Impacted by UnitedHealthcare’s Decision to Drop Door County Medical Center from Their Medicare Advantage Network? You Have Options.
Door County Medical Center’s (DCMC) mission has always been to provide quality, accessible care close to home. Every decision we make begins with that commitment.
Effective January 1, 2026, DCMC will no longer be considered an in-network provider for most UnitedHealthcare (UHC) Medicare Advantage plans. This change follows UHC’s decision to modify its Medicare Advantage network, which includes the removal of DCMC. In their Tuesday, July 29, 2025 investor call, UHC is quoted as follows, “We are shifting to narrower networks and focusing on more disciplined managed products, particularly in Medicare Advantage.” Additionally, in these remarks, they state, “We have made the difficult decision to exit plans that currently serve over 600,000 members.” While DCMC made every effort to remain within the network, UHC has finalized its decision—an outcome we find deeply disappointing.
We understand this change may create uncertainty for some patients, and we want to explain why this step is necessary to protect the future of healthcare in our community. To help clarify the situation, Brian Stephens, CEO of Door County Medical Center, addressed several myths currently circulating.
Here’s What’s Happening
“The most common myth is that this affects all UnitedHealthcare plans. I want to reassure you that this does not impact any other UnitedHealthcare plans. This change only affects people who are on Medicare Advantage plans through UnitedHealthcare, which are sometimes called UnitedHealthcare or AARP plans. If you have commercial insurance through United or Medicaid through UnitedHealthcare or a Medicare Supplement Plan through United, this does not affect you.”
Another misconception is that this change is the result of a rate dispute or a quality issue. “This is not a negotiation about rates or about the quality of our services. In fact, Medicare Advantage plans pay us the Medicare rate, so there is nothing to negotiate. This is a national initiative by UnitedHealthcare to reduce participation in their Medicare Advantage plans by excluding certain providers, including rural healthcare providers.”
Finally, enrollment changes remain possible for those currently impacted. “If you are on a UnitedHealthcare Medicare Advantage plan, you do have the option to remain with Door County Medical Center providers and facilities, but you must change your health insurance plan. The open enrollment period runs through December 7 and allows you to evaluate your coverage. You can return to traditional Medicare, which includes nearly every provider in northeast Wisconsin, or explore other Medicare Advantage plans. We are in-network with every other Medicare Advantage plan sold in our area for 2026.”
Stephens emphasized that patients are not alone during this transition. “If you are on a UnitedHealthcare Medicare Advantage plan, please know that you have resources available. You can work with insurance agents, the ADRC, or call us. Our Patient Financial Services team is happy to help you understand your options.”
DCMC Patient Financial Services Has Your Back
Our Patient Financial Services team is ready to help patients identify plans that include DCMC in their network. Free appointments can be booked between now and January 15, 2026. Community members are advised to review their health insurance options during the Medicare open enrollment period, which ends December 7, 2025, to ensure there are no coverage gaps in 2026. To schedule, call 920-746-0409 or email DCMC_PFS@dcmedical.org.
Important information for your appointment:
- Bring Social Security numbers and dates of birth for all immediate family members, proof of 2024 income, email address, and healthcare.gov login details (if known).
- Certified Application Counselors will guide you through the process step by step using a computer in our conference room.
- Appointments are available Monday–Friday, 8 a.m.–3 p.m., with outside hours upon request. Location: DCMC Patient Financial Services, Cherry Point Mall, 1300 Egg Harbor Rd, Suite #140, Sturgeon Bay.
As a Medicare 5-star rated hospital, DCMC continues to focus on providing high-quality care and strengthening ties within the community. We value the ongoing trust and support of our patients and neighbors and are here to assist them during this transition.
What You Need to Know:
- DCMC stays in-network for UnitedHealthcare Medicare Advantage plans until December 31, 2025.
- This change affects only UnitedHealthcare Medicare Advantage plans, sometimes called UHC or AARP Medicare Advantage plans, and does not affect other UnitedHealthcare plans.
- Emergency services will continue to be covered at DCMC facilities. Participants should review UHC's definition of emergent conditions.
- You have many options to stay with Door County Medical Center by making a change in your insurance coverage during the Open Enrollment period.
Sources:
- Niasse, A. (2025, October 2). UnitedHealth to exit Medicare Advantage plans in 109 US counties. Reuters.
https://www.reuters.com/legal/litigation/unitedhealth-exit-medicare-advantage-plans-16-us-counties-2025-10-01/ - MedPage Today. (2025, April 8). Rural hospitals question viability of Medicare Advantage contracts. https://www.medpagetoday.com/publichealthpolicy/medicare/115016
