Genesis HealthCare System, the hospital network anchored by Genesis Hospital in Zanesville, Ohio, has told four Medicare Advantage insurers at once that it plans to leave their networks. Aetna, UnitedHealthcare, Medical Mutual and CareSource all received notice that their MA contracts with Genesis will lapse at the end of 2026, unless the system and the insurers reach new agreements first. For a single rural system to set the same deadline against four carriers simultaneously is unusual even in a year when hospital-insurer breakups have become routine. Until a new deal is signed, older patients in the Muskingum Valley who rely on one of those four plans do not know whether their local hospital will still be in network on January 1.
Four Insurers, One Deadline: What Genesis Actually Told Them
According to Becker’s Hospital Review, Genesis notified Aetna, UnitedHealthcare, Medical Mutual and CareSource that its Medicare Advantage contracts with each insurer will terminate at the end of 2026 without “fair new agreements” in place. The system did not announce a finished split; it announced a deadline. That conditional wording, common among the health systems Becker’s has tracked this year, means the outcome for any one of the four insurers could still change between now and January 1, 2027, if Genesis and that carrier reach terms first.
What is not conditional is the calendar Genesis set. Current Medicare Advantage members do not lose Medicare coverage itself; they keep whatever plan they are enrolled in. What can change, if Genesis and an insurer fail to reach a new contract, is whether Genesis Hospital, its outpatient clinics and its affiliated physicians are billed as in-network or out-of-network under that specific plan once the new year begins.
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Two National Insurers, Two With Deep Ohio Roots
The four insurers named in Genesis’s notice are not identical in scale or footprint. Aetna and UnitedHealthcare are two of the largest national Medicare Advantage carriers, while Medical Mutual is a Cleveland-based insurer with a long history specifically in the Ohio market, and CareSource began as an Ohio Medicaid managed-care plan before expanding into Medicare Advantage. A single hospital system successfully drawing the same line against both national giants and long-established regional carriers, on the same date, is part of what makes the Genesis notice stand out even among the 30 systems Becker’s is tracking this year. Becker’s does not report whether Genesis is negotiating with all four at the same table or separately.
A Rural System Joins a List That Has Reached 30 in 2026
Genesis is one entry on a running tally Becker’s has kept “since 2023”: 30 U.S. health systems that broke or failed to renew at least one Medicare Advantage contract in 2026, a list updated as recently as Sept. 10. Becker’s reports that providers walking away from MA plans most often cite prior-authorization denial rates and slow reimbursement, while in some cases on the same list it is the insurer that ends the relationship instead. Genesis has not spelled out which of those pressures drove its notice to four carriers on the same timeline, but joining a list that size shows the dispute is not an isolated one.
The scale matters because of how much of Medicare now runs through these private plans. Becker’s notes Medicare Advantage “now covers more than half of eligible Medicare beneficiaries,” so a contract break at even one mid-sized system like Genesis can leave a large share of a county’s older residents deciding whether to keep a plan that may no longer reach their usual hospital.
What Changes for a Patient if January 1 Arrives Without a Deal
If no new agreement is reached, a Medicare Advantage enrollee who keeps seeing a Genesis physician or uses Genesis Hospital after January 1 would generally face out-of-network cost-sharing under that plan’s rules, and care that once ran through the network could instead require the plan’s own out-of-network exceptions process. Traditional Medicare is not affected by any of this; the dispute is specific to the four MA carriers Genesis named, not to Medicare eligibility itself.
The geography raises the stakes. Zanesville sits in a rural stretch of southeastern Ohio, and Genesis is among the few hospital systems serving Muskingum County and the surrounding counties, which narrows the practical alternatives for an enrollee whose plan goes out of network there compared with a patient in a large metro area with several competing systems.
A Threatened Exit, Not Yet a Completed One
Other systems on Becker’s list have already finished the exit that Genesis is so far only threatening. Little Rock-based CHI St. Vincent left Arkansas Blue Cross Blue Shield’s Medicare Advantage network on Sept. 1, a change that has already taken effect for its patients. Winchester, Va.-based Valley Health System is due to leave UnitedHealthcare’s Medicare Advantage network on Oct. 1, weeks before Genesis’s own deadline arrives. Genesis, by contrast, has not left any of the four networks yet: Aetna, UnitedHealthcare, Medical Mutual and CareSource remain in-network with Genesis today, and stay that way unless the January 1 deadline passes without a signed agreement.
The Deadline Still Stands, as of Becker's Latest Count
As of Becker’s most recent update to its 2026 list, dated Sept. 10, no agreement between Genesis and any of the four insurers had been reported. That leaves the system’s own condition, “fair new agreements,” as the only thing standing between the current arrangement and a January 1 network split covering Aetna, UnitedHealthcare, Medical Mutual and CareSource Medicare Advantage members in and around Zanesville.
Inside the decision kit
A cost calculator spreadsheet comparing plans on cost, drugs and doctors, a prescription-by-plan comparison, a provider call script and the Open Enrollment calendar.
The 2027 Medicare Open Enrollment Decision Kit includes a 42-page decision kit, a cost calculator spreadsheet that compares plans on cost, drugs and doctors and a prescription-by-plan comparison.
Open The 2027 Medicare Open Enrollment Decision Kit.
This report was produced with AI assistance and checked against its sources before publishing.
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.
