Major Medicare Advantage changes are coming to North Carolina in 2026, and they will directly affect anyone using UNC Health providers under certain Medicare Advantage plans.
Starting January 1, 2026, UNC Health will no longer be in-network with several major Medicare Advantage plans. This means that unless changes are made before the Annual Election Period (October 15 to December 7, 2025), many North Carolina residents will lose full coverage to their preferred doctors and specialists.
What’s Changing?
If you’re a retiree under the North Carolina State Health Plan, the good news is that nothing will change for you. You will continue to have full access to all UNC Health facilities, doctors, and specialists without disruption.
However, if your current Medicare Advantage plan is among those affected, you will experience significant changes to your costs, coverage, and benefits. This includes higher out-of-pocket expenses for hospital stays and treatments. Additionally, some specialists and healthcare facilities may not accept your plan once they move out of network, resulting in limited access and higher fees for certain services.
If you do not switch plans before the Annual Election Period ends, your existing plan will automatically renew but your UNC Health access will become severely restricted. You risk losing access to your preferred specialists and paying significantly more for care.
Next Steps
At Broad River Insurance, we understand that losing in-network access can be stressful, especially for retirees who depend on UNC Health doctors and specialists. While these changes are the result of system-level decisions, there are important steps you can take now to protect your coverage.
You will continue to have full network access to UNC Health through December 31, 2025. This window is the ideal time to review your current Medicare insurance plan and explore your options to ensure you have the right coverage for your needs. We advise you to contact us before the enrollment period begins.
The Medicare insurance system can be complex, particularly when major changes occur. The advantage of working with Broad River Insurance is that our licensed insurance agents provide hands-on support throughout the process, helping you understand your options and find a plan that fits your healthcare needs.
With thoughtful planning, you can maintain access to your preferred UNC Health providers and ensure that your Medicare insurance coverage continues to work for you. Call Broad River Insurance today at (828) 884-3885 (TTY: 711) to schedule your no obligation Medicare insurance consultation, or visit broadriverins.com to learn more about your options.