
  • Dual Special Needs Plans (D-SNP) — Dual Special Needs Plans are a form of a Medicare Advantage plan, with additional Medicaid coverage attached.  Patients with the D-SNP plans will not be impacted.
    • Please review your insurance card for the indication of “D-SNP” to determine if your plan qualifies.
  • Community Care Network for military veterans is not impacted. Coverage continues for these patients.

Coverage Options to Consider

  1. Impacted patients may qualify for Continuity of Care protections, which, if approved by UnitedHealthcare, allow you to continue seeing your Valley Health provider at in-network benefit levels. Continuity of Care applies to certain types of active treatment, such as scheduled surgeries or ongoing care for a serious or complex medical condition. The Medicare Advantage plan must approve Continuity of Care, so please call your UnitedHealthcare customer service number to request approval if you think you may qualify.
  2. There are certain situations, including significant disruptions in access to care, in which Medicare Advantage plan enrollees may be eligible for a Special Enrollment Period (SEP). During an SEP, enrollees can change Medicare Advantage plans or switch to Original Medicare. The new enrollment becomes effective on the first day of the month after the change is specified. SEPs must be approved by Centers for Medicare and Medicaid Services (CMS), and you can contact CMS at 1-800-MEDICARE (1-800-633-4227) to ask about this option.
  3. The Medicare Annual Enrollment Period (AEP), also known as Fall Open Enrollment, occurs annually from October 15 - December 7. During this period, beneficiaries can change Medicare Advantage plans or switch to Original Medicare. More information about the AEP can be found on Medicare’s website: www.medicare.gov/health-drug-plans/open-enrollment. Selections made during this year’s AEP become effective January 1, 2027. 
  4. Resources are available to help you understand and navigate these options. Each state has a State Health Insurance Assistance Program that provides free, unbiased, one-on-one Medicare counseling. In Virginia, you may access this assistance by calling 1-800-552-3402 or visiting this website: dars.virginia.gov/aging/home community/medicare-counseling/. In West Virginia, you may contact 1-877-987-4463.

Frequently Asked Questions

What is happening? 

UnitedHealthcare has notified Valley Health it rejects Valley Health's proposal to renew the contract for group and individual Medicare Advantage plans. The current contract will terminate on September 30, 2026. Valley Health and UnitedHealthcare reached an agreement to extend their Medicaid contract, so members of UnitedHealthcare’s Community Plans and Complete Dual Complete plans will not be impacted.  

Will emergency care still be available?

Yes. If you are experiencing a medical emergency, call 911 or go to the nearest emergency department. You will always have access to emergency care at Valley Health, regardless of your insurance network status.

What if I'm in the middle of a treatment plan?

State and federal continuity-of-care protections may allow some patients who are already receiving certain types of active treatment — such as pregnancy care, treatment for a serious or complex condition, scheduled surgery or ongoing treatment — to continue receiving care from Valley Health at in-network benefit levels for a limited period of time, even if Valley Health becomes out of network.

Because these protections depend on each patient’s plan and circumstances, patients should contact UnitedHealthcare directly and speak with their Valley Health provider’s office before making changes to their care.

Does this affect me right now?

No. Valley Health remains in network with UnitedHealthcare today, and no immediate changes are occurring. Patients should continue scheduling appointments and receiving care as normal through September 30, 2026. Continue to visit this web page frequently, as Valley Health will keep it updated with current information and guidance.

What does "out of network" mean?

When Valley Health becomes out of network with UnitedHealthcare, some members may not be able to access some services at Valley Health using their UnitedHealthcare health plans. Others may have higher out-of-pocket costs for services received through Valley Health. The impact can vary depending on your specific health plan and benefits and should be verified with UnitedHealthcare. You will always have access to emergency care at Valley Health, regardless of your insurance network status.

When would any changes take effect?

Group and individual Medicare Advantage plans will be out of network with Valley Health beginning October 1, 2026. 

Why are the organizations unable to reach an agreement? 

Valley Health is seeking a contract that supports continued access to high-quality healthcare in our communities and reflects the increasing costs associated with delivering care. Valley Health believes it is important that health insurance premiums are invested in patient care and local healthcare services.

What should I do if I have a scheduled appointment after October 1?

At this time, patients should make their decisions on appointments past October 1 based on information provided by UnitedHealthcare.  Some people will qualify for “continuity of care” services if approved by UnitedHealthcare.  Others may have out-of-network benefits they choose to use.  Questions on this should be directed to UnitedHealthcare.

 

Our Commitment to Patients

Valley Health was founded to serve our communities and remains committed to delivering safe, high-quality, compassionate care close to home. We are committed to keeping patients informed and helping them understand their options.

Myth: Valley Health is asking for unreasonable increases.

Fact: Valley Health has proposed an agreement that we believe fairly supports the cost of providing healthcare and maintaining access to local services.

 

Myth: This dispute is only about money.

Fact: Valley Health is also seeking to address issues that affect patient care, including administrative requirements, denials, delays, and other barriers that can impact access to medically necessary services.

 

Myth: Patients will immediately lose access to care.

Fact: Valley Health will be out of network for UnitedHealthcare group and individual Medicare Advantage plans effective October 1, 2026.  In some situations, continuity-of-care protections may allow patients already receiving active treatment to continue care with Valley Health at in-network benefit levels for a defined period. Because coverage varies by plan and circumstance, patients should contact UnitedHealthcare directly and speak with their Valley Health provider’s office before making decisions about their care.

 

Understanding the Claims You May Hear

Valley Health’s position is simple: this is about protecting access to high-quality care close to home and ensuring that a national insurance company fairly supports the local healthcare system its members rely on every day.

Valley Health is not seeking disruption for patients. We are seeking a fair agreement that reflects the cost of providing care, addresses administrative barriers that can delay care, and helps sustain the services our communities depend on.

 

Stay Informed

For the latest information:

  • Check this page regularly for updates.
  • Speak with your Valley Health provider's office about questions related to your care.
  • Call Valley Health customer service at 888-472-0045 with any additional questions.