A contract fight between the country’s largest health insurer and a regional hospital system is about to land on the doorsteps of older patients across the Shenandoah Valley. UnitedHealthcare has told Valley Health it will not renew the agreement that keeps the system in its Medicare Advantage network, and unless the two sides reverse course, Valley Health’s hospitals, physicians and outpatient sites in Virginia and West Virginia stop being in-network for many UnitedHealthcare Medicare Advantage members on October 1. For retirees who chose a plan specifically to keep their longtime doctors, the decision reopens a question they thought they had settled at enrollment.
Why Valley Health leaves UnitedHealthcare’s Medicare Advantage network on Oct. 1
UnitedHealthcare has confirmed that it rejected Valley Health’s proposal to renew its contract for group and individual Medicare Advantage plans, and that the current agreement terminates September 30, 2026. Beginning the next day, Valley Health’s hospitals, facilities and physicians throughout Virginia and West Virginia will be out of network for people enrolled in UnitedHealthcare Medicare Advantage individual plans and Group Retiree plans. Local reporting has put the number of affected patients at roughly 8,000 across the two states, including a large share in Winchester and Frederick County. Going out of network does not mean a patient cannot walk into a Valley Health facility; it means the plan may treat those visits as out-of-network, which typically carries higher cost sharing or, in some cases, no coverage at all beyond emergencies.
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Continuity-of-care protection for patients in active treatment
Patients in the middle of treatment are not simply cut off on October 1. UnitedHealthcare says people who are in active or ongoing treatment for a serious or complex condition at Valley Health at the time the provider leaves the network are eligible for continuity of care, which continues in-network benefits for a limited period. That protection is designed for situations such as cancer treatment, a scheduled surgery or a pregnancy already underway, not for routine visits that can be moved to another in-network provider. Members who think they qualify generally have to request the arrangement rather than receive it automatically, and the window is finite, so the practical step is to call the number on the member ID card and ask how long the transition period runs for a specific diagnosis. Group Retiree PPO members are in a different position: those enrolled in certain UnitedHealthcare Group Retiree PPO plans may still see a Valley Health physician or hospital as an out-of-network provider while paying the same cost share as if the care were in-network.
Medicare Supplement enrollees are not affected
The split matters most for people who have to choose between two very different ways of getting Medicare coverage. Medicare Advantage plans run their own provider networks, which is exactly why a contract dispute can strand a patient. Medicare Supplement — Medigap — works alongside Original Medicare, which does not use networks, so a Medigap policyholder can see any provider in the country that accepts Medicare, Valley Health included. That is why the UnitedHealthcare notice does not touch Medigap enrollees. Switching from Medicare Advantage to Original Medicare with a Medigap policy is possible, but it is not always simple: outside of a person’s initial six-month Medigap open enrollment period, an insurer can use medical underwriting to raise the price or deny a policy in most states. A network exit like this one can, in some circumstances, trigger a guaranteed-issue right to buy certain Medigap plans without health questions, but only within a limited window, so the timing of any move is what decides whether it is affordable.
How the fall enrollment window changes the math
The timing of the October 1 termination sits right against Medicare’s annual open enrollment, which runs from October 15 to December 7, with changes taking effect January 1. During that window, members can switch to a different Medicare Advantage plan that includes Valley Health, drop back to Original Medicare, or add or change a drug plan. Anyone whose main reason for staying with a plan is keeping a Valley Health doctor should confirm two things before choosing: whether Valley Health has reached a contract with any other Medicare Advantage carrier for 2027, and whether a specific physician participates in the plan being considered, since network directories can lag behind the actual contracts. A contract can also be settled at the last minute — insurers and hospital systems frequently reach terms after publicly warning patients — so members should verify the network status of their plan again just before open enrollment closes rather than acting on the August announcement alone.
This article was researched and drafted with the assistance of AI and reviewed by The Financial Wire editorial team.
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David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
