Genesis HealthCare System in Zanesville, Ohio, sent a single notice this month naming four separate insurers at once: Aetna, UnitedHealthcare, Medical Mutual of Ohio and CareSource. All four Medicare Advantage contracts, plus a Medicaid managed-care agreement with CareSource, are set to end together unless new terms are reached before January 1, 2027. For any Genesis patient carrying one of those plans, the effect lands directly on the household budget: non-emergency care at Genesis hospitals and clinics could stop counting as in-network the moment the calendar turns, and the annual window to switch plans without penalty closes weeks before that date arrives.
Nine Thousand Denied Claims Behind the September Notice
Genesis says the break follows two years of rising denials and payment takebacks for care its own doctors had already ordered and delivered. The system is currently disputing roughly 9,000 active denials, which it says represents millions of dollars in unpaid care. “This was not our first choice but was our last resort,” said Matthew Perry, Genesis’ president and CEO, adding that the hospital system “will gladly renew” the contracts if the insurers agree to cover the care its doctors determine patients need.
The dispute covers Aetna’s, UnitedHealthcare’s and Medical Mutual of Ohio’s Medicare Advantage business, plus both CareSource’s Medicare Advantage and its separate Ohio Medicaid managed-care plan. Genesis’s own patient notice confirms the same timeline for all four: contracts stay in force through December 31, 2026, and lapse on January 1, 2027, if no agreement is reached first.
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What Stays the Same Through the End of the Year
Nothing changes for patients today. Coverage under all four plans continues at current terms through December 31, and emergency care is always covered at the in-network rate regardless of what happens with the contracts. Commercial, employer-sponsored insurance is not part of the dispute, and traditional Medicare Supplement, or Medigap, policies are unaffected entirely. The break is confined to Medicare Advantage business and, for CareSource specifically, its Medicaid managed-care line.
This is not Genesis’s first fight over a Medicare Advantage network. In an October 2023 notice, Genesis dropped Anthem and Humana Medicare Advantage plans for 2024 over similar terms, while keeping Aetna, UnitedHealthcare, Medical Mutual and CareSource in-network. Those same four carriers, kept in that earlier round, are the ones now facing the December 31 deadline — a system moving against every Medicare Advantage insurer it has left, on one shared date, rather than dropping one at a time.
What Out-of-Network Status Would Mean for a Medicare Advantage Bill
Medicare Advantage plans generally pay in-network providers at a negotiated rate and cover emergency care everywhere at that same in-network rate, but non-emergency care from an out-of-network hospital or doctor typically costs a plan member more, and some plan types don’t cover it at all outside emergencies. If Genesis becomes out-of-network with Aetna, UnitedHealthcare or Medical Mutual of Ohio on January 1, a member who keeps seeing a Genesis doctor for a routine visit, a scheduled procedure or an ongoing prescription could face a larger share of the bill, or a denied claim, depending on the plan’s specific rules. That is the household-budget stake behind the contract dispute: not a change in premium, but a change in what a plan will actually pay for care at a hospital system a family may have used for years.
The CareSource Medicaid Wrinkle Most of These Notices Don’t Have
Because CareSource also administers Ohio Medicaid managed care for many Genesis patients, the notice creates a second track that Medicare Advantage members don’t share. Medicaid enrollees are not locked into an annual enrollment calendar the way Medicare beneficiaries are; Ohio Medicaid managed-care members can change plans if their preferred hospital system goes out of network. Genesis has pointed CareSource Medicaid patients toward Ohio’s Medicaid consumer hotline to make that switch if the January 1 date arrives without a new contract in place, since the process and timeline differ from the Medicare side entirely. A household with one member on CareSource Medicaid and another on a CareSource Medicare Advantage plan would therefore be working two different clocks and two different sets of rules to stay covered at the same hospital.
A Six-Week Window Closes Before the Contracts Do
Medicare’s Annual Enrollment Period runs October 15 through December 7 every year, the one stretch when most Medicare Advantage members can join, drop or switch a plan, or move back to Original Medicare, without a qualifying life event. Any change made in that window takes effect January 1 — the same date the Genesis contracts would lapse — which means a Genesis-area household waiting to see whether a deal gets done risks missing the deadline to act on it. CMS notes that beneficiaries should compare their plan’s Annual Notice of Change against their actual doctors and hospitals each year, a step that matters more than usual for anyone on Aetna, UnitedHealthcare, Medical Mutual or CareSource Medicare Advantage in the Zanesville service area this fall.
As of this writing, no new agreement between Genesis and any of the four insurers has been reported. Genesis has said it will share updates as discussions continue and has committed to not billing patients directly for amounts it believes an insurer is responsible for covering, but the contracts remain on track to end at the turn of the year absent a settlement. For a Zanesville-area household weighing whether to wait out the negotiation or shop for a different plan this fall, that lack of resolution is itself the relevant fact: the safer assumption, at least for now, is that all four contracts end on schedule.
When a Local Hospital’s Network Status Becomes Part of the Plan Math
Genesis’ notice adds a variable that a plan’s premium and drug list don’t capture on their own: whether the hospital and doctors a household already uses will still be in-network next year. Comparing Medicare Advantage options during the Annual Enrollment Period usually means checking cost and prescription coverage side by side, but Zanesville-area households also have to weigh a contract dispute that was still unresolved as insurers finalize 2027 plan details. That comparison gets harder when four insurers are moving on the same clock and a fifth relationship, CareSource Medicaid, follows a completely different set of rules.
The 2027 Medicare Open Enrollment Decision Kit is a 42-page decision kit that includes 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.
Read The 2027 Medicare Open Enrollment Decision Kit to compare plan networks and costs.
AI-assisted research and drafting; reviewed by an editor.
