RALEIGH, N.C. — The Medicare Advantage contract between WakeMed Health and Hospitals and UnitedHealthcare has officially expired, leaving some North Carolinians potentially without coverage at WakeMed facilities. The expiration comes amid ongoing contract negotiations and conflicting claims from both sides over rate increases.
What Happened
As of Saturday, November 16, 2025, UnitedHealthcare Medicare Advantage plans are no longer accepted at WakeMed hospitals, outpatient clinics, and urgent care facilities. WakeMed stated that UnitedHealthcare “decided to remove Medicare Advantage” from negotiations on November 7. UnitedHealthcare, in turn, said WakeMed left its network by refusing proposed rate agreements.
Patients are now considered out-of-network for Medicare Advantage coverage at WakeMed, meaning higher out-of-pocket costs. WakeMed warned that if an agreement is not reached, patients and employers could face up to 40% higher rates for certain services.
Negotiations over commercial contracts will continue, with WakeMed and UnitedHealthcare scheduled to resume discussions on Monday, November 17.
Who Are WakeMed and UnitedHealthcare
WakeMed Health and Hospitals is one of the leading health care providers in Raleigh, North Carolina, operating multiple hospitals, outpatient clinics, and urgent care centers. UnitedHealthcare is a major insurance provider offering Medicare Advantage and commercial health plans across the United States, including North Carolina.
The contract expiration affects Medicare Advantage members, who rely on WakeMed for routine care, specialty services, and emergency treatments.
Case Details and Implications
WakeMed said the pullback from Medicare Advantage is part of a nationwide UnitedHealthcare strategy to scale back these plans. According to WakeMed spokeswoman Kristin Kelly, patients will see significantly higher costs without a new contract in place.
UnitedHealthcare’s Carolinas Health Plan CEO Laurie Mandell said WakeMed is demanding a near 40% price hike, including a 30% increase in the first year alone. Mandell stated the proposal would raise health care costs by over $94 million across two years for North Carolinians and employers.
UnitedHealthcare emphasized its commitment to providing continuity of care for members currently receiving treatment at WakeMed facilities. Members are advised to contact the insurer to ensure uninterrupted care while negotiations continue.
Public and Community Reactions
The contract expiration has caused concern among patients and families in Raleigh. Social media and local forums show many residents worried about access to care and the financial burden of out-of-network charges. Community leaders have called for a swift resolution, emphasizing the importance of keeping health care affordable and accessible.
Official Statements and Next Steps
WakeMed and UnitedHealthcare continue negotiations to resolve the impasse. WakeMed urged patients to prepare for higher costs if an agreement is not reached. UnitedHealthcare reiterated that its priority is reaching a fair and market-competitive rate structure.
Both parties have stressed the importance of transparency and communication with patients, particularly those undergoing ongoing treatment at WakeMed facilities.
This story may be updated with more information as it becomes available.
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