UnitedHealthcare Medicare Advantage Service Area Reductions for 2026: What Providers Need to Know
- Modern Medical Billing
- 2 days ago
- 4 min read
UnitedHealthcare has announced that it will reduce some Medicare Advantage service areas and discontinue certain plans effective January 1, 2026. Many of your current Medicare Advantage patients may receive letters about these changes, and they’ll likely turn to your office with questions.
This article breaks down the key points from UnitedHealthcare’s 2026 FAQ and offers practical guidance on how your practice can respond and stay organized.
What Is Changing for 2026?
Each year, UnitedHealthcare reviews its Medicare Advantage (MA) plans and service areas to decide where it will continue or discontinue offerings. For plan year 2026, UnitedHealthcare has decided to:
Reduce some service areas, and
Discontinue some Medicare Advantage plans entirely, starting Jan. 1, 2026.
This means that in certain states and counties, specific plans that exist today will not be available next year.
Which Plans Are Affected?
The FAQ makes it clear that there is no single list that applies nationwide. Instead:
The affected plans vary by state and county.
To see which plans will be available in 2026, UnitedHealthcare directs providers to:
UHCprovider.com/plans → select location → Medicare → plan name → Tools and Resources → Medicare Advantage Benefit Plan Names.
Practically, this means your office may see different impacts at each practice location, depending on the counties you serve.
How Will Members Be Notified?
UnitedHealthcare will send non-renewal notices dated Oct. 2, 2025 to impacted members.
Those letters will explain:
That their current plan will not be offered in their county for 2026
Whether other UnitedHealthcare MA options are available in their service area
That plan choices may be more limited in 2026 in some markets
The member’s Special Election Period (SEP) and other coverage options (Medicare Advantage, Medigap, and/or Part D, as applicable).
Your front desk and billing staff should expect an increase in questions once these letters go out.
Does This Change Provider Participation Agreements?
Short answer: no.
UnitedHealthcare states clearly that these changes do not affect your participation agreement as a contracted health care professional for UnitedHealthcare Medicare Advantage plans.
Even though some plans and service areas are ending, UnitedHealthcare continues to offer network-based MA plans, so your existing contract remains in force.
What Happens If a Member Doesn’t Choose a New Plan?
Members have choices—and important deadlines.
During Annual Election Period (AEP)
For 2026 coverage, an impacted member who wants to enroll in another Medicare Advantage plan can do so:
Between Oct. 15, 2025 and Dec. 31, 2025
For a Jan. 1, 2026 effective date,by completing a new enrollment form.
If They Do Nothing
If a member does not enroll in another MA plan:
They will automatically return to Original Medicare on Jan. 1, 2026.
Special Election Period (SEP)
Members who return to Original Medicare on Jan. 1, 2026 but still want a Medicare Advantage plan will have a Special Election Period:
They can enroll in another MA option until Feb. 28, 2026.
Your staff may need to help patients understand that a gap or change in coverage could affect their cost-sharing, network access, and benefits.
Part D (Prescription Drug) Implications
If a discontinued Medicare Advantage plan included Part D prescription drug coverage, the member will also lose Part D benefits in 2026 unless they enroll in another MA-PD plan or a standalone Part D plan.
From a practice standpoint, that means:
Some patients may arrive in January with different drug coverage or formularies,
Others may unintentionally have no Part D if they don’t make a new election in time.
Encourage patients to review their medication coverage when choosing a new plan.
Where Can Members Get More Information?
The FAQ directs members to two main resources:
UnitedHealthcare Customer Service
Phone number on the back of their member ID card
Phone number listed in their non-renewal notice
For comparing available plans and reviewing 2026 coverage options
As a provider, you can also use the UnitedHealthcare Provider Portal (including chat) and the Contact Us page for additional questions.
Practical Tips for Your Practice
To stay ahead of these 2026 changes, your office can:
Flag UnitedHealthcare MA patients in your practice management system so staff know who may receive non-renewal letters.
Remind patients to open and read any mail from UnitedHealthcare or Medicare this fall.
Encourage patients to review their options during AEP (Oct. 15–Dec. 31) so coverage doesn’t lapse.
Train front desk and billing staff with a simple script, such as:
“Yes, UnitedHealthcare is making updates to some Medicare Advantage plans for 2026. Your letter will explain your options, and for plan details you can call the number on your card or visit Medicare.gov. We’ll continue to verify your coverage before each visit.”
Keep your eligibility verification and benefits checks tight in January–February, since many patients will be changing plans.
How Modern Medical Billing Can Help
Changes like these add extra workload to already busy practices. Modern Medical Billing helps providers:
Navigate payer changes and annual plan shifts
Perform accurate eligibility and benefits checks for Medicare Advantage patients
Reduce denials and rework when plans terminate or change mid-year
Keep A/R follow-up and posting accurate when members switch products or revert to Original Medicare
If you’d like support preparing your billing workflows for the 2026 Medicare Advantage landscape, we can help you put a process in place that protects both your practice and your patients.
📧 Email: info@providersbilling.com 🌐 Website: www.modernmedicalbilling.com
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