Doctors and hospitals across the country are ending their contracts with UnitedHealthcare at a notable pace, driven by a combination of low reimbursement rates, aggressive claim denials, and administrative practices that providers say make it harder to deliver care. The trend is hitting Medicare Advantage plans especially hard, but commercial plans are affected too.
Reimbursement That Doesn’t Cover Costs
The most common reason providers cite is straightforward: UnitedHealthcare isn’t paying enough to keep up with rising costs. Hospitals and physician groups negotiate reimbursement rates with insurers, and when those rates fall behind what it costs to actually deliver care, the math stops working.
Hartford HealthCare, a major Connecticut system, stated publicly that UnitedHealthcare’s offers “simply do not cover our cost increases, including salaries and benefits, medical supplies, drugs and vendor services.” The system warned that accepting those rates would hurt its ability to recruit and retain clinical staff. Prisma Health, a large system in South Carolina, disclosed that UnitedHealthcare’s last offer included less than a 0.3% increase for physician services in the first year and a 0.0% increase in the second year.
Commercial insurers typically pay providers above Medicare rates. Nationally, commercial prices for professional services average about 122% of Medicare rates. But that average masks enormous variation, and when a specific insurer pushes rates toward or below what Medicare pays, providers lose their financial incentive to stay in the network. For context, Medicare Advantage plans (which UnitedHealthcare dominates as the largest insurer) are funded by the federal government at Medicare-level rates, giving the insurer less room to offer competitive payments to providers while still maintaining profit margins.
Prior Authorization Denials Lead the Industry
UnitedHealth Group plans denied 12.8% of prior authorization requests in 2024, the highest rate among major Medicare Advantage insurers. For comparison, Elevance Health (which operates Anthem plans) denied just 4.2%. That gap is significant. It means UnitedHealthcare doctors and their staff spend more time fighting for approvals, resubmitting paperwork, and appealing decisions.
Here’s what makes those denials particularly frustrating for providers: when UnitedHealthcare’s own denials were reconsidered through the appeals process, 79.1% were reversed in the patient’s favor. In other words, nearly 4 out of 5 denied requests turned out to be medically appropriate after all. For doctors, this looks like a system designed to create delays and discourage claims rather than to identify genuinely unnecessary care. Every denied request that gets overturned on appeal represents hours of staff time spent on paperwork instead of patients.
Slow Payments and Unpaid Claims
Beyond denials, providers describe a pattern of payment delays and disputes that strain their operations. Prisma Health publicly accused UnitedHealthcare of “no-pay, low-pay and slow-pay tactics,” saying the insurer either denied out-of-network claims outright, paid significantly less than expected while telling providers to bill patients for the difference, or simply never responded to submitted claims. For a hospital system processing thousands of claims, unresolved payments create serious cash flow problems.
These payment disputes also create confusion for patients caught in the middle. Prisma Health noted that some patients in active cancer treatment or midterm pregnancy were unable to get responses from UnitedHealthcare about their continuity of care benefits during the contract standoff. When a provider leaves a network, patients with ongoing treatment are supposed to have protections that let them continue seeing their current doctors temporarily. Delays in processing those requests can disrupt critical care.
Major Health Systems Walking Away
The trend isn’t limited to small practices. Some of the country’s most prominent hospital systems have entered public disputes with UnitedHealthcare or moved toward leaving its networks entirely.
NewYork-Presbyterian, one of the nation’s top-ranked hospital systems, extended its contract through April 30, 2026, while negotiations continue. But if no agreement is reached, all NewYork-Presbyterian hospitals and medical group practices will become out-of-network for UnitedHealthcare commercial, Medicaid, and most Medicare Advantage members starting May 1, 2026. UnitedHealthcare has already excluded NewYork-Presbyterian from its individual family plans in New York State as of January 2026.
These aren’t small rural clinics with limited negotiating power. When systems of this size threaten to leave or actually leave a network, it signals that the financial terms have become untenable even for institutions with significant leverage.
Network Gaps Are Already Showing
As providers exit UnitedHealthcare networks, the insurer faces growing gaps in coverage. In Texas, UnitedHealthcare received approved waivers for network adequacy shortfalls across eight different plan types in 2024 alone, including its Choice, ChoicePlus, Core, and PPO products. Network adequacy waivers are regulatory approvals that insurers must seek when their provider networks don’t meet state-mandated standards for patient access. Eight waivers in a single state in a single year suggests the network is thinning faster than UnitedHealthcare can fill it.
For patients, thinner networks mean longer wait times, longer drives to see a specialist, and a higher chance of receiving care from an out-of-network provider. Out-of-network care costs Americans more than $40 billion annually, and before federal protections were strengthened, roughly 1 in 5 emergency claims included at least one surprise bill. The No Surprises Act now shields patients from the worst of these scenarios in emergency settings, but it doesn’t eliminate the inconvenience and cost of having fewer in-network options for routine and specialty care.
Why This Is Hitting Medicare Advantage Hardest
UnitedHealthcare is the largest Medicare Advantage insurer in the country, and Medicare Advantage is where the contract disputes are most intense. The reason is structural: Medicare Advantage plans receive fixed payments from the federal government, which limits how much insurers can offer providers. When hospital costs rise but government funding doesn’t keep pace, insurers like UnitedHealthcare face pressure to hold reimbursement rates down, and providers feel the squeeze most acutely.
At the same time, Medicare Advantage plans use tools like prior authorization more aggressively than traditional Medicare, which has no prior authorization requirement for most services. For doctors who treat a large number of Medicare-age patients, the combination of lower pay and higher administrative burden creates a strong incentive to drop the plan and see those patients through traditional Medicare instead, where payment is more predictable and paperwork is lighter.
What This Means If You Have UnitedHealthcare
If your doctor or hospital system drops UnitedHealthcare, you’ll likely receive a notice giving you time to find an in-network alternative or request continuity of care protections for ongoing treatment. In practice, the transition can be bumpy. You may need to switch providers, travel farther for care, or navigate an appeals process to keep seeing your current doctor temporarily.
If you’re on a Medicare Advantage plan, you have the option to switch to traditional Medicare during the open enrollment period (October 15 through December 7 each year) or during certain special enrollment windows. Traditional Medicare gives you access to any provider who accepts Medicare, which is the vast majority of doctors nationwide. The tradeoff is that traditional Medicare doesn’t cap your out-of-pocket costs the way Medicare Advantage does, so many people pair it with a supplemental Medigap policy.
If you’re on an employer-sponsored plan, your options are more limited. You can raise the issue with your employer’s benefits team, since large employers do switch insurers when network disruptions affect their workforce. Checking your plan’s provider directory regularly is worth doing, since network changes can happen mid-year when contracts expire.