Univera’s coverage of Roswell Park highlights Medicare Advantage changes this year

The days of “set it and forget it” are over for seniors choosing a Medicare Advantage plan.

Even with fewer disruptions than last year, changes to benefits, costs and provider networks mean seniors should review their coverage during Medicare’s annual open enrollment, which runs through Dec. 7.

“I would say take that time to do the review and get your individual situation lined up against the plans that are available to find the one that fits for you,” advised Alyssa McGovern, director of Medicare at insurance firm Lawley.

Her team has added evening and weekend appointments to help seniors evaluate their options. McGovern described this year’s market as “a little bit less disruptive,” but some plans have still changed, and coverage for Roswell Park Comprehensive Cancer Center continues to shift.

Rising healthcare costs and lower government reimbursements have squeezed insurers’ profits, prompting them to retire plans, introduce new ones and revise provider networks.

In Medicare Advantage, the government pays private insurers to operate approved health insurance plans for those 65 and older as an alternative to traditional Medicare. In 2026, 55% of eligible beneficiaries nationwide enrolled in Medicare Advantage, compared with 78% in Erie County, according to health policy organization KFF.

Here’s what seniors should know during open enrollment:

Changes for Roswell Park

Effective Jan. 1, Roswell Park’s main campus and its outpatient centers – 100 College Parkway, Suite 290, in Amherst; 203 Park Club Lane in Amherst; and 6934 Williams Road in Wheatfield – will be in network with one Univera Medicare Advantage individual plan: the SeniorChoice Secure plan.

That is a change from the 2026 plan year, when Roswell Park was in network with all of Univera’s Medicare Advantage plans.

In addition to the SeniorChoice Secure plan, Univera said Roswell Park will remain in network with Medicare Advantage employer group plans, employer-sponsored plans, self-funded plans, Medicaid and other New York State plans.

“With Medicare Advantage plans facing growing pressures nationwide, we worked closely with Roswell throughout the year to explore every possible option to keep it in our network for as many members as possible,” Univera said in a statement.

Roswell Park’s main campus and outpatient centers also will be out of network with all of Independent Health’s individual Medicare Advantage plans for the second straight year. Independent Health noted, however, that Roswell Park is in network with its Medicare Advantage employer group plans, employer-sponsored plans, self-funded plans and Medicaid plans.

Roswell Park is listed as in network with four out of six individual Medicare Advantage plans from Highmark Blue Cross Blue Shield.

According to Roswell Park’s website, the cancer center also will be in network for 2027 with all individual Medicare Advantage plans from Aetna, Wellcare and Wellcare by Fidelis Care.

There are network differences between Roswell Park’s main campus and its Care Network. The Roswell Park Care Network includes community practices and affiliations with other health systems across the state.

Univera said Roswell Park Care Network locations will remain in network with all of its individual Medicare Advantage plans.

Letter: Be careful with Medicare Advantage sign-ups

Roswell Park is warning seniors that many 2027 Medicare Advantage Plans don't include Roswell Park in their HMO / PPO networks. Check roswellpark.org/medicare.

Aetna, Highmark, UnitedHealthcare, Univera and MVP Health Care have several plans each for 2027 that include the Roswell Park Care Network.

Care Network practices offer consultations, chemotherapy/infusion and follow-up care for cancer and many noncancer conditions. The practices then work with the main Buffalo campus for inpatient care, advanced surgeries, clinical trial access and complex treatments.

WNY is not alone

Coverage for National Cancer Institute-designated comprehensive cancer centers has been shifting across the country.

For example, Moffitt Cancer Center in Florida became out of network for Humana Medicare Advantage plans on July 1, and Mass General Brigham Health Plan removed Dana-Farber Cancer Institute in Boston from its Medicare Advantage network Oct. 1.

Further, a study published in June found that fewer than one-quarter of Medicare Advantage plans covered NCI-designated comprehensive cancer centers.

Another Voice: Decisions on Medicare could affect access to life-saving cancer care

Access to Roswell Park care through certain individual Medicare Advantage products may become more limited in 2027. The majority of Medicare Advantage plans limit patient choice on oncology providers

As oncology networks have narrowed, Roswell Park has reached out to make patients aware of changes year to year with individual Medicare Advantage plans.

“We encourage those with individual Medicare Advantage plans to reach out to us for help understanding what their plans will cover for the year ahead,” said Dr. Julia Faller, chief medical officer at Roswell Park. “This community knows the value of Roswell Park care, and we will continue to work with patients and health plans to explore every reasonable option for access.”

Changes with other plans

While Independent Health said it retired one Medicare Advantage plan and added a new one for 2027, Highmark said its 2027 Medicare Advantage offerings will consist of HMO plans in addition to the Freedom Valor PPO plan designed for veterans.

HMO plans are generally less expensive than PPO plans, though PPO plans offer more flexibility in provider choice.

Highmark said members currently enrolled in PPO plans will be able to choose from several Medicare Advantage offerings during open enrollment. Among the benefits members have access to, according to Highmark: $0 primary care visits, preventive care services, many $0 Tier 1 prescription drugs, as well as dental, vision, hearing and fitness benefits.

Independent Health discontinued one plan for 2027 – the Encompass 65 Red 043 plan, which has a $190 monthly premium – and added a new plan: the Encompass 65 Red 045 plan, which has a $286 monthly premium.

Independent Health’s Medicare Advantage offerings for 2027 include four HMO plans and one PPO plan. Those plans, depending on the plan selected, include a $0 routine eye exam and an allowance toward eyewear; $0 preventive dental services, including in- and out-of-network dental coverage; hearing aids; telehealth; and the SilverSneakers fitness program.

Help is available

McGovern, director of Medicare at Lawley, recommends every senior closely reads their Annual Notice of Change and considers scheduling a review with a Medicare broker.

“There's so many plans out there that I'm confident that we can find plans that closely match,” McGovern said.

According to KFF, there are 27 Medicare Advantage prescription drug plans available to Medicare beneficiaries in Erie County, similar to the nationwide average of 28 plans.

Medicare Advantage enrollees also can switch to another plan or drop their plan and return to traditional Medicare during Medicare Advantage’s open enrollment period from Jan. 1 to March 31.

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