Florida Doctors and the 2027 UnitedHealthcare Split: A Guide

An internist in Cape Coral opened her schedule last week to find three new-patient requests from people she had never met, each one a UnitedHealthcare Medicare Advantage member who had been told that Lee Health would be out of network on January 1. She has room for one of them. The other two will call the next independent office on the list, because the largest health system in Lee County and the largest Medicare Advantage insurer in the country have stopped talking.

Lee Health is not alone. Sarasota Memorial Health Care System and its First Physicians Group expect to leave UnitedHealthcare’s Medicare Advantage network on the same date. AdventHealth, whose contract UnitedHealthcare itself terminated, goes out of network across every Florida location on January 1 unless a new agreement is signed. University of Miami Health System is already out of network for most UnitedHealthcare Medicare Advantage plans. Medicare open enrollment began on October 15 and runs through December 7, so the patients caught in these disputes are choosing their 2027 plans right now, and many will ask a physician what to do.

What Happened

On August 26, Lee Health notified UnitedHealthcare that it would end both its hospital participation agreement and its medical group participation agreement on December 31, 2026. Beginning January 1, Lee Health hospitals and Lee Physician Group physicians will be out of network for UnitedHealthcare employer-based, individual, and Medicare Advantage plans. WINK News has reported that roughly 50,000 Lee Health patients could be affected, and in an October 12 investigation the health system put UnitedHealthcare’s unpaid and underpaid claims at an estimated $150 million. UnitedHealthcare says the notice was unexpected, that it has reached out to Lee Health leadership several times, and that Lee Health is using patients as a bargaining tool in a dispute tied to the system’s out-of-network status for the insurer’s individual exchange plan.

Sarasota Memorial’s Medicare Advantage agreement with UnitedHealthcare, signed in 2023 for a three-year term, also expires December 31. On September 25, First Physicians Group’s chief medical officer, Dr. Jack Rodman, wrote to the group’s physicians that the system expected to be out of network on January 1. Sarasota Memorial says UnitedHealthcare is changing contract provisions that protected members from delayed or denied care. UnitedHealthcare says the system is seeking price increases. The commercial and exchange contracts expire the same day, and the system has said it is more optimistic about renewing those.

AdventHealth’s case is different in one respect: UnitedHealthcare terminated that contract. AdventHealth says it is not seeking rate increases above inflation and wants terms that address delays, denials, and prior authorization. Every AdventHealth clinician and service in Florida would be out of network for UnitedHealthcare Medicare Advantage, exchange, commercial, and Medicaid plans on January 1 without a new deal.

Why It Matters for Florida Physicians

Becker’s Hospital Review counted 34 health systems that have ended or are ending Medicare Advantage relationships in 2026, twelve of them with UnitedHealthcare. Florida has four of the largest. It is tempting to treat this as a hospital story, a billing fight between two institutions with legal departments. That misses where the patients go. They go to the independent physician down the street, who is still in network, who did not negotiate any of this, and who now inherits a panel of displaced Medicare Advantage patients with the same prior authorization requirements the hospital systems found intolerable.

The complaint behind every one of these terminations is the same. Lee Health has said that about one third of its denials come from UnitedHealthcare and that most are overturned on appeal. A KFF analysis cited in the Sarasota coverage found UnitedHealthcare denied 17 percent of Medicare Advantage prior authorization requests in 2025, the highest of six insurers studied, with roughly 60 percent of appealed denials overturned. The HHS Office of Inspector General reported in June that the three largest Medicare Advantage organizations denied long-term acute care and inpatient rehabilitation requests at some of the highest rates among 19 plans reviewed, and that plans overturned 36 percent of long-term care denials and 43 percent of rehabilitation denials on appeal. A denial that is reversed on appeal was not a medical judgment. It was a delay, and the cost of the delay fell on the physician’s staff and the patient.

Hospital systems can absorb that cost or walk away. A three-physician practice in Fort Myers or Venice cannot walk away from UnitedHealthcare without losing a large share of its Medicare patients. The bargaining power in this market belongs to whoever can afford to leave, and that has never been the independent physician.

What Florida Physicians Should Do Now

1. Pull a list of your UnitedHealthcare Medicare Advantage, commercial, and exchange patients and sort it by whether their specialists, surgeons, or hospital of record sit inside Lee Health, Sarasota Memorial, AdventHealth, or UHealth. Those are the patients whose referrals break on January 1, and they should hear it from you before December 7.

2. Identify every patient in active treatment with one of the departing systems, including anyone pregnant, mid-chemotherapy, awaiting surgery, or in a course of dialysis or rehabilitation, and tell them to apply to UnitedHealthcare’s Continuity of Care program now. UnitedHealthcare accepts applications until 30 days after a provider leaves the network, but approval is case by case, so an application filed in October is better than one filed in January.

3. Know the Florida backstop for state-regulated HMO patients. Section 641.51(8), Florida Statutes, requires an HMO to cover continued treatment with a terminated provider through completion of the current course of care, until the subscriber picks a new provider or the next open enrollment, whichever is longer, up to six months, and through postpartum care for any patient who began prenatal care. That statute governs Florida HMO contracts and not federal Medicare Advantage plans. None of this constitutes legal advice, so a practice with a contested continuity case should have its health care counsel read the plan documents before it bills.

4. Decide now how many displaced patients your practice can take, and tell your front desk the number. A new patient who arrives with an open prior authorization from a departing system will need that authorization restarted under your name in January.

5. Update your referral directory before the new year. A referral to a Lee Physician Group cardiologist or a First Physicians Group endocrinologist for a UnitedHealthcare patient becomes an out-of-network referral on January 1, and Lee Health says it has had limited success obtaining out-of-network authorizations from insurers without a contract.

6. Report what you see. The Florida Medical Association and your county medical society should be collecting denial, appeal, and overturn data from independent practices, the same data these hospital systems used in their negotiations, so there is something to bring to the Office of Insurance Regulation and to CMS.

The Bigger Picture

Three weeks ago we reported that Florida loses 51 Medicare Advantage plans for 2027. This is the other half of that story. The plans that remain are shedding the hospital systems that argued with them, and many of the 5.3 million Floridians on Medicare are being asked to choose between a plan and a hospital during a seven-week enrollment window. The physician in the middle has one thing neither party at the negotiating table has, which is the trust of the patient in the room. Use it to send that patient to a SHINE counselor, to the Continuity of Care application, and to a plan that still includes the surgeon she needs. Then write down what it cost your practice, because the next contract fight in this state will be decided by whoever brings the better records.

For more on UnitedHealthcare and Medicare Advantage in Florida, see our coverage of the 51 Medicare Advantage plans Florida is losing for 2027, UnitedHealthcare’s October 1 prior authorization change and the proposed Medicare Advantage directory rule. All of our reporting on this subject is collected in our guide to Medicare and payer changes for 2027.

Frequently Asked Questions

Which Florida health systems are leaving UnitedHealthcare in 2027?

Lee Health has ended its hospital and medical group agreements effective December 31, 2026, and will be out of network for UnitedHealthcare employer-based, individual, and Medicare Advantage plans on January 1, 2027. Sarasota Memorial Health Care System and First Physicians Group expect to leave the UnitedHealthcare Medicare Advantage network on the same date. AdventHealth’s Florida locations go out of network on January 1 unless a new agreement replaces the one UnitedHealthcare terminated, and University of Miami Health System is already out of network for most UnitedHealthcare Medicare Advantage plans.

Are Medicare Supplement patients affected by the Lee Health and UnitedHealthcare split?

No. Lee Health and UnitedHealthcare both say Medicare Supplement plans through United or AARP are not part of the dispute. Those patients keep access because Original Medicare pays first and the supplement pays second, regardless of network status.

What is UnitedHealthcare’s Continuity of Care program and who qualifies?

It is the insurer’s process for letting members in active treatment keep seeing a departing provider at in-network rates for a limited period after the contract ends. UnitedHealthcare lists pregnant members and members receiving complex treatment or critical care for a chronic illness as examples, reviews each application individually, and accepts applications until 30 days after the provider leaves the network. Patients apply by calling the number on their member card.

Does Florida law require continuity of care when a physician leaves a health plan network?

For state-regulated HMOs, yes. Section 641.51(8), Florida Statutes, requires the HMO to cover continued treatment with the terminated provider through completion of the course of care, up to six months after the contract ends, and through postpartum care for a patient already receiving prenatal care. Medicare Advantage plans are governed by federal rules and the plan’s own continuity process rather than by that statute.

When does Medicare open enrollment end for 2027 coverage?

The annual enrollment period runs from October 15 through December 7, 2026. A Medicare Advantage member who wants a plan that includes Lee Health, Sarasota Memorial, or AdventHealth must change plans in that window, and SHINE counselors through the Florida Department of Elder Affairs offer free help comparing options.

This article was drafted with the assistance of AI writing tools, then reviewed, edited, and approved by Dr. Sean C. Orr, M.D., who holds full editorial responsibility for its content. The header illustration was created with AI image tools.

References

1. Lee Health, “UnitedHealthcare Insurance Plan Notice” (patient FAQ on the December 31, 2026 contract termination). leehealth.org
2. UnitedHealthcare, “Network Negotiations with Lee Health,” updated October 6, 2026. uhc.com
3. WINK News, “Lee Health ending contracts with UnitedHealthcare starting in 2027,” August 26, 2026. winknews.com
4. WINK Investigates, “Geographic monopoly amplifies fallout as Lee Health and UnitedHealthcare split,” October 12, 2026. winknews.com
5. WINK News, “UnitedHealthcare launches FAQ page as Lee Health patients prepare for 2027 coverage changes,” October 8, 2026. winknews.com
6. West Villages Sun (via InsuranceNewsNet), “SMH, UnitedHealthcare wrangle over coverage,” October 12, 2026. insurancenewsnet.com
7. AdventHealth, “UnitedHealthcare Contract Update” (patient FAQ). adventhealth.com
8. WFTV, “UnitedHealthcare members face loss of in-network access to AdventHealth in 2027,” September 25, 2026. wftv.com
9. Becker’s Hospital Review, “34 health systems dropping Medicare Advantage plans,” September 22, 2026. beckershospitalreview.com
10. HHS Office of Inspector General, “The Three Largest Medicare Advantage Organizations Denied Requests for Long-Term Acute Care and Inpatient Rehabilitation at Some of the Highest Rates,” OEI-09-24-00330, June 2026. oig.hhs.gov
11. Florida Statutes, Section 641.51(8), continuity of care after provider contract termination. leg.state.fl.us
12. Florida Trend, Daily Pulse, October 15, 2026, citing Orlando Sentinel coverage of 2027 Medicare drug coverage changes for 5.3 million Florida enrollees. floridatrend.com