Wakemed (NC)

WakeMed chooses to leave UnitedHealthcare’s network

WakeMed has allowed our contract to expire after refusing to move off its demands for unreasonable rate increases. As a result, WakeMed’s facilities and specialty providers are out of network for people enrolled in the following plans, effective Nov. 15, 2025:

  • Employer-sponsored and individual commercial plans
  • Medicare Advantage plans, including Group Retiree, and Dual Special Needs Plan (DSNP) 

Primary care physicians employed by WakeMed are not impacted by this negotiation and will remain in network. People enrolled in our Medicaid plans will continue to have network access to WakeMed’s hospitals and providers. People enrolled in a Medicare Supplement plan can also continue accessing care with WakeMed on and after Nov. 15, 2025.

Our goal throughout this negotiation has always been to reach an agreement that is affordable for consumers and employers while maintaining continued, uninterrupted network access to WakeMed. We made numerous compromises, including proposing rates that would have continued to reimburse WakeMed at market-competitive rates.

Unfortunately, WakeMed maintained its demands for unsustainable rate increases, which would increase health care costs for North Carolinians and employers.

While we remain open to discussions with WakeMed, our primary focus at this time is providing our members uninterrupted access to the care they need through either continuity of care or supporting them as they transition to new care providers.

We know that network changes can be difficult, but our members can rest assured that they will continue to have access to quality, affordable care from a broad network of hospitals and physicians.

Our commitment to you and your family’s health care needs

If you are in active or ongoing treatment for a serious or complex condition with a WakeMed provider at the time they left our network, you are eligible to continue care for a period of time at in-network costs.

Continuity of care allows people in ongoing or active treatment for a serious or complex condition at the time a provider leaves our network to continue accessing care with their provider at in-network rates for a period of time. Some examples of people who qualify for continuity of care include, but are not limited to:

  • Women who are pregnant
  • Patients with newly diagnosed or relapsed cancer, or those currently in active cancer treatment.

Any member who believes they need continuity of care should contact UnitedHealthcare to determine if they are eligible.

For information regarding how to apply, whether you might be eligible for continuity of care and much more, please call the number on your health plan ID card. Our dedicated team of advocates are ready to assist you with all your health care needs.

We know WakeMed choosing to leave our network is difficult

We want you to know you continue to have access to a broad network of hospitals and physicians across the Raleigh area, including, but not limited to: 

  • UNC Rex Hospital
  • UNC Medical Center
  • UNC Health Johnston
  • UNC Health Johnston in Clayton
  • Duke Raleigh Hospital
  • Duke Regional Hospital
  • Duke University Medical Center
  • Wilson Medical Center
  • Cape Fear Valley Central Harnett Hospital

If you have questions or are in need of assistance finding alternative providers in your area, please call us at the number on your health plan ID card. You can also visit your plan’s website:

If a member needs assistance transitioning to a different provider, they can call UNC Health directly at: 984-974-CARE [2273]. This line offers prioritized appointment access within the UNC Health system to help ensure uninterrupted care.

You should always go to the nearest hospital in the event of an emergency. Services will be covered at the in-network benefit level, regardless of whether the hospital participates in UnitedHealthcare’s network.

Frequently asked questions

Despite our repeated efforts to reach a compromise, WakeMed has chosen to leave UnitedHealthcare’s network. As a result, WakeMed’s facilities and specialty providers are out of network for people enrolled in the following plans, effective Nov. 15, 2025:

  • Employer-sponsored and individual commercial plans
  • Medicare Advantage plans, including Group Retiree, and Dual Special Needs Plan (DSNP)

Primary care physicians employed by WakeMed are not impacted by this negotiation and will remain in network. People enrolled in our Medicaid plans will continue to have network access to WakeMed’s hospitals and providers. People enrolled in a Medicare Supplement plan can also continue accessing care with WakeMed on and after Nov. 15, 2025.

Our goal throughout this negotiation has always been to reach an agreement that is affordable for consumers and employers while maintaining continued, uninterrupted network access to WakeMed. We made numerous compromises, including proposing rates that would have continued to reimburse WakeMed at market-competitive rates.

Unfortunately, WakeMed refused to move off its demands unreasonable price hikes. If we agreed to WakeMed’s unsustainable proposal, health care costs for North Carolinians and employers would significantly increase.

While we remain open to discussions with WakeMed, our primary focus at this time is providing our members uninterrupted access to the care they need through either continuity of care or supporting them as they transition to new care providers. We know that network changes can be difficult, but our members can rest assured that they will continue to have access to quality, affordable care from a broad network of hospitals and physicians.

WakeMed’s facilities and specialty providers in the Raleigh region are out of network for people enrolled in the following plans, effective Nov. 15, 2025:

  • Employer-sponsored and individual commercial plans
  • Medicare Advantage plans, including Group Retiree, and Dual Special Needs Plan (DSNP) 

Primary care physicians employed by WakeMed are not impacted by this negotiation and will remain in network.

People enrolled in our Medicaid plans will continue to have network access to WakeMed’s hospitals and providers.

People enrolled in a Medicare Supplement plan can also continue accessing care with WakeMed on and after Nov. 15, 2025.

Yes. Primary care physicians employed by WakeMed are not impacted by this negotiation and will remain in-network, regardless of the outcome of our negotiation.

The following hospitals are out of network, effective Nov. 15, 2025:

  • WakeMed Cary Hospital
  • WakeMed Raleigh Campus
  • WakeMed North Hospital

This negotiation impacts members enrolled in the following plans:

  • Employer-sponsored and individual commercial plans
  • Medicare Advantage plans, including Group Retiree, and Dual Special Needs Plan (DSNP) 

Primary care physicians employed by WakeMed are not impacted by this negotiation and will remain in network.

People enrolled in our Medicaid plans will continue to have network access to WakeMed’s hospitals and providers.

People enrolled in a Medicare Supplement plan can also continue accessing care with WakeMed on and after Nov. 15, 2025.

People enrolled in our Medicare Advantage PPO and Group Retiree plans may receive care from an out-of-network provider, if the provider is a Medicare participating provider which accepts the plan.

If people have a Group Retiree PPO plan, their share of the cost is typically the same as if the provider was part of the network.

Members enrolled in our Medicare Advantage PPO and Group Retiree plans are encouraged to speak with the provider to confirm they will provide care, regardless of their network status.

Primary care physicians employed by WakeMed are not impacted by this negotiation and will remain in network.

For support finding in-network hospitals, members can call the customer care number on their health plan ID card or visit their plan’s website:

Our members will continue to have access to a broad network of hospitals and specialty providers across the Raleigh area, including, but not limited to:

  • UNC Rex Hospital
  • UNC Medical Center
  • UNC Health Johnston
  • UNC Health Johnston in Clayton
  • Duke Raleigh Hospital
  • Duke Regional Hospital
  • Duke University Medical Center
  • Wilson Medical Center
  • Cape Fear Valley Central Harnett Hospital

Primary care physicians employed by WakeMed are not impacted by this negotiation and will remain in network.

People enrolled in our Medicaid plans will continue to have network access to WakeMed’s hospitals and providers.

People enrolled in a Medicare Supplement plan can also continue accessing care with WakeMed on and after Nov. 15, 2025.

For support finding in-network hospitals, members can call the customer care number on their health plan ID card or visit their plan’s website:

UnitedHealthcare members who are in the middle of treatment at a WakeMed hospital or with a WakeMed specialty provider may qualify for continuity of care, which provides continued in-network benefits for a specified period of time after a hospital or physician leaves our network.

Examples of patients who may qualify include:

  • Women who are pregnant
  • Patients with newly diagnosed or relapsed cancer, or those currently in active cancer treatment.

People who have questions about continuity of care, including whether they might be eligible and how to apply, should call the number on the back of their health plan ID card.

UnitedHealthcare members should always go to the nearest hospital in the event of an emergency. Their services will be covered at the in-network benefit level, regardless of whether the hospital participates in UnitedHealthcare’s network.

For support finding in-network hospitals, members can call the customer care number on their health plan ID card or visit their plan’s website: