CarolinaEast Medical Center has struck a last-minute truce with UnitedHealthcare that keeps United Medicare Advantage members in-network through Dec. 31, 2026, even as the hospital pulls its facility out of network for Blue Cross Blue Shield Medicare Advantage plan holders starting Wednesday. The split move spares United members from immediate upheaval but leaves many local seniors staring at higher bills or longer drives for routine, non-emergency care. Hospital officials say emergency treatment will remain in-network and that care with CarolinaEast Physicians will not be interrupted by the change.
What the deal means for patients
CarolinaEast confirmed a short-term extension with UnitedHealthcare that keeps United Medicare Advantage members in-network through Dec. 31, 2026. Local insurance agent Kimberly Krauss said she was relieved, while a Blue Cross Medicare Advantage enrollee told reporters he now plans to travel to Raleigh for knee replacement surgery because his plan remains out-of-network. CarolinaEast told the station that emergency services will remain in-network and that CarolinaEast Physicians are not affected, according to WITN.
Blue Cross members left out
Blue Cross and Blue Shield of North Carolina says CarolinaEast will no longer accept Blue Medicare Advantage at its hospital beginning Wednesday, and warns members they may face higher out-of-pocket costs for non-emergency care. The insurer has posted tools and resources to help members find in-network facilities and recommends calling the customer service number on the back of the ID card for assistance. Blue Cross also notes that CarolinaEast Physicians remain in-network even though the hospital facility will be out-of-network, per Blue Cross NC.
Why CarolinaEast pulled the plans
CarolinaEast announced in May that it intended to end in-network participation with Medicare Advantage plans from both Blue Cross and UnitedHealthcare, arguing that "burdensome payment policies, denials and reimbursement delays" had made continued participation financially and operationally unsustainable, as reported by Becker's. The termination notices applied to the hospital facility only, and the system said CarolinaEast Physicians and emergency services would not be affected, per CarolinaEast's patient pages.
Practical next steps for patients
Insurance agents and hospital spokespeople tell affected Medicare Advantage members to check their plan rules, call their insurer and ask about prior authorizations or continuity-of-care protections. Seniors can also contact the State Health Insurance Assistance Program or 1-800-MEDICARE for free counseling, and some agents suggested assessing supplement options if plans no longer cover preferred hospitals. Those suggestions were relayed in local reporting on the dispute, according to WITN.
Where this fits in a bigger fight
CarolinaEast's move fits a broader pattern of health systems pushing back against Medicare Advantage plans over prior authorization requirements and payment disputes, a trend that has disrupted access at other systems across the state. Hospitals and trade outlets warn that because Medicare Advantage now covers a large and growing share of beneficiaries, these contract fights can quickly affect access to care for many patients; Becker's reports the program covers roughly 55% of eligible Medicare beneficiaries. Officials on both sides say talks could resume, and patients should monitor statements from the hospital and their insurers.
