Thousands of Southwest Florida patients covered by UnitedHealthcare could lose in-network access to Lee Health hospitals and physicians starting Jan. 1, 2027, as a billing dispute between the two organizations continues. Lee Health has notified patients that affected employer-based, individual and Medicare Advantage plans will be treated as out-of-network beginning that date, while the two sides continue negotiating.
The standoff dates back to August 2026, when Lee Health first signaled it intended to drop UnitedHealthcare as an in-network provider, according to Gulf Coast News and Weather. Lee Health has cited what it describes as $150 million in unpaid claims as a root of the conflict, per the outlet's reporting. On its own website, Lee Health confirms the Jan. 1, 2027 cutoff: “Beginning January 1, 2027, Lee Health hospitals and physicians will be out-of-network for affected UnitedHealthcare employer-based, individual, and Medicare Advantage plans,” according to Lee Health.
Not every UnitedHealthcare patient would be affected the same way. Lee Health says it will keep billing United or AARP Medicare Supplement coverage as secondary to traditional Medicare after the network split, meaning those with supplement plans tied to original Medicare may see no disruption. Lee Health also says some patients in active treatment may be able to keep seeing its providers at in-network rates for a limited time through a continuity-of-care process, with UnitedHealthcare determining eligibility. Other patients may still be able to receive care using out-of-network benefits, but could face higher out-of-pocket costs.
Who May Qualify for Transitional Care
CMS says a qualifying continuing-care patient covered by a plan subject to the No Surprises Act may elect transitional care only until the earlier of 90 days after notice of a network-status change or the point when the patient no longer qualifies as a continuing-care patient. CMS also clarifies that the Act’s continuity-of-care requirements do not apply to Medicare enrollees, so they should not be presented as the protection for UnitedHealthcare Medicare Advantage members in this dispute, according to CMS.
A Last-Minute Offer, and a Rejection
The dispute has not been for lack of trying on either side. UnitedHealthcare told WINK News it sent Lee Health a new proposal on Oct. 30 aimed at preserving long-term network access for commercial and Medicare Advantage members, according to WINK News. The insurer also said its commercial and Medicare Advantage members would retain network access to Lee Health through Dec. 31, 2026, regardless of how talks proceed.
Lee Health was not satisfied with the offer. “UnitedHealthcare’s latest proposal does not address the longstanding concerns Lee Health has repeatedly raised,” the health system said, as reported by gulfcoastnewsnow.com. Those concerns reportedly include outstanding financial obligations and whether UnitedHealthcare has honored previously agreed terms. It remains unclear whether the two sides will reach a deal before the January deadline.
The fallout extends beyond Lee Health. AdventHealth Port Charlotte is also locked in its own contract dispute with UnitedHealthcare and could similarly go out of network by Jan. 1, 2027, per the same Gulf Coast News and Weather report.
Checking Whether a Provider Is In Network
A provider’s participation can vary by plan. NCH lists UnitedHealthcare’s Individual & Family Plan among its contracted payers, but cautions that it may not be in network for every product offered by a carrier. “NCH may not be a network provider for ALL products offered by the carrier,” according to NCH, which advises patients to check directly with practitioners.
That caveat is important for anyone considering a different provider: a system’s listing for one UnitedHealthcare product does not confirm that a particular doctor, facility or plan combination is in network.
Directories Can Help, but Confirm Directly
Patients seeking primary care rather than hospital-level services have additional choices scattered across the Gulf Coast. Millennium Physician Group operates primary-care facilities in Cape Coral, Bonita Springs, Port Charlotte, Naples and other locations throughout the region, the outlet reports. Physicians Primary Care of Southwest Florida has locations throughout Lee County, including Estero, Cape Coral and Lehigh Acres.
Family Health Centers of Southwest Florida also offers a broad geographic footprint, with sites stretching from Bonita Springs to Port Charlotte, including a location at 4300 Kings Highway, Suite 210, in Port Charlotte, according to Family Health Centers of Southwest Florida. The organization specializes in adult medicine, pediatrics and behavioral health, per Gulf Coast News and Weather's reporting. On the insurer's side, UnitedHealthcare's own provider directory touts a network of more than 1.7 million physicians and care professionals and over 7,000 hospitals and care facilities nationwide, according to UnitedHealthcare.
Patients unsure whether their specific plan and provider combination will be affected can call the number listed on their insurance card or contact Lee Health directly at (239) 320-1234, the health system says. With the Jan. 1, 2027 deadline approaching and negotiations ongoing, UnitedHealthcare members should confirm their coverage status well before the new year.
