During the Medicare Open Enrollment Period (Oct. 15 to Dec. 7, 2025), United Healthcare Medicare Advantage enrollees may want to consider returning to traditional Medicare coverage or transferring to a Medicare Advantage plan that has an in-network participation agreement with Tift Regional Medical Center and Southwell Medical.
After three years of unresolved disputes, Tift Regional Medical Center/Southwell Medical (collectively “TRMC”) still does not have an in-network participation agreement with the United Healthcare Medicare Advantage (“UHCMA”) plan. This does not affect traditional Medicare or United Healthcare’s commercial plans.
“TRMC did not renew the agreement last year because payments from UHCMA were delayed in many cases and did not appropriately cover the true cost of care,” said Christopher Dorman, TRMC President/CEO. “We rely on fair, timely payments to provide the high-quality services expected by our patients and the community. Basically, UHCMA was paying what they wanted to pay and when they wanted to pay without regard to what was in the agreement.”
Dorman noted that TRMC is not alone and that some of the other hospital systems within the region do not have a network participation agreement with UHCMA for the same reasons as TRMC.
“Unlike for-profit United Healthcare, TRMC has no stockholders—we just have stakeholders,” Mr. Dorman said. “TRMC is a nonprofit hospital which negotiated contract terms in good faith on behalf of the communities we serve.”
Dorman said TRMC is reminding the public now because the open enrollment period for Medicare started on Oct. 15 and ends on Dec. 7.
“The open enrollment period is an opportunity for UCHMA enrollees to transfer to a Medicare Advantage plan that has a network participation agreement with TRMC,” he stated. “These Medicare Advantage plans include Aetna, Anthem Blue Cross Blue Shield, Clear Spring Health, Clover Health, Humana, Pruitt Health Premier, and WellCare. Of course, we are also covered by traditional Medicare.”
Other options include:
- Visit medicare.gov to search for available plans based on zip code and other criteria.
- Call 1-800-MEDICARE for guidance from a representative with the federal Medicare operation.
- Contact the Georgia State Health Insurance Assistance Program at 866-552-4464, option 4, for free assistance with reviewing Medicare enrollment options.
- Call the phone number on the back of your insurance card for more information.
“It is important to note that TRMC continues to provide services to UHCMA enrollees as an out-of-network provider,” Mr. Dorman said. “In network means we have contracted rates with the Medicare Advantage plan. In many cases, deductibles for patients under an out-of-network Medicare Advantage plan are the same as an in-network plan.”
For further assistance, patients can call TRMC Patient Financial Services at 229-353-7072.
“We thank Medicare Advantage patients for their continued trust in TRMC,” said Dorman.