THE VILLAGES, Fla. – As negotiations between UnitedHealthcare and The Villages Health continue, patients are wondering whether their UHC plans will be accepted at TVH in 2026.
UnitedHealthcare says about 25,000 members received services in some capacity from The Villages Health in the past year.
Kevin Day has worked in benefits administration for 25 years and said these longer negotiations are becoming more common. He said costs could be playing a part in these discussions.
[WATCH: Thousands left in limbo as Medicare deal for The Villages Health remains elusive]
“From the UnitedHealthcare standpoint, they want to pay the least amount for the services,” Day said. “So, they say doctor’s visit is ‘X’ dollars right now and in the contract, they want ‘Y.’ They’re going to push for that lower amount. But all those claims, it’s a lot of money. And you think, okay, a couple dollars here, a couple of dollars there, add that up over a year and it’s a significant amount.”
“Conversely, from the clinic side, they’re saying, well, you know, we want to be reimbursed for our time, so we have to pay our folks more, equipment costs more, liability insurance costs more, all those things that go into running a doctor’s office or a practice and they say we want to be reimbursed a greater amount from UnitedHealthcare,” Day said.
The Villages Health sale to CenterWell, a division of Humana, closed on Nov. 7.
[WATCH: What The Villages Health sale will mean for its patients]
That same day, The Villages Health CEO, Bob Trinh, sent out a notice to patients, saying if no deal is reached, TVH can no longer accept UHC plans beginning Jan. 1, 2026.
Day thinks the sale could be playing into this.
“Especially the fact that it was sold to a Humana entity,” Day said. “So now you have two different carriers, which, of course, are competing in the marketplace, Humana and UnitedHealthcare.”
Day said it’s possible we could see this again with other carriers.
Though The Villages Health said it will accept plans from Florida Blue, Aetna, Humana and CarePlus in 2026.
“If the provider wins out and says, hey, we got a better deal, we’re getting more money now for our services,” Day said, “Then they’re going to want to re-up that with all of the other carriers that they deal with as well, to say, hey, we want to be paid that same what we view as a fair amount.”
Day said there is hope. He said he’s been through negotiations that last up until the last second and the contracts were finalized.
He also said people with UHC should do their research on other providers in case the deal doesn’t go through, and make sure to make any changes before their deadline.