UnitedHealthcare Sends Lee Health a New Offer, but the Hospital System Says It Falls Short as the Jan. 1 Network Exit Nears

UnitedHealthcare has sent Lee Health a proposal meant to keep its members in network at Southwest Florida's largest hospital system in 2027, but Lee Health says the offer does not resolve its concerns. Unless the two sides reach a deal, Lee Health hospitals and physicians will be out of network for UnitedHealthcare employer-based, individual and Medicare Advantage plan members beginning Jan. 1, 2027. With fewer than eight weeks left and Medicare's annual enrollment window closing Dec. 7, patients in Lee County and beyond are being urged to check their coverage now.

The new offer

UnitedHealthcare said it sent its proposal to Lee Health on Oct. 30, WINK News reported. The insurer said the offer would preserve long-term network access for its commercial and Medicare Advantage plans, and it also included an option for Lee Health to join the network for UnitedHealthcare's individual and family plans. The insurer did not release the financial terms.

UnitedHealthcare said reaching an agreement that supports access to quality, affordable care is its top priority, that it has reached out to Lee Health's leadership multiple times, and that it wants the system to return to negotiations.

Lee Health's response

Lee Health said in a statement that it welcomes communication and wants a resolution in patients' best interests, but that the latest proposal "does not address the longstanding concerns Lee Health has repeatedly raised." The system said any agreement must protect access to care, address what it called UnitedHealthcare's outstanding financial obligations, and ensure the insurer honors the terms it agrees to.

When it announced the split in late August, Lee Health gave its reasons in more detail. According to Becker's Hospital Review, the system said roughly one-third of its medical necessity denials are tied to UnitedHealthcare Medicare Advantage plans, and it alleged that UnitedHealthcare owes it more than $100 million in disputed and underpaid claims. Those figures come from Lee Health and have not been independently verified.

How the dispute started

Lee Health notified UnitedHealthcare on Aug. 26 that it would end both of its participation agreements, the hospital contract and the agreement covering its physician practices, when they expire at the end of 2026. Lee Health said the decision was not made lightly and acknowledged it could concern patients, families and employers, WGCU reported.

UnitedHealthcare said the notice came without advance warning or discussion, called itself surprised and disappointed by Lee Health's tactics, and said it would use the remaining months of the contract to pursue a good-faith negotiation toward a long-term agreement.

In October, the insurer launched an FAQ page at uhc.com/leehealth to help members prepare. WINK has reported that about 50,000 Lee Health patients could be affected.

Lee Health has said its priorities are putting patients first and minimizing disruption, and that it is working with physicians, community partners and other health plans, noting that patients have choices of providers and plans. WINK hosted a Medicare help event on Oct. 12 where trained SHINE counselors answered questions from patients facing the change, days before Medicare's annual enrollment period opened.

Which plans are affected

The key dates and plan types, based on statements from both organizations:

Lee Health operates the region's major hospitals in Fort Myers, Cape Coral and Bonita Springs, along with Golisano Children's Hospital of Southwest Florida and a large network of physician practices, so the change would reach well beyond a single facility.

What patients can do now

Lee Health has advised patients to keep scheduled appointments, tests and procedures through the end of 2026, and to review their options before canceling any care planned for 2027.

• Ask about continuity of care. Patients in the middle of treatment can call the number on the back of their UnitedHealthcare card. The insurer's Continuity of Care process may allow some patients to keep seeing Lee Health providers at in-network rates for a limited time.
• Check out-of-network benefits. Some plans pay for out-of-network care, but usually with higher out-of-pocket costs or other limits.
• Medicare Advantage members can switch plans now. Medicare's annual enrollment period, which opened Oct. 15, runs through Dec. 7. Coverage chosen during that window starts Jan. 1. Medicare Advantage members also get a second chance from Jan. 1 through March 31 to switch to another Advantage plan or return to Original Medicare.
• Talk to an employer. People with UnitedHealthcare coverage through work may be able to choose a different carrier during their employer's open enrollment.
• Get free counseling. SHINE, Florida's Serving Health Insurance Needs of Elders program, offers free, unbiased Medicare counseling.

Lee Health has posted information at LeeHealth.org/UnitedHealthcare and takes questions at 239-320-1234. UnitedHealthcare's FAQ covers continuity of care, emergency care, Medicare Supplement plans, Medicare Advantage group retiree plans and where members could seek care if Lee Health leaves the network.

Part of a broader pullback from Medicare Advantage

Lee Health is not alone. Health systems across the country have been dropping Medicare Advantage contracts, citing prior authorization denials and payment delays. University of Miami Health System is also ending its UnitedHealthcare Medicare Advantage contracts, according to Becker's. Closer to home, Naples Comprehensive Health in Collier County is also leaving some Medicare Advantage networks in 2027, though its dispute is with Wellcare and HealthSpring rather than UnitedHealthcare.

For Southwest Florida's large retiree population, the timing matters. A deal reached after Dec. 7 would restore access for UnitedHealthcare members, but anyone who switched plans to keep Lee Health doctors would already be locked into a new plan for the start of 2027.

What's next

The current contracts run through Dec. 31. Both sides say they want an agreement, and network disputes like this one are often settled in the final weeks, or even after a contract lapses. Until a deal is announced, UnitedHealthcare members who rely on Lee Health should plan as if the exit will happen: confirm their doctors' network status for 2027, ask about continuity of care, and make any Medicare plan change before Dec. 7.