If you’re enrolled in a UnitedHealthcare or Humana Medicare Advantage plan and rely on Mayo Clinic for your care, a significant change is coming January 1, 2026. Mayo Clinic is discontinuing its contracts with these major insurers for most individual Medicare Advantage plans across Minnesota, Wisconsin, and Iowa. Medicare Open Enrollment ends December 7, so now’s the time to check your options and see if you need to make a change.
What’s Changing at Mayo Clinic
Starting January 1, 2026, Mayo Clinic locations in Minnesota, Wisconsin, and Iowa will no longer be in-network for UnitedHealthcare and Humana Medicare Advantage individual plans. This also includes Dual Special Needs Plans (D-SNP) from these insurers. If you’re currently seeing doctors at Mayo and have one of these plans, you’ll either need to switch to a different plan or pay significantly higher out-of-network costs to continue your care there.
However, not everyone is affected by this change. If you have Original Medicare (Part A and Part B) with or without a Medicare Supplement plan, you can still receive care at Mayo Clinic without any disruption. The clinic continues to accept traditional Medicare and all Medicare Supplement plans. Additionally, if you have a Medicare Advantage plan through your employer or a Group Retiree plan, Mayo has reached multi-year agreements that maintain your access. It’s specifically the individual Medicare Advantage plans that are losing coverage.
Mayo Clinic isn’t leaving Medicare Advantage networks entirely. A few insurers will still include Mayo in their networks for 2026, with Wellmark Blue Advantage PPO being one option that maintains access. If staying at Mayo is important to you, you’ll want to explore which Medicare Advantage plans still cover their facilities. You can also consider switching to Original Medicare with a Medicare Supplement plan, though this option may require medical underwriting depending on your situation and timing.
Why Major Hospitals Are Leaving
Mayo Clinic isn’t alone in this decision. At least 33 health systems across the United States have dropped Medicare Advantage contracts in 2024 and 2025. Major medical centers like Mass General Brigham, Johns Hopkins Medicine, and dozens of other hospitals have ended relationships with various Medicare Advantage insurers. Some hospitals in Nebraska have stopped accepting any Medicare Advantage plans at all. This trend signals a significant shift in how healthcare providers view these private Medicare plans.
The primary issue driving hospitals away from Medicare Advantage is the prior authorization process. Medicare Advantage plans require doctors to get approval before providing certain treatments or services. Recent data shows that insurers denied 6.4% of prior authorization requests in 2023, affecting millions of patients. What’s more troubling is that when patients appeal these denials, about 80% of them get overturned, suggesting many denials shouldn’t have happened in the first place. Physicians report that 94% of the time, prior authorization delays patient access to necessary care.
Financial pressures are squeezing both sides. Hospitals say Medicare Advantage plans reimburse at lower rates than Original Medicare and take much longer to process payments. Some providers report realization rates as low as 90% of what they’d receive from traditional Medicare. On the other hand, insurers argue that providers are requesting reimbursement rates significantly higher than Original Medicare pays. Humana specifically stated that Mayo Clinic’s requested rates would strain the healthcare system and ultimately cost patients more through higher premiums.
The situation is compounded by recent federal budget cuts. The 2025 One Big Beautiful Bill Act will reduce Medicare funding by approximately $500 billion between 2026 and 2034. This means less money flowing to both insurers and healthcare providers, creating financial pressure that’s forcing difficult decisions on both sides. Government reimbursement to Medicare Advantage plans has fallen 20% from 2023 levels, even with a 5.06% increase approved for 2026.
The Impact on Patients
The changes at Mayo Clinic have created chaos during the current enrollment period. Minnesota’s Senior LinkAge Line reported receiving over 1,000 calls per day during Medicare Open Enrollment, with 2,000 calls on the first day alone. That’s compared to their typical daily volume of 200 to 300 calls. Staff members describe patient reactions ranging from pure anger to tears as people realize they may lose access to their longtime doctors and medical teams.
If you’ve been a Mayo Clinic patient for years and suddenly find yourself facing this change, you’re dealing with more than just paperwork. You’ve likely built relationships with your care team, and your medical records and treatment history are all at Mayo. Switching to a new hospital system means starting over with new doctors who don’t know your medical history as well. For patients with complex conditions or ongoing treatments, this disruption can be particularly stressful.
The timing makes everything more urgent. The Medicare Open Enrollment Period runs from October 15 through December 7, 2025. If you don’t make a change during this window and you’re affected by the Mayo Clinic decision, you’ll face a difficult choice on January 1. You’ll either need to pay expensive out-of-network costs to stay at Mayo or find a different hospital system on short notice. Some patients may qualify for continuity of care if they’re in active treatment for serious conditions, but this only provides temporary in-network access.
Insurance advisors are reporting this as the most chaotic Medicare enrollment period in more than four decades. In Minnesota alone, average Medicare Advantage premiums are expected to increase nearly 18% in 2026, and the state is seeing the second-largest drop in available plans nationwide. You’re not just dealing with the Mayo Clinic issue but also facing higher costs and fewer choices across the board.
Your Coverage Options for 2026
If you’re affected by the Mayo Clinic changes, you have several paths forward. First, you can switch to a different Medicare Advantage plan that still includes Mayo in its network. Wellmark Blue Advantage PPO is confirmed to maintain Mayo access, and there may be other options available in your area. A licensed insurance agent can show you which plans cover Mayo and help you compare costs and benefits.
Switching to Original Medicare with a Medicare Supplement plan is another option that guarantees Mayo coverage. Medicare Supplement plans (also called Medigap) work with Original Medicare and are accepted at Mayo Clinic and virtually all hospitals that accept Medicare patients. The advantage is that you get broad provider access without worrying about networks. The downside is that you’ll typically pay higher monthly premiums than Medicare Advantage, and you’ll need a separate Part D plan for prescription drug coverage.
Be aware that if you’re switching from Medicare Advantage to a Medicare Supplement plan outside of certain protected periods, you may face medical underwriting. Insurance companies can ask about your health history and potentially deny coverage or charge higher rates based on pre-existing conditions. If you’re in good health, this might not be a problem, but if you have ongoing medical issues, you could face challenges getting approved for the supplement plan you want.
You should also check whether you qualify for any special enrollment periods that might give you additional options beyond the standard Annual Enrollment Period. If you’re eligible for both Medicare and Medicaid (dual eligible), you may have different rules and more flexibility in changing plans. A licensed agent familiar with your state’s specific regulations can explain what special circumstances might apply to your situation. For immediate assistance, call 866-633-4427.
Act Now During Open Enrollment
The clock is ticking on your ability to make changes. The Medicare Open Enrollment Period ends on December 7, 2025, giving you just a few weeks to compare plans, understand your options, and enroll in new coverage. After this deadline passes, you’ll generally have to wait until next year’s enrollment period to make changes, unless you qualify for a Special Enrollment Period due to specific life events.
Don’t wait until the last minute to start this process. Licensed insurance agents are reporting that appointments are filling up quickly due to unprecedented demand. The earlier you begin comparing plans, the more time you’ll have to carefully evaluate your options, understand the costs, and ensure your doctors and medications are covered. If you wait until late November or early December, you might find yourself rushed into a decision without fully understanding the implications.
When comparing plans, look beyond just the monthly premium. Check which doctors and hospitals are in-network, what your prescription drug costs will be, and what your out-of-pocket maximum is for the year. Some Medicare Advantage plans have low or zero premiums but higher costs when you actually need care. Others might have higher premiums but better coverage when you’re sick. The right choice depends on your health status, budget, and healthcare needs.
Remember that if you’re currently in active treatment at Mayo Clinic, you need to factor in how a plan change might affect your ongoing care. Some patients decide it’s worth paying more for a plan that keeps them at Mayo, while others find comparable care elsewhere at a lower cost. There’s no universal right answer, but you need to make this decision based on your specific medical situation and financial circumstances.
Conclusion
The Mayo Clinic decision to leave UnitedHealthcare and Humana Medicare Advantage networks reflects broader tensions in the American healthcare system. Financial pressures, administrative burdens, and disagreements over reimbursement rates are forcing hospitals and insurers to make difficult choices that ultimately affect your access to care. While Mayo Clinic and dozens of other health systems believe they can’t sustainably participate in many Medicare Advantage networks, beneficiaries in Minnesota, Wisconsin, and Iowa now face urgent decisions about their 2026 coverage.
You still have time to act during Medicare Open Enrollment, but you need to move quickly. Whether you choose to switch to a different Medicare Advantage plan that covers Mayo, move to Original Medicare with a supplement plan, or find a new healthcare provider, time is running out to decide. It’s advised to contact a licensed agent who can explain the differences between plans, compare costs, and find coverage that works for your medical needs and budget. For help choosing a Medicare plan, please call 866-633-4427 to speak with a Senior Healthcare Solutions Medicare expert.
