Nine community and county hospital systems have walked away from a Medicare Advantage contract with Humana, Aetna or UnitedHealthcare so far this year, according to a running tally kept by Becker’s Hospital Review plus one small-market system confirmed independently. For patients in a big metro area, that usually means driving to a different hospital across town. For patients in a smaller market, it can mean the nearest in-network hospital is now an hour or more away.
The Nine Systems and What They Dropped
Becker’s Hospital Review has tracked hospital-insurer Medicare Advantage breakups since 2023, and its running 2026 list, last updated August 31, includes several systems outside the major metro markets that usually dominate this kind of coverage. Kettering Health in western Ohio ended its contracts with Humana and Devoted Health Medicare Advantage plans on January 1. Montrose Regional Health in western Colorado did the same with Humana on the same date. St. Luke’s Health System in Boise, Idaho stopped taking Humana Medicare Advantage patients in network at the start of the year, and Tacoma, Washington-based MultiCare stopped contracting with any nongroup Medicare Advantage PPO plan in the Puget Sound region, also effective January 1.
Spartanburg Regional in South Carolina went out of network with Aetna on April 16 after payment-policy talks broke down. Avera Health in Sioux Falls, South Dakota ended its Aetna Medicare Advantage participation on December 31, 2025. And White River Health in Batesville, Arkansas and South County Hospital in South Kingstown, Rhode Island both lost Aetna Medicare Advantage coverage this year too, though their situations changed again over the summer, as explained below.
The ninth system fits the same pattern on a smaller scale. Iowa Specialty Hospitals and Clinics, based in Clarion, Iowa, told patients it would stop taking non-emergency care from most Medicare Advantage plans effective January 1, while continuing to accept only Aetna, Medigold, UnitedHealthcare and Wellmark Blue Cross Blue Shield going forward — meaning Humana Medicare Advantage dropped out of network. The hospital’s own current list of contracted insurers still shows Aetna and UnitedHealthcare, and Humana is absent, confirming the change has held. Main Street Dollars covered Iowa Specialty’s situation in more detail in a separate article on September 2.
Free retirement updates: Keep more of your Social Security and savings with plain-English updates on the changes, deadlines, and costly mistakes retirees miss. Subscribe free.
Why Hospitals Keep Walking Away From the Same Three Insurers
Becker’s reporting describes a consistent complaint across these breakups: hospitals say Medicare Advantage insurers are denying more prior-authorization requests and slow-paying the claims that do get approved, which pushes the cost of unpaid or delayed care onto the hospital. Kettering Health’s own announcement said it tried since May 2025 to resolve “significant issues with denials, reduced or non-payment” with Humana and Devoted Health before deciding not to renew. Montrose Regional Health and Spartanburg Regional cited similar administrative and payment disputes in their own public statements. It is not a story about one bad insurer; it is the same fight playing out with Humana, Aetna and UnitedHealthcare in different states.
When “Out of Network” Doesn’t Stay That Way
Two of the nine systems show that these breakups aren’t always permanent, which matters if you’re trying to figure out where your own coverage stands today. White River Health went out of network with UnitedHealthcare Medicare Advantage on April 1 after a contract dispute, but the two sides reached a new agreement two weeks later that put UnitedHealthcare Medicare Advantage patients back in network through December 31, 2026. White River Health’s split with Aetna, which took effect February 1, was not part of that deal and remains in place.
South County Hospital’s situation is similarly split. The hospital and Aetna restored in-network access effective June 1 for elective outpatient and surgical services only. Emergency department visits, inpatient stays, observation care and home health remain outside the deal, so an Aetna Medicare Advantage patient scheduling a knee replacement is covered, but the same patient showing up to the emergency room is not automatically covered the same way. Anyone with Aetna coverage in that area needs to ask which specific service they’re using before assuming their card will work.
What an Out-of-Network Hospital Actually Costs You
Medicare Advantage plans are required to cover emergency care, urgent care and temporary out-of-area dialysis regardless of network status, but routine, non-emergency care at an out-of-network hospital is a different story. Under most Medicare Advantage HMO and PPO designs, going outside the network for a non-emergency service means paying a higher share of the bill, and for some plans it means paying the full cost yourself, according to Medicare’s own plan network fact sheet. For 2026, federal rules cap what a Medicare Advantage plan can charge for in-network care at $9,250 out of pocket, and up to $13,900 combined for plans that blend in-network and out-of-network costs, according to KFF’s 2026 Medicare Advantage analysis. Those caps only apply if the plan covers out-of-network care at all; some designs, particularly HMOs, may not cover it beyond emergencies, leaving a household on the hook for the full hospital bill.
Checking Your Own Hospital Before the Fall Enrollment Window Opens
Medicare’s annual open enrollment period runs October 15 through December 7, and any change made during that window takes effect January 1. That’s the one chance most Medicare Advantage enrollees get each year to switch plans if their hospital has dropped their insurer, or to move to a plan their hospital still accepts, without waiting for a special circumstance to qualify. Because several of these breakups have already reversed in part, the safest step is not to rely on a list from earlier in the year. Each hospital listed here publishes its own current network status page, and calling the number on the back of a Medicare Advantage card will confirm whether a specific hospital, and a specific type of visit, is currently in network before enrollment decisions lock in for another year.
This article was produced with AI assistance and reviewed by a human editor. Figures are linked to their primary sources; where a claim could not be verified from the public record, we say so.
More Financial Reading
