Thousands of Stanislaus patients need Medicare Advantage switch to keep doctors

Healthcare providers are dealing with a shakeup in Medicare Advantage coverage in Stanislaus County.

UnitedHealthcare will discontinue three Medicare plans that provided extra benefits for residents 65 years and older and for certain disabled individuals. The change will take effect Jan. 1.

Sutter Health sent an Oct. 1 letter informing affected patients that the AARP Medicare Advantage HMO through UnitedHealthcare won’t include access to Sutter physicians, specialists and healthcare centers next year. Patients wishing to continue with Sutter physicians, hospitals, lab and imaging services will need to choose another Medicare Advantage plan or use basic Medicare.

Sacramento-based Sutter Health owns Memorial Medical Center in Modesto.

A spokesperson said Tuesday that about 4,100 Sutter patients in this county are impacted by UnitedHealthcare’s decision to leave the local Medicare Advantage market. The UnitedHealthcare AARP plans also have given patients access to the Modesto-based AllCare independent physicians group.

“We are committed to supporting patients during this transition,” Sutter said in a statement. “We are reaching out to all (our) affected patients through letters, emails and outbound calls to provide resources and guidance — including co-hosting in-person events and webinars with licensed insurance agents to help them understand their coverage options and maintain continuity of care where possible.”

Sutter identified three other Medicare Advantage plans that it accepts in Stanislaus County. Those include Alignment Health My Choice PPO and Sutter Senior Advantage, which is a SCAN Medicare HMO.

Sutter also accepts a Health Plan of San Joaquin HMO, a special needs plan for low-income patients eligible for both Medicare and Medi-Cal. Acceptance of the Health Plan of San Joaquin HMO is limited to established patients, the letter said.

The communication directed patients to an online site to learn about Medicare Advantage options accepted by Sutter in various counties including Stanislaus. The letter said licensed insurance agents or Sutter customer service reps are good resources for explaining options for patients and help with finding a new plan that meets their needs.

Nine insurers offer Medicare-approved Advantage plans in this county, with some including access to Kaiser Permanente medical offices and hospitals, AllCare physicians or Central Valley Medical Group. In 2025, the monthly premiums for the government-subsidized Medicare plans ranged from zero to $97.

Medicare Advantage places an annual limit on copayments and other out-of-pocket expenses and covers prescription drugs, dental, hearing and vision.

People eligible for Medicare can make changes to their coverage during a fall enrollment period, Oct. 15 to Dec. 7. They’re advised to make sure the health plan includes their doctors and covers their prescription drugs before enrolling in Medicare Advantage.

Information hasn’t been available on the total number of patients affected by UnitedHealth’s decision. Sutter noted that changes disclosed this month do not affect employer-sponsored Medicare plans that it accepts, such as UnitedHealthcare Medicare Advantage plans through CalPERS and large employers.

The Health Insurance Counseling and Advocacy Program in Modesto will hold an informational event at 9 a.m. Oct. 17 about changes to Medicare programs, premium costs and benefits in 2026. The forum will be held at the Stanislaus Veterans Center, 3500 Coffee Road.

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