The Healthcare System Medicare Advantage Could Be Dropping Soon

Some Medicare Advantage beneficiaries are facing a potential 2026 Medicare upheaval. UnitedHealthcare may drop NewYork-Presbyterian, a major health network serving the New York metropolitan area, from its covered networks within Medicare Advantage as early as January 1, 2026, according to a statement on the network's website. 

UnitedHealthcare is the largest health insurance company in the U.S., with considerable power in negotiations. UnitedHealth Group, the company's owner, is one of the largest companies in the world. Still, the rising costs of Medicare Advantage have caused clashes between the insurer and health networks like NewYork-Presbyterian. 

There is still time for UnitedHealthcare and NewYork-Presbyterian to resolve issues and decide on agreement terms to keep Medicare Advantage coverage the same for 2026. But if the parties fail to reach an agreement, Medicare Advantage seniors may be forced to find new doctors within other covered networks. A dozen hospitals and health care organizations, as well as thousands of seniors under Medicare Advantage, would be impacted by this development. Changes are already pending for Medicare Advantage plans in 2026, but if continued covered care can't be found for those who rely on NewYork-Presbyterian, out-of-network costs may need to be forked over for care with the same providers. This may instill looming financial dread among patients managing mounting health care costs.

Notably, UnitedHealthcare hasn't confirmed that the decision to drop NewYork-Presbyterian has been finalized. In comments made to CBS News, United Healthcare stated that it's still possible to work through the issues. Even though UnitedHealthcare notified members about the potential drop of NewYork-Presbyterian in October 2025, insurance company representatives said (via CBS News), "Our goal is to reach an agreement that is affordable while maintaining continued network access to NYP. However, should NYP leave our network, we will work with our Medicare Advantage members to ensure they have access to the care they need through continuity of care or a smooth transition to another provider, as appropriate."

While it may seem hopeful that a balance will be struck, NewYork-Presbyterian seems to contradict this message. The health network announced that "UnitedHealthcare (operating in New York State collectively as UnitedHealthcare, Oxford Health Plans, and Sierra Health and Life Insurance Company) has made the decision to exclude NewYork-Presbyterian from their Medicare Advantage network starting January 1, 2026." The website goes on to highlight all facilities impacted by UnitedHealthcare's decision.

While UnitedHealthcare and NewYork-Presbyterian are publicly at odds with each other, there is not much left for Medicare Advantage members impacted to do except worry and wait. It can help to research other, similar clashes between UnitedHealthcare and networks like Johns Hopkins and Capital Women's Care. Recently failed contract negotiations can highlight some reasons why battle lines get drawn between insurance companies and health care providers. However, patients may have more than enough research to do while hunting for covered health care.

Cancer patient Judy Losasso, 81, is in remission but worried about her health care future. The UnitedHealthcare and NewYork-Presbyterian clash could mean she is separated from her health care team. "It's not fair. It's not fair what the hospital and the insurance companies are doing," Losasso told CBS News. Patients like Losasso may reconsider their own Medicare plans, splitting differences between Medigap and Medicare Advantage. Paying full out-of-network costs may be impossible for many impacted seniors, and hunting for all-new health care may be exhausting.

UnitedHealthcare and another insurance company have already ditched Medicare Advantage in two states because profitability would not remain high enough to offer Medicare Advantage. According to an NPR report, UnitedHealthcare may also want to ditch the company's Medicare Advantage ties due to a Department of Justice probe exploring whether it had fraudulently made money off of Medicare Advantage. If UnitedHealthcare ditches NewYork-Presbyterian, it will add more weight onto the shoulders of Americans who rely on Medicare.