Guest Commentary | Keeping patients at the center of every decision
Whether we’re part of the medical staff, housekeeping, facilities or management teams, we come to Lee Health for the same reason: to help people. We’re here to make a meaningful difference in the health and well-being of our community, helping people live longer, fuller and healthier lives.
We recognize that changes involving healthcare coverage can bring questions for patients and families. That’s why we want to be transparent about what is changing, what it means for you and the steps you can take to prepare for 2027.
Lee Health is ending its hospital and physician contracts with UnitedHealthcare effective Dec. 31, 2026. Through the end of this year, Lee Health hospitals and physicians will remain in-network for affected UnitedHealthcare employer-based, individual and Medicare Advantage plans, except UnitedHealthcare Exchange/Marketplace plans, which UnitedHealthcare declines to include Lee Health as an in-network provider currently.
Beginning Jan. 1, 2027, Lee Health hospitals and physicians will be considered out-of-network for affected UnitedHealthcare employer-based, individual and Medicare Advantage plans.
If you have appointments, tests or procedures scheduled through the end of this year, please continue to receive the care you need. If you already have an appointment with a Lee Health provider scheduled for 2027, we encourage you to keep it while you take time to understand your options, rather than canceling it without first checking your coverage.
If you are experiencing a medical emergency, please go to the nearest emergency department. Federal law requires emergency care to be available regardless of whether the hospital is in your insurance network.
We chose to share this information now to give patients and families time to understand their coverage, explore their options and make informed decisions about their care for 2027 and beyond. If you have questions about your specific coverage, your insurance company is the best resource for understanding your individual benefits and options.
Please know that this was not a decision we made lightly. It followed years of good-faith discussions and efforts to resolve significant concerns with UnitedHealthcare. Throughout that process, our responsibility remained the same: to do what is best for the patients and communities we serve.
As a nonprofit health system, Lee Health must examine every aspect of how we provide care and ensure we can continue delivering high-quality services to the people of Southwest Florida.
One area we have carefully considered involves the authorization, review and denial processes associated with medically necessary care. Approximately one-third of Lee Health’s medical necessity denials are associated with UnitedHealthcare Medicare Advantage plans, and many of those denials are ultimately overturned on appeal.
For patients and families, additional review can mean more questions and uncertainty during an already emotional time. Our goal is to ensure patients can receive the care they need, when and where they need it.
Lee Health must also consider the resources needed to sustain and grow the care we provide. UnitedHealthcare currently owes Lee Health more than $100 million in disputed and underpaid claims. As a nonprofit health system, appropriate reimbursement enables us to continue investing in our caregivers, technology, facilities and services — helping ensure Southwest Florida has access to advanced, high-quality care close to home, so patients and families can receive the specialized care they need without leaving their community.
These considerations were part of a careful and thoughtful process that ultimately led us to this decision.
For more than 100 years, Lee Health has provided reliable and compassionate care to the people of Southwest Florida. That commitment remains as strong as ever, and our focus on the health and well-being of this community will not change.
Our priority now is to help patients navigate this transition with as much information and as little disruption as possible. We will continue to work every day to ensure Southwest Florida has access to the high-quality healthcare it deserves.
For more information, guidance and helpful FAQs, please visit leehealth.org/unitedhealthcare.
If you prefer to speak to someone directly, a team member from our dedicated community information line is available to assist you at 239-320-1234.
For more information about health insurance plans accepted by Lee Health, please visit leehealth.org/billing/insurance-help.
Dr. Nariman Heshmati is Lee Health’s Chief Clinical Officer – Lee Physician Group and Ambulatory Care Services.