UnitedHealthcare Medicare Advantage patients won’t have to wait to change coverage

Thousands of Rhode Island seniors and disabled residents no longer covered for non-emergency visits at four local hospitals can switch insurance plans ahead of the fall open enrollment period. 

Gov. Dan McKee and the Rhode Island Office of Healthy Aging announced a two-month special enrollment period for UnitedHealthcare Medicare Advantage patients on Thursday — exactly one month after the health insurer’s existing contract with Brown University Health ended. 

The Centers for Medicare and Medicaid Services (CMS) determined the insurance change period was needed after reviewing UnitedHealthcare’s notice of the soon-to-cease contract, submitted in May before coverage ended.

The health system and the health insurer failed to negotiate a new agreement due to disputes over reimbursement rates — a point of contention between insurance companies and providers nationwide. This, in turn, meant thousands of Rhode Islanders were suddenly considered “out of network” for most treatments and physician visits at Rhode Island Hospital, Hasbro Children’s Hospital, The Miriam Hospital, and Newport Hospital. 

Medicare contract talks between Brown Health and United are over. Uncertainty is just beginning.

Mailers and online information pages sought to alert affected patients ahead of the July 1 termination date for coverage. But conflicting narratives about when coverage ended left some plan participants surprised to find their surgeries suddenly canceled, according to news reports. Losing insurance coverage could also force affected patients to pay more for the same treatments.

“This is important news for seniors in Rhode Island whose coverage was disrupted earlier this month,” McKee said in a statement Thursday. “Without this special election period, every impacted individual had to submit an individual waiver request to change carriers—with no guarantee that they would be granted. Our team at the Office of Healthy Aging stands ready to assist impacted Rhode Islanders.”

Jessica Wharton, a spokesperson for Brown University Health, expressed gratitude to state officials for advocating for patient health care access in a statement Friday.

“We remain committed to delivering exceptional, patient-centered care to the Rhode Island community and supporting individuals as they navigate their coverage options,” Wharton said.

The health care provider maintains its physicians will still treat United Medicare Advantage patients through June 2026. UnitedHealthcare previously said this was inaccurate.

UnitedHealthcare did not respond to inquiries for comment Friday.

The special enrollment period was triggered by United’s notice to federal regulators of the end to its contract with Brown University Health. The Rhode Island Office of Healthy Aging and the Rhode Island Office of the Attorney General also submitted letters to CMS asking for a special window for plan participants to change insurance plans or carriers.

“We were primarily concerned about the impact on our senior population,” Steven Boudreau, a spokesperson for the Office of Healthy Aging, said in an interview Friday.

Federally reported data estimates 129,000 Rhode Islanders are enrolled in Medicare Advantage health insurance plans available for people 65 and older, or with disabilities or chronic conditions like end-stage kidney failure or ALS (also known as Lou Gehrig’s disease.) The commercial alternative to government-run traditional Medicare has grown in popularity nationwide and in Rhode Island with the promise of additional benefits and cost savings to participants. Participation in United’s Medicare Advantage program in Rhode Island grew 10.1%, to 37,000 plan participants, in 2023, according to the Rhode Island Office of the Health Insurance Commissioner’s (OHIC) 2025 annual report.

However, private providers have faced backlash for inflating testing and diagnostics as a means to increase their bottom lines. 

Complaints are ‘very few’

The Office of Healthy Aging continues to field inquiries — though “very few” complaints — from affected plan participants, Boudreau said.

“We certainly prepared ourselves for a heck of a lot more,” he said.

The most common question Boudreau’s office has gotten: “What are my options?” 

The Attorney General’s office also continues to receive consumer questions, Timothy Rondeau, an office spokesperson, said in a text. The AG has updated its webpage about the insurance coverage change to include information about the new special enrollment period.

Once UnitedHealth mails notices to affected patients, they have 60 days to switch to a different Medicare Advantage plan, or return to government-run Medicare. Other commercial insurers that offer Medicare Advantage in all or parts of Rhode Island include Blue Cross Blue Shield of Rhode Island, Aetna, Humana, WellCare, and Cigna.

Terms of the special enrollment period are set by CMS, including a one-month delay between when coverage ended and the new enrollment begins to give affected enrollees enough time to make informed decisions about changing their coverage, Boudreau said.

Eligible individuals can get help deciding which insurance option is right for them by contacting the State Health Insurance Assistance Program hotline at 1-888-884-8721.

The regular open enrollment period for changing health insurance runs from Oct. 15 to Dec. 7.

The end to the contract between Brown University Health and United did not affect dual Medicare and Medicaid recipients, nor did it affect coverage at Brown University Health’s Massachusetts hospitals. There are also assurances for continuity of care in certain cases, including patients with newly diagnosed or relapsed cancer, or those in active cancer treatment. United Medicare Advantage plan participants whose insurance is covered through a former employer under a group plan may also continue to receive care at Brown University Health hospitals.

Updated to include comments from Brown University Health.