State of Franklin Healthcare Associates, a multi-specialty physician group serving Tennessee and Virginia’s Tri-Cities region, will stop participating in UnitedHealthcare’s Medicare Advantage network on April 1, 2027. The practice is directing its Medicare patients to this fall’s federal enrollment window to decide whether to stay with United or move to a different plan before the change takes hold. UnitedHealthcare’s Complete Dual Special Needs Plan, which covers patients who also qualify for TennCare, is not part of the change.
What the network-exit notice doesn’t settle: State of Franklin’s notice names the date its UnitedHealthcare Medicare Advantage contract ends, not whether a new plan keeps a specialist in network, the check The 2027 Medicare Open Enrollment Decision Kit runs. Script the provider call before the April 1 change →
A Regional Practice’s Notice, Not a National Insurer Move
State of Franklin Healthcare Associates, known locally as SOFHA, operates primary and specialty care offices across the Tri-Cities area spanning northeast Tennessee and southwest Virginia. In a notice posted to its website, the practice told patients it will end its participation agreement with UnitedHealthcare’s Medicare Advantage plans effective April 1, 2027, and pointed them toward Medicare’s fall enrollment period to review alternatives ahead of that date. The notice does not attribute the decision to a dispute over a specific service or billing practice, framing it instead as the expiration of the practice’s contract with United’s Medicare Advantage line rather than a sudden or contested break.
The notice is narrower than a plan being discontinued outright. It is a single, contracted physician group ending its network agreement with one insurer’s Medicare Advantage line, which changes where SOFHA’s own patients can see their doctors in network, not what UnitedHealthcare offers to Medicare Advantage members elsewhere.
What Stays Covered, and What Doesn’t
SOFHA specified that UnitedHealthcare’s Complete plan, a Dual Special Needs Plan for members who also qualify for Tennessee’s Medicaid program, continues unaffected. Every other UnitedHealthcare Medicare Advantage plan loses in-network status with the practice once April 1, 2027 arrives. A patient enrolled in one of those standard plans who wants to keep seeing a SOFHA physician after that date has two practical paths: switch to a different UnitedHealthcare product that still includes SOFHA, if one exists, or move to a different insurer’s Medicare Advantage plan or Original Medicare that keeps the practice in network, a choice UnitedHealthcare’s own 2027 member renewal materials point members toward reviewing each fall. What that choice costs depends heavily on the plan type. Most Medicare Advantage HMO plans pay little or nothing toward care from a doctor outside the network except in an emergency, while some PPO-style Medicare Advantage plans and Original Medicare allow out-of-network visits at a higher cost rather than cutting them off entirely. Which category a patient’s current plan falls into changes how urgent the April 1 date actually is.
Why the Date Falls in Spring, Not at the Start of a Plan Year
Most Medicare Advantage coverage changes that patients read about take effect January 1, when a new plan year begins, or arrive in a insurer’s own contract-year notices tied to open enrollment. A provider’s own participation agreement with an insurer runs on a separate timeline, and can end whenever that underlying contract lapses. That is the mechanism behind the April 1 date: it is the point at which SOFHA’s agreement with UnitedHealthcare’s Medicare Advantage plans expires, independent of when a member’s plan year happens to start. Medicare’s own consumer guide to Medicare Advantage plans notes that most network changes are instead rolled out at the start of a plan year and disclosed through the Annual Notice of Change mailed each September, which is what makes a mid-cycle exit like SOFHA’s the less common pattern.
How the Fall Enrollment Window Fits a Spring Deadline
Medicare’s Annual Enrollment Period runs from October 15 through December 7, 2026, the standard window in which Medicare Advantage and Part D enrollees nationwide choose their coverage for the coming plan year. SOFHA is telling patients to use that window now, months before its own April 1 exit, because coverage elections made this fall determine what a patient is enrolled in when the practice’s UnitedHealthcare contract actually ends. A member who waits until spring to act would already be locked into a 2027 plan chosen without the network change in mind, and outside the fall window a plan change generally requires a qualifying special enrollment period rather than an open choice.
Checking a New Plan Before Switching
Anyone affected has a narrower task than comparing every Medicare Advantage plan sold in the Tri-Cities market: confirming whether a specific alternative keeps a specific doctor, hospital or prescription covered at an acceptable cost. Insurer directories are not always current, and the only reliable confirmation is calling the provider’s office directly and asking whether it is contracted with the plan being considered for 2027, alongside checking whether current prescriptions appear on that plan’s drug list at the same tier before enrolling.
Three Dates, Not Just One
SOFHA’s April 1 date is actually the last of three relevant dates on the calendar. The federal Annual Enrollment Period runs through Dec. 7, 2026, when any Medicare Advantage member can freely pick a different plan or move to Original Medicare for 2027. Current Medicare Advantage members then get one more opportunity, the Medicare Advantage Open Enrollment Period, which runs Jan. 1 through March 31 and allows a single additional plan switch. That window happens to close just one day before SOFHA’s network exit takes effect, giving affected patients a real, if narrow, second chance to act if they miss the fall deadline. Anyone who lets both windows pass generally cannot change plans again until the following fall.
Verifying Care Access Before a Network Ends
State of Franklin Healthcare Associates has named the date its UnitedHealthcare Medicare Advantage contract ends, but a notice like that cannot tell an individual patient whether a different plan keeps the same specialists in network or the same prescriptions at the same cost. That comparison has to happen doctor by doctor and drug by drug, before the fall enrollment window closes, not after the spring deadline arrives.
The 2027 Medicare Open Enrollment Decision Kit pairs a cost calculator spreadsheet that compares plans on cost, drugs and doctors with a provider call script for confirming network status directly with an office.
Compare plan options against a doctor and prescription list in The 2027 Medicare Open Enrollment Decision Kit.
This article was produced with AI assistance and checked against the primary sources linked above.
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.
