UNC Health will no longer be in-network for Humana Medicare Advantage, Wellcare Medicare Advantage, and Health Care Service Corporation Medicare Advantage (HealthSpring) plans, effective January 1, 2026. Affected Medicare Advantage members, except North Carolina State Health Plan retirees on Humana plans, will lose in-network access to UNC Health facilities.
North Carolina State Health Plan retirees on Humana plans will continue to have in-network access after January 1, 2026. Thousands of Medicare Advantage members in North Carolina will lose in-network access to UNC Health facilities on January 1, 2026, and will face significantly higher out-of-network costs to access them under their current Medicare Advantage plans after this date.
If you have Medicare Advantage members on these three plans in North Carolina, you need to:
- Identify the Medicare coverage options in your North Carolina markets that still provide in-network access to UNC Health facilities on and after January 1, 2026, that you can present to the clients wanting to have in-network access to UNC Health facilities.
- Identify the Medicare Advantage clients on Humana, Wellcare, and HealthSpring using UNC Health that you have in your records to do immediate outreach, informing them of this change, and asking them to contact you immediately to discuss their options.
- Communicate this change to all your Humana, Wellcare, and HealthSpring Medicare Advantage clients, and ask them to contact you if this is a concern.
There’s A LOT to do in a short amount of time, and Agility is here to help Medicare agents strategize to find the best solutions for any of your members who want to continue accessing UNC Health facilities with in-network status.
- Local market managers who offer regional insight and grassroots intelligence about what’s happening in your markets.
- Dedicated Producer Support at (866) 590-9771 or support@enrollinsurance.com to answer any insurance questions and direct you to our Medicare, ACA, and ancillary experts. They can also add you to our weekly email list for tips and updates.
In this AEP, let Agility empower you to evolve your capabilities and capture opportunities like this one.
