Lee Health, the nonprofit hospital system anchoring Fort Myers and the rest of Southwest Florida, is walking away from its UnitedHealthcare contract, and the fallout lands squarely on Medicare Advantage enrollees. Beginning January 1, 2027, the system’s hospitals and physicians will no longer count as in-network for UnitedHealthcare’s employer-based, individual, and Medicare Advantage members, a change that reaches every Lee Health location in the region. For older patients who have built years of care around Lee Health doctors, it means weighing higher out-of-network costs against switching plans during this fall’s Medicare enrollment window.
What Ends December 31, and What Doesn’t
Lee Health said it is terminating its Hospital Participation Agreement and Medical Group Participation Agreement with UnitedHealthcare, with the current contract running through December 31, 2026. After that date, Lee Health’s hospitals and physicians across every one of its locations will be out-of-network for UnitedHealthcare’s affected employer-based, individual, and Medicare Advantage plans, according to the health system’s own patient notice. Appointments, tests, and procedures scheduled through the end of 2026 are unaffected, and patients who already have visits booked into 2027 are being told not to cancel them without first checking their options.
One coverage type is carved out of the change entirely. Members who pair traditional Medicare with a UnitedHealthcare or AARP Medicare Supplement, often called Medigap, will keep seeing Lee Health providers exactly as before, with the supplement still billed secondary to Medicare. The network break applies only to UnitedHealthcare’s Medicare Advantage, employer, and individual plans, not to Medicare itself or to supplemental coverage layered on top of it. Physicians under separate contracts, such as Florida Heart Associates, are unaffected as well, and Lee Health has posted a running list of which plans remain in-network beyond January 1 for patients who want to check a specific provider or plan.
A Third of Denials and a Disputed $100 Million
Lee Health has pointed to UnitedHealthcare’s handling of prior authorizations and claims as its reason for the split. In an open letter to patients, the system said roughly one-third of its medical necessity denials trace back to UnitedHealthcare’s Medicare Advantage plans, and it alleges the insurer owes it more than $100 million in disputed and underpaid claims. Lee Health described the divide as a matter of “fundamentally different priorities” between a nonprofit system guided by community benefit and a publicly traded insurer answering to shareholders.
UnitedHealthcare disputes that framing. A company spokesperson said Lee Health issued the termination notice without raising the alleged issues beforehand and that no contract negotiations were underway ahead of the announcement. The insurer says more than four months remain on the existing agreement and that it intends to use that time to pursue a renewed deal rather than let the network lapse, calling public pressure on patients an unproductive substitute for direct talks.
The Marketplace Dispute Already in Place
The Medicare Advantage exit compounds a separate, ongoing disagreement over UnitedHealthcare’s Affordable Care Act marketplace plans. Lee Health’s patient notice states that UnitedHealthcare already treats the system as out-of-network for its Exchange/Marketplace plans, a position Lee Health has not accepted but has told patients to plan around in the meantime. Add the 2027 exit from UnitedHealthcare’s Medicare Advantage, employer, and individual plans, and the practical effect for many Fort Myers-area households is that a UnitedHealthcare card increasingly does not guarantee access to the area’s dominant hospital system…