Two Medicare Advantage networks fracture on the same date next week, and neither involves a plan folding or leaving the market. Ohio State University’s Wexner Medical Center, its James Cancer Center and its affiliated physicians drop out of Humana’s Medicare Advantage network on October 1, while Winchester, Virginia-based Valley Health System exits UnitedHealthcare’s Medicare Advantage network the same day, affecting roughly 8,000 patients across Virginia and West Virginia. The insurance cards in members’ wallets stay the same; what changes is whether the hospital behind them still counts as in-network. The fixes exist, but most carry medical-condition requirements, billing changes or a federal approval step that isn’t automatic.
Two Contract Breaks, One October Deadline
Ohio State’s break traces to a contract Humana itself is ending, not one Ohio State chose to leave. Effective October 1, 2026, Wexner Medical Center, the James Cancer Center and OSU-affiliated physicians all become out-of-network for anyone carrying a Humana Medicare Advantage or Humana Healthy Horizons Medicaid plan. Ohio State says it remains interested in renewing the agreement, while Humana frames the relationship as still open to a new deal even as the current one lapses on schedule.
Humana’s own statement confirms that account and adds a practical detail: members already notified by mail can reach continuity-of-care support through the toll-free number on the back of a Humana ID card, and those with certain medical conditions may qualify to keep seeing their current provider at in-network benefit levels for a defined period. The carve-out targets people mid-treatment — someone managing a chronic condition or undergoing active cancer care at the James, not someone with a routine appointment on the calendar.
Valley Health’s split with UnitedHealthcare followed a failed negotiation rather than a unilateral insurer decision. Valley Health told its patients that it proposed terms meant to offset reimbursement cuts tied to what the system called excessive denials and administrative burden, and that UnitedHealthcare rejected the offer without a counterproposal. Both individual and group UnitedHealthcare Medicare Advantage plans go out-of-network at Valley Health’s Virginia and West Virginia facilities on October 1, a change the system estimates affects roughly 8,000 patients, including about 1,900 in Winchester and Frederick County alone.
The Ohio State exit reaches beyond a single hospital building. Because Wexner Medical Center, the James Cancer Center and the OSU-affiliated physician group all lose in-network status on the same date, the change touches outpatient oncology visits and primary care relationships alongside any inpatient stay. A Humana member being treated for cancer at the James and a Humana member seeing an OSU-affiliated primary care doctor face the identical October 1 cutoff, even though their care looks nothing alike.
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The Off-Ramps Are Narrower Than They Look
Neither insurer is leaving members without options, but the options come with conditions attached. Humana says members with certain medical conditions may qualify to keep seeing their Wexner Medical Center or James Cancer Center providers at in-network benefit levels for a defined transition period, a protection generally reserved for those already in active treatment. Valley Health describes a similar continuity-of-care carve-out for UnitedHealthcare members undergoing scheduled surgery or treatment for a serious or complex condition, though approval runs through the insurer rather than the hospital itself.
Switching plans outright is possible but not instant. Valley Health’s notice to patients lists a special enrollment period that would let affected members change Medicare Advantage plans or move to Original Medicare, but that period requires approval from the Centers for Medicare and Medicaid Services rather than applying automatically to everyone in the network split. Absent that approval, the fallback is the standard annual Medicare Open Enrollment Period, which runs October 15 through December 7 and takes effect January 1 — meaning a member who qualifies for neither continuity-of-care protection nor a CMS-approved switch could face two full months of out-of-network exposure before any new plan choice kicks in.
The billing mechanics shift as the calendar turns. Through the end of 2026, Valley Health says it will keep filing out-of-network claims with UnitedHealthcare on affected patients’ behalf, though members will still owe the higher out-of-network cost share on those visits. Starting in 2027, the health system moves to billing patients directly at Medicare rates, shifting the task of filing reimbursement claims with UnitedHealthcare onto the member. One protection holds regardless of network status at either system: emergency care must be covered at in-network cost levels because federal rules require Medicare Advantage plans to pay for emergency and urgently needed services no matter where a member is treated.
Not every plan tied to these two systems is affected the same way. UnitedHealthcare has agreed to keep covering Medicaid patients and armed-forces veterans receiving Community Care Network benefits at Valley Health even as the Medicare Advantage contract lapses, while commercial plans obtained through an employer or the ACA marketplace remain under a separate negotiation that could also end without a deal once the underlying contract expires September 30.
A Pattern Becker’s Has Tracked Since 2023
Ohio State and Valley Health are not outliers this year. Becker’s Hospital Review counts 28 U.S. health systems that have dropped or lost a Medicare Advantage contract in 2026, a list the publication has tracked since 2023 and that has grown from 20 systems on its 2025 tally. The current list also includes Mayo Clinic, NewYork-Presbyterian and Mass General Brigham — large academic systems, not only small rural hospitals — walking away from UnitedHealthcare or Humana contracts over complaints that echo Valley Health’s own account: reimbursement that providers say no longer covers claim denials and administrative costs.
The insurers’ side of that argument rarely appears in the same announcement, but the pattern across Becker’s list points the same direction in most entries: a hospital system says a payer’s authorization requirements or payment rate made the contract unsustainable to keep, and the payer either lets the deal lapse or declines to match the system’s counteroffer. Humana’s statement that it remains open to renewing with Ohio State, paired with UnitedHealthcare’s outright rejection of Valley Health’s counterproposal, shows both versions of that standoff playing out within the same industry-wide trend in the same month.
The dispute matters beyond Ohio and the Shenandoah Valley because Medicare Advantage now covers more than half of everyone eligible for Medicare, per Becker’s own framing of why it tracks these breaks at all. As more systems conclude that Medicare Advantage contracts no longer pay enough to keep signing, the member holding one of these plans increasingly bears the cost of finding out whether a familiar hospital will still take it — and how much runway they get before that answer changes underneath them.
This article was researched and drafted with the assistance of artificial intelligence.
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