UnitedHealthcare Medicare Advantage Update
Tennessee Orthopaedic Alliance (TOA) is committed to providing clear, transparent information about insurance coverage and how it impacts your care. As of May 1, 2026, TOA will no longer participate in-network with UnitedHealthcare Medicare Advantage plans. We understand that changes like this can raise questions, and we want to ensure you have the information you need to make informed decisions about your healthcare.
Below, you’ll find answers to common questions about this change, what it means for your coverage, and the options available to you moving forward.
TOA Patient FAQ: UnitedHealthcare Medicare Advantage Update
What is changing with UnitedHealthcare Medicare Advantage plans at TOA?
Tennessee Orthopaedic Alliance (TOA) will no longer be in-network with UnitedHealthcare Medicare Advantage plans starting May 1, 2026. TOA will remain in-network through April 30, 2026.
Why is this change happening?
UnitedHealthcare Medicare Advantage plans reimburse below standard Medicare rates and require additional steps such as referrals before seeing a orthopedic specialist. These policies create delays in patient care and increase overall healthcare costs for the patient.
What does this mean for me?
If you have a UnitedHealthcare Medicare Advantage plan, TOA will be out-of-network beginning May 1, 2026.
Does this impact commercial plans?
No, this only impacts UnitedHealthcare Medicare Advantage plans.
Can I still be seen at TOA if I have UHC Medicare Advantage after May 1?
We are not able to see patients with UnitedHealth Medicare Advantage out-of-network. Medicare plans are not the same as commercial plans. Each type of Medicare Advantage plan has its own complicated processes for out-of-network benefits that could result in high out-of-pocket costs for patients.
What if I want to pay cash for my visit?
TOA is not able to accept self-payment from patients who have UHC Medicare Advantage plans.
What Medicare plans does TOA accept?
- Traditional Medicare
- Always accepted at all TOA locations.
- AARP Medicare Supplement (Medigap)
- Accepted.
- No referral is needed.
- Works alongside your regular Medicare coverage.
- Amerivantage
- BlueCross BlueShield of Tennessee
- BlueAdvantage (HMO / PPO)
- BlueAdvantage Plus (including Garnet/Ruby/Diamond)
- Aetna
- Aetna Medicare Premier, Value, Advantra, Freedom, Eagle
- Cigna Healthcare (now called Health Springs)
- Cigna Preferred Medicare (HMO)
- Cigna Health Springs
- Cigna True Choice (PPO)
- Cigna Preferred Plus (HMO-POS)
- Humana
- Humana Gold Plus (HMO)
- HumanaChoice (PPO)
- Humana Value Plus (PPO)
- Humana Honor (PPO)
- Devoted Health
- Devoted CORE TN (HMO)
- Devoted PRIME TN (HMO)
- Wellcare (Centene)
- Wellcare Medicare Value (HMO)
- Wellcare Medicare Freedom (PPO)
Does this affect patients with traditional Medicare?
No. Patients with traditional Medicare or Medicare Supplement plans are not affected.
Will I need a referral to see a TOA specialist?
For most accepted plans, no referral is required, though this may vary by plan.
What should I do next?
If you currently have UHC Medicare Advantage and would like to know which doctors will continue to be in your network, please contact UHC by calling the number on the back of your card.
What is TOA’s commitment to patients?
TOA remains committed to providing high-quality orthopedic care and advocating for patient access and affordability.