Lee Health
An update regarding our network relationship with Lee Health
Lee Health unexpectedly notified us in late August that it intends to leave our commercial and Medicare Advantage network, beginning Jan. 1, 2027. This decision came without any advance notice or discussions from the health system concerning our agreement.
We know the relationship people have with their doctors is deeply personal and important, and we understand Lee Health’s actions have created stress and concern for families.
Our top priority is to reach an agreement with Lee Health that preserves network access to the health system. We are fully committed to engaging in good-faith negotiation and have made multiple outreaches to Lee Health leadership over the past several weeks. We continue to ask Lee Health to join us at the negotiating table and do what’s in the best interests of the communities we collectively serve.
As we continue our discussions with Lee Health, we have created the following FAQs so you are prepared with the information you need should the health system choose to leave our network.
Frequently asked questions
Our top priority is to renew our network relationship with Lee Health and maintain continued, long-term access to the health system. However, if we are unable to reach an agreement, Lee Health’s hospitals, facilities and its physicians will be out of network for the following plans, effective Jan. 1, 2027:
- Employer-sponsored commercial plans
- Medicare Advantage plans, including Dual Special Needs Plan (D-SNP) and Group Retiree plans
People enrolled in a Medicare Supplement plan continue to have access to all of Lee Health’s hospitals, facilities and its physicians, even if the health system goes out of network on Jan. 1, 2027. Medicare Supplement plans are not impacted by our negotiation.
If we are unable to reach an agreement, Lee Health will be out of network for the following plans, beginning Jan. 1, 2027:
- Employer-sponsored commercial plans
- Medicare Advantage plans, including Dual Special Needs Plan (D-SNP) and Group Retiree plans
People enrolled in a Medicare Supplement plan continue to have access to all of Lee Health’s hospitals, facilities and its physicians, even if the health system goes out of network on Jan. 1, 2027. Medicare Supplement plans are not impacted by our negotiation.
Lee Health unexpectedly notified us in late August that it intends to leave our commercial and Medicare Advantage network, beginning Jan. 1, 2027. This decision came without any advance notice or discussions from the health system concerning our network relationship.
We have had no discussions with or indications of concern from Lee Health regarding our agreements for our Medicare Advantage and employer-sponsored commercial plans. We meet with Lee Health monthly as part of our collaborative efforts to maintain a strong relationship and not once has the health system brought forth any concerns regarding our agreement.
Based on information Lee Health shared with the media on Aug. 27, it appears that the health system’s recent actions may be connected, at least in part, to the health system being out of network for our Individual Family Plan (IFP) for the past several years. Rather than engaging in good-faith dialogue to address any perceived issues pertaining to our current network relationship, Lee Health instead has used patients enrolled in our Medicare Advantage and commercial plans as leverage over something that has nothing to do with them.
We are doing everything we can to reach an agreement and will remain at the negotiating table as long as it takes. We have made multiple outreaches and recently exchanged communications with Lee Health’s leadership. We ask them to join us at the negotiating table and do what’s in the best interests of the communities we serve.
Yes. People enrolled in a Medicare Supplement plan continue to have access to all of Lee Health’s hospitals, facilities and its physicians, even if the health system goes out of network on Jan. 1, 2027. Medicare Supplement plans are not impacted by our negotiation.
UnitedHealthcare members enrolled in a Group Retiree PPO plan may still receive care at Lee Health as an out-of-network provider should they agree to see them.
The share of the cost will be the same for Group Retiree PPO members as if the provider was part of the network. We encourage UnitedHealthcare Group Retiree members to speak with Lee Health to confirm they’ll continue to see them, regardless of their network status.
For additional information about our Group Retiree plan as well as information on how to find a provider, UnitedHealthcare members should go to retiree.uhc.com.
Continuity of care allows UnitedHealthcare members in active treatment for a serious or complex condition with a provider at the time they left our network to continue receiving in-network benefits with their provider for a period of time after they went out of network.
Some examples of conditions eligible for continuity of care include but are not limited to:
- Patients who are pregnant
- People currently in active cancer treatment
UnitedHealthcare members must apply and be approved for continuity of care. People can apply at any time from now through 30 days after a provider has left our network. They should call the number on their health plan ID card if they need assistance or have questions. Our dedicated team of advocates are ready to support them every step of the way.
The people we serve will continue to have access to a large network of providers throughout Southwest Florida and the surrounding areas should Lee Health leave our network.
UnitedHealthcare members should call the number on their health plan ID card if they need assistance finding another provider. They can also use the provider directory on our member website to search for alternative hospitals and doctors.
UnitedHealthcare members should always go to the nearest hospital in the event of an emergency. Their services will be covered at the in-network benefit level, regardless of whether the hospital participates in UnitedHealthcare’s network.
Yes. We negotiate thousands of provider contracts every year, and the vast majority of those negotiations result in renewed contracts with no disruption for our members, and also no external noise as the negotiations are handled professionally and behind closed doors.
We are fully committed to engaging in productive, good-faith negotiation and remain focused on our goal of renewing our contract with Lee Health to allow people continued access to quality, affordable care.