Raleigh, NC – The Medicare Advantage contract between WakeMed Health & Hospitals and UnitedHealthcare has officially ended, leaving some North Carolinians potentially without coverage at WakeMed facilities. The termination comes amid ongoing contract negotiations and conflicting claims from both sides over the rate increase.
What happened
Starting Saturday, November 16, 2025, UnitedHealthcare Medicare Advantage plans are no longer accepted at WakeMed hospitals, outpatient clinics and urgent care facilities. WakeMed said UnitedHealthcare “decided to remove Medicare Advantage” from negotiations on Nov. 7. In turn, UnitedHealthcare said that WakeMed abandoned its network by refusing the proposed rate agreements.
Patients are now considered out-of-network for Medicare Advantage coverage at WakeMed, which means higher out-of-pocket costs. WakeMed warned that if no agreement was reached, patients and employers could face rates up to 40% higher for some services.
Negotiations on commercial contracts will continue, with WakeMed and UnitedHealthcare scheduled to resume discussions on Monday, November 17.
Who are WakeMed and UnitedHealthcare?
WakeMed Health & 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 leading insurance provider offering Medicare Advantage and commercial health plans throughout the United States, including North Carolina.
The termination of the contract affects Medicare Advantage members who rely on WakeMed for routine care, specialty services and emergency treatment.
Case details and implications
WakeMed said the withdrawal from Medicare Advantage is part of a nationwide UnitedHealthcare strategy to underfund these plans. Without the new contract, patients would face significantly higher costs, according to WakeMed spokeswoman Kristin Kelly.
Laurie Mandel, CEO of UnitedHealthcare’s Carolinas Health Plan, said WakeMed is demanding a nearly 40% price increase, including a 30% increase in the first year alone. Mandel said the proposal would increase health care costs for North Carolinians and employers by more than $94 million over two years.
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 are concerned about access to care and the financial burden of out-of-network fees. Community leaders have called for a quick solution, stressing the importance of keeping health care affordable and accessible.
Official statement and next steps
WakeMed and UnitedHealthcare are continuing talks to resolve the impasse. WakeMed urged patients to prepare for higher costs if no deal is reached. UnitedHealthcare reiterated that its priority is to reach a fair and market-competitive rate structure.
Both sides have stressed the importance of transparency and communication with patients, especially those undergoing ongoing treatment at WakeMed facilities.
This story may be updated with more information as it becomes available.
