A regional hospital system in Southwest Florida is walking away from one of the nation’s largest health insurers, and the fallout lands on patients’ calendars rather than in a courtroom. Lee Health’s hospitals and physicians will stop taking UnitedHealthcare’s employer, individual and Medicare Advantage plans once the year turns over, leaving households across Fort Myers, Cape Coral and the surrounding counties to sort out where they can get care starting in January. The rift traces back to a dispute over what gets paid and what gets denied.
Both UnitedHealthcare Contracts End December 31
Lee Health is terminating both of its agreements with UnitedHealthcare — the Hospital Participation Agreement and the Medical Group Participation Agreement — effective December 31, 2026, according to the health system’s own patient notice: “Lee Health is ending its hospital and physician contracts with UnitedHealthcare, effective December 31, 2026.” Beginning January 1, 2027, the notice states, Lee Health’s hospitals and physicians “will be out-of-network for affected UnitedHealthcare employer-based, individual, and Medicare Advantage plans.” Care scheduled on or before December 31, 2026 is unaffected, and Lee Health is telling patients with a 2027 appointment already booked not to cancel it before understanding their options.
Patients who keep seeing Lee Health providers after the cutoff without a special arrangement could see their bills change. The notice warns that patients relying on out-of-network benefits “may face higher out-of-pocket costs or other coverage limitations,” though federal law still requires emergency care regardless of network status. The scope is systemwide rather than limited to a single hospital: the notice’s own FAQ says “all Lee Health hospitals and physicians across every Lee Health location will be out of UnitedHealthcare’s network beginning January 1, 2027.” Asked why, Lee Health says only that it made the decision “after years of challenges that we believe affect our patients and our ability to serve the community,” and adds that it does not currently “see a path forward that would allow us to bridge our differences” with the insurer.
Inside the decision kit: A cost calculator spreadsheet comparing plans on cost, drugs and doctors, a prescription-by-plan comparison, a provider call script and the Open Enrollment calendar. Open The 2027 Medicare Open Enrollment Decision Kit.
Medicare Supplement Members Are Told They’re Untouched
Not every UnitedHealthcare-linked patient is affected. Buried in the notice’s frequently-asked-questions section is a direct answer for anyone holding a UnitedHealthcare or AARP Medicare Supplement — commonly called Medigap — alongside traditional Medicare: “This network change between Lee Health and UnitedHealthcare will not affect your Medicare Supplement coverage.” Lee Health says it will keep billing that supplement as secondary to Medicare exactly as it does now, so the contract termination has no bearing on coverage for patients who pair Original Medicare with a Medigap policy rather than a Medicare Advantage plan. The split is precise: Medicare Advantage members sit squarely inside the network change, while Medigap holders are carved out of it entirely, on the same notice page. A separate group falls outside the change for a different reason: UnitedHealthcare does not currently include Lee Health in its Affordable Care Act Exchange and Marketplace plans at all, so those enrollees are already out-of-network today, independent of the December 31 termination.
A $100 Million Dispute Over Denials and Payment
The split is rooted in money, not politics. In an open letter to patients reported by the healthcare trade outlet Becker’s Payer Issues, Lee Health said UnitedHealthcare owes the health system more than $100 million in disputed and underpaid claims, and that roughly one-third of its medical-necessity denials are linked to UnitedHealthcare’s Medicare Advantage plans. “Ultimately, Lee Health and UnitedHealthcare have fundamentally different priorities,” the letter said, arguing that Lee Health’s nonprofit mission is “guided by patient access, outcomes and community benefit,” while UnitedHealthcare “is a for-profit company with obligations to its global shareholders.” The letter identifies UnitedHealthcare’s authorization, review and denial processes as the specific mechanism behind the complaint, arguing those processes have slowed timely access to care for Lee Health patients enrolled in UnitedHealthcare plans. Lee Health said it raised these concerns with UnitedHealthcare over several years before deciding to end the contracts.
UnitedHealthcare Says the Notice Came Without Warning
UnitedHealthcare disputes that framing. A company spokesperson told Becker’s Payer Issues that the concerns Lee Health raised publicly had not been brought to the insurer beforehand, saying “Lee Health unexpectedly issued a notice to end our network relationship at the conclusion of our current contract without any advance notice or discussions.” The spokesperson said UnitedHealthcare remains willing to use the months left on the existing agreement for “productive conversations, rather than public threats that leverage patients.” As of Lee Health’s own notice page, unchanged as of today, no new agreement has been announced, and the December 31 termination date stands. Lee Health first notified patients of the planned termination in late August 2026, meaning both sides have had roughly four months to negotiate before the contracts actually lapse.
One Cardiology Group Stays In-Network, and Options Before January
The termination is not total. Florida Heart Associates, a Lee Health-affiliated cardiology practice, keeps its UnitedHealthcare contract: the notice states plainly that “these contracts are not included in the network change between Lee Health and UnitedHealthcare.” Patients whose care does fall under the change have two paths to check before January. UnitedHealthcare’s Continuity of Care process can preserve in-network rates temporarily for pregnancies, active cancer treatment and other complex care already underway, and Lee Health directs patients to call the number on their insurance card to ask about it. Medicare Advantage members can also compare in-network alternatives directly through the federal government’s Medicare Plan Compare tool, and Lee Health keeps its own running list of which health plans remain contracted at leehealth.org/insurancecoverage. Anyone who gets UnitedHealthcare coverage through an employer or a former employer’s retirement program is directed to check with human resources or the plan administrator, since group plans can offer choices individual enrollees do not have. Patients who switch physicians or hospitals entirely can still get their records: Lee Health says a new provider can request copies once a patient has made a selection.
The Medigap Carve-Out
Lee Health’s notice tells Medicare Advantage patients they are losing network access and Medigap holders they are not, but it does not walk either group through what to do with that information. It does not compare what a new Medicare Advantage plan would cost against the prescriptions a patient already fills or the specialists a patient already sees at Lee Health, and it does not lay out a calendar for tracking Open Enrollment against the December 31 cutoff.
The 2027 Medicare Open Enrollment Decision Kit is a 42-page decision kit built around a cost calculator spreadsheet that compares plans on cost, drugs and doctors, along with a provider call script for confirming whether a new plan actually keeps a Lee Health doctor in network.
Check the plan options against the Open Enrollment calendar in The 2027 Medicare Open Enrollment Decision Kit.
AI-assisted research and drafting; reviewed by an editor.
