Patients in Maryland enrolled in UnitedHealthcare Medicare Advantage plans lost in-network access to every Johns Hopkins Medicine provider and facility starting in August 2025. The contract termination between one of the nation’s largest insurers and one of its most recognized health systems forces affected beneficiaries to choose between paying sharply higher out-of-pocket costs or finding new doctors, new hospitals, or a new insurance plan altogether. With the 2026 Medicare Open Enrollment period approaching, the fallout is already shaping how state regulators communicate plan options to seniors.
What the Johns Hopkins network loss means for Maryland Medicare Advantage enrollees
The split between UnitedHealthcare and Johns Hopkins Medicine is not a billing technicality. It directly changes what patients pay and where they can receive care. Medicare Advantage plans operate through contracted provider networks, and when a major health system exits that network, patients who continue seeing those providers face balance billing, higher copays, and potentially the full cost of services. The Maryland Insurance Administration has warned that UnitedHealthcare Medicare Advantage plan changes result in higher out-of-pocket costs for beneficiaries who previously relied on Johns Hopkins.
The practical effect is stark. Patients with established relationships at Johns Hopkins hospitals, specialty clinics, and primary care offices now must either absorb those added expenses or transition to unfamiliar providers within UnitedHealthcare’s remaining network. For seniors managing chronic conditions or mid-treatment care plans, switching providers is not a simple administrative step. It can mean delays in care, repeated diagnostic testing, and disrupted medication management.
The hypothesis that Maryland beneficiaries will switch away from UnitedHealthcare Medicare Advantage products at elevated rates during the 2026 open enrollment window rests on a straightforward logic. When a plan’s network no longer includes a dominant regional health system, the plan’s value proposition weakens for anyone who lives near or depends on that system. Premium comparisons alone do not capture this shift. A plan with a lower monthly premium but no access to Johns Hopkins may cost more in practice than a competitor that includes it. Whether enrollment data ultimately confirms accelerated departures from UnitedHealthcare will depend on how many beneficiaries in the state had active care relationships at Johns Hopkins and how aggressively competing plans market their continued access to the system.
State regulators confirm the August 2025 network change
Two separate consumer advisories from the Maryland Insurance Administration establish the facts of the split. The state’s open enrollment guidance for 2026 states plainly that UnitedHealthcare no longer includes Johns Hopkins Medicine in its network for Medicare Advantage plans and that the change began in August 2025. A second advisory, focused on clarifying the difference between Medicare Supplement and Medicare Advantage coverage, confirms that for UnitedHealthcare Medicare Advantage plans, Johns Hopkins providers remain out-of-network and that hospitals and facilities are also out-of-network.
The distinction between Medicare Supplement and Medicare Advantage matters here because the two product types follow different rules. Medicare Supplement policies, also known as Medigap, generally allow beneficiaries to see any provider that accepts original Medicare. Medicare Advantage plans, by contrast, use contracted networks, and going outside that network typically triggers higher costs or outright coverage denials. The Maryland Insurance Administration issued its advisory specifically to prevent confusion among beneficiaries who might assume their Medigap coverage and their Medicare Advantage coverage work the same way.
No joint statement from UnitedHealthcare and Johns Hopkins Medicine explaining the reasons behind the contract termination has surfaced in the state’s published guidance. The available government documents focus on consumer impact rather than the business dispute. Similarly, the exact number of UnitedHealthcare Medicare Advantage enrollees in Maryland affected by this change does not appear in the state’s advisories. Without that enrollment figure, the full scale of disruption is difficult to quantify, though Johns Hopkins Medicine’s extensive footprint across the Baltimore–Washington corridor suggests the affected population is substantial.
Gaps in the public record and what enrollees should do now
Several questions remain unanswered by the available evidence. Neither the Maryland Insurance Administration’s advisories nor any located public filings include granular claims data showing how out-of-pocket costs have changed for patients who continued seeing Johns Hopkins providers after August 2025. Pre- and post-change cost comparisons would clarify whether the financial burden on patients is moderate or severe, but that data has not been published.
The two state advisories also present the network status in slightly different phrasing. One states that Johns Hopkins providers “remain out-of-network,” while the other says UnitedHealthcare “no longer includes” Johns Hopkins Medicine. Both point to the same outcome, but the first phrasing could imply a longer-standing exclusion, while the second clearly frames it as a recent change. The Maryland government site has not published additional clarification reconciling the two descriptions, though the open enrollment guidance ties the change to August 2025.
The absence of a public explanation from either UnitedHealthcare or Johns Hopkins Medicine about why the contract ended leaves beneficiaries guessing about whether a future agreement could restore in-network access. Contract disputes between insurers and health systems sometimes resolve after periods of stalemate, but there is no indication in the state’s materials that negotiations are ongoing or that a reinstatement is imminent. For now, enrollees must make decisions based on the assumption that Johns Hopkins will remain out-of-network for the 2026 plan year.
In this environment of limited information, consumer advocates emphasize steps beneficiaries can take before and during open enrollment. First, patients should confirm the network status of their current doctors and hospitals directly with both the plan and the provider’s billing office. Relying on outdated provider directories or word-of-mouth can lead to costly surprises. Second, beneficiaries who consider switching plans should review each option’s network, drug formulary, premiums, and maximum out-of-pocket limits, not just headline benefits like gym memberships or dental coverage.
For individuals who view continued access to Johns Hopkins as essential, one option is to move from Medicare Advantage back to original Medicare paired with a Medigap policy and a standalone Part D prescription drug plan, if they qualify. Because Medigap policies are regulated differently and generally allow access to any provider that accepts Medicare, this route can restore flexibility, though it may come with higher premiums and medical underwriting depending on timing and eligibility rules. Others may opt to enroll in a different Medicare Advantage plan that still contracts with Johns Hopkins, if such plans are available in their county for 2026.
Beneficiaries who decide to stay with UnitedHealthcare despite the network loss should ask detailed questions about out-of-network coverage, including whether any exceptions exist for continuity of care. In some circumstances, plans may grant temporary in-network cost-sharing for patients in active treatment, such as those undergoing chemotherapy or recent surgical follow-up, although such protections are not guaranteed and are not described in the state advisories. Documenting treatment plans and securing written confirmation of any exceptions can help patients avoid unexpected bills.
State regulators, meanwhile, appear focused on ensuring that seniors understand the basic contours of their choices. By highlighting the Johns Hopkins network change in open enrollment materials and issuing a separate advisory on the differences between Medicare Advantage and Medigap, the Maryland Insurance Administration is signaling that network design is now a central factor for many residents. How many enrollees ultimately change plans in response will not be clear until after the 2026 enrollment data is reported, but the contract termination has already reshaped the decision-making landscape for thousands of Marylanders who once took their access to Johns Hopkins for granted.
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