Important Update: NMHS Terminates United Healthcare Medicare Advantage Contracts

# Important Update: NMHS Terminates United Healthcare Medicare Advantage Contracts

TUPELO, Miss.— North Mississippi Health Services (NMHS) facilities and providers have officially terminated agreements with United Healthcare (UHC) Medicare Advantage and Medicaid required Dual Special Needs Medicare Advantage Plans, effective June 1, 2025. This significant change impacts thousands of Medicare beneficiaries in the North Mississippi region, particularly those in the Tupelo area.

What This Means for Your Coverage

As of June 1, NMHS facilities and providers are now considered **out of network** for all United Healthcare Medicare Advantage PPO and HMO plans.

**United Healthcare Medicare Advantage PPO plans:* NMHS will continue to schedule services, as PPO plans typically offer out-of-network benefits. However, members should be aware that out-of-network services may incur higher costs.
**United Healthcare Medicare Advantage HMO plans:** These plans generally **do not cover out-of-network facilities and providers*. Exceptions are usually limited to emergencies and serious medical conditions requiring ongoing care (e.g., cancer treatment, kidney dialysis), and these situations require written prior approval from UHC.

Why the Termination?

According to Wally Davis, NMHS Vice President of Payor Strategy and Partnerships, the termination was due to patients with these insurance plans experiencing **delayed or denied care**.

"We notified UHC Medicare Advantage leadership about this concern in February 2024," Davis stated. "Last month, 42% of inpatient claims at North Mississippi Medical Center-Tupelo were initially denied. Despite following the labor-intensive appeals process and achieving an overturn rate of up to 85% or higher, we never received a definitive answer from UHC on why this was happening."

What You Should Do

If you are an NMHS patient with a United Healthcare Medicare Advantage plan, it is crucial to take action:

• **Verify Benefits:** Call the customer service phone number on the back of your insurance card to verify your benefits and eligibility.

2. **Continuity of Care:** If you are being treated for ongoing medical conditions, you must complete a separate request for each condition to seek written prior approval from UHC for continuity of care.
3. **Special Enrollment Period (SEP):** This termination may qualify you for a Special Enrollment Period, allowing you to change your Medicare Advantage plan outside of the standard enrollment periods. Contact 1-800-MEDICARE to inquire about your SEP rights.
4. **Explore Alternatives:**
* Visit [medicare.gov](https://www.medicare.gov) for information on all your options.
* Speak with a local, independent insurance agent or broker who can help you compare plans available in your area.

Ultimate Senior Benefits is Here to Help

Navigating Medicare changes can be confusing and stressful. Our licensed agents at Ultimate Senior Benefits are here to provide personalized, unbiased guidance. We can help you:

• Understand your current coverage and the impact of these changes.


• Explore all available Medicare Advantage, Medigap, and Part D plans in your area.


• Determine if you qualify for a Special Enrollment Period.


• Enroll in a plan that best suits your healthcare needs and budget.

Don't face these changes alone. Contact us today for a free consultation.

Call us at [662-664-7040](tel:662-664-7040) or [schedule an appointment](/contact) online.

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Disclaimer: Ultimate Senior Benefits is an independent insurance agency and is not affiliated with North Mississippi Health Services or United Healthcare. We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area. Please contact Medicare.gov or call us at 1-800-MEDICARE (TTY: 1-877-486-2048) to get information on all of your options.