By Paul Barrett, CMIP | The Modern Medicare Agency | Melville, NY 18+ years Medicare-exclusive experience | Licensed in 34 states | 40+ carriers Last updated: June 2026
If your doctors are at Northwell Health and you have a Medicare Advantage plan, there is something you need to know right now — before your next appointment.
Three major insurance carriers have either already terminated or are in the process of terminating their network relationships with Northwell Health in 2026. If you are enrolled in any of their plans, you may already be paying out-of-network rates, or you may be about to lose covered access to your doctors and hospitals without realizing it.
This article tells you exactly which plans are out, which plans remain strong, and what you can do today if you’re affected.
Why Northwell Health Matters for Farmingdale Residents
Northwell Health is the largest health system in New York State. With 28 hospitals, more than 1,000 ambulatory care facilities, and over 105,000 employees across Long Island, New York City, Westchester, and the Hudson Valley, Northwell is not just one option among many for Nassau County residents — for most Farmingdale families, it is the backbone of local healthcare.
The Northwell facilities most relevant to Farmingdale and Nassau County residents include:
- North Shore University Hospital (Manhasset) — flagship hospital, ranked #1 in New York State by U.S. News & World Report
- Long Island Jewish Medical Center (New Hyde Park) — major regional medical center, top 5% nationally by Healthgrades
- Plainview Hospital (Plainview) — top 5% nationally by Healthgrades, 2026 Patient Safety Excellence Award
- South Shore University Hospital (Bay Shore)
- Huntington Hospital (Huntington)
- Syosset Hospital (Syosset)
- Glen Cove Hospital (Glen Cove)
- Northwell Health — Farmingdale (475 Main St, Farmingdale, NY 11735) — local outpatient location directly serving the 11735 community
- Garden City/Syosset SurgiCenter — accepting Northwell-affiliated insurance plans
When you choose a Medicare Advantage plan, you’re not just choosing a premium and a copay structure. You’re choosing which doors stay open to you when you get sick. In Nassau County, those doors are almost always Northwell doors.
That’s why the network changes happening right now are not just administrative footnotes. They are decisions that determine whether you can keep your cardiologist, your oncologist, or your orthopedist — or whether you have to start over.
The Three Carriers That Have Lost Northwell Access in 2026
WELLCARE — Out of Network as of July 1, 2026
What happened: Wellcare chose not to renew its contract with Northwell Health. The contract expired June 30, 2026. As of July 1, 2026, all Northwell hospitals, physician groups, ancillary facilities, and affiliated providers are out-of-network for Wellcare Medicare Advantage members.
What Northwell published officially:
- Through June 30: All Wellcare members could continue scheduled visits normally
- July 1 – August 29: Established Medicare Advantage patients may continue treatment with Northwell clinicians, subject to Wellcare’s authorization and approval
- After August 29: Patients with chronic medical needs (cancer treatment, diabetes) will be supported in either continuing care out-of-network (depending on plan benefits) or transitioning to in-network Wellcare providers
- Emergency care: Emergency services remain covered at all Northwell emergency departments for Wellcare members regardless of network status
Source: Northwell Health official Wellcare update page, northwell.edu/wellcare-update
What this means for you: If you are currently enrolled in a Wellcare Medicare Advantage plan and see any Northwell doctors, you are in a time-sensitive situation. The continuity of care window through August 29 is not unlimited, not automatic, and requires Wellcare’s active authorization for each service. Do not assume your upcoming appointments are covered — call Wellcare directly, confirm authorization, and call my office to discuss your plan change options.
HEALTHSPRING (formerly Cigna Medicare) — Out of Network as of January 1, 2026
What happened: HealthSpring (now operating under that name after HCSC acquired Cigna’s Medicare business in 2025) terminated its relationship with Northwell Health effective December 31, 2025. As a broker partner of HealthSpring, I received direct written notification from the carrier stating:
“Despite negotiations in good faith, Northwell Health will be leaving our Medicare Advantage (MA) network in New York effective December 31, 2025. This termination includes all Northwell Health hospitals, ancillaries, and provider groups, as well as their clinically integrated network.”
What this means: If you are enrolled in a HealthSpring Medicare Advantage plan, Northwell has been out-of-network since January 1, 2026. This is not a future risk — it has already happened. Every Northwell visit you’ve had in 2026 on a HealthSpring plan has been processed at out-of-network rates.
Unlike the Wellcare situation which unfolded publicly, the HealthSpring termination received very little consumer-facing attention. Many HealthSpring members in Nassau County may not even know Northwell left their network six months ago.
FIDELIS CARE — Out of Network for Medicare Advantage as of July 15, 2026
What happened: Fidelis Care issued a termination notice to Northwell. The contract terminated May 15, 2026, with a transition period. According to Northwell’s official update, Medicare Advantage patients could continue seeing Northwell providers through July 14, 2026, with Fidelis Medicare Advantage members considered out-of-network as of July 15, 2026.
Source: Northwell Health official Fidelis update page, northwell.edu/fidelis-update
Important note: As of the time this article was written, Fidelis and Northwell were still in active negotiations. Fidelis stated they were working toward a resolution. Whether a deal was reached by the July 15 deadline was not confirmed in publicly available information at publication. If you are on a Fidelis Care Medicare Advantage plan, call Northwell’s dedicated patient line at (516) 856-8489 or check northwell.edu/fidelis-update for the most current status.
The context: The public dispute between Northwell and Fidelis mirrors disputes happening nationally. Northwell stated that “Fidelis proposed reimbursement rates that fall well below the actual cost of delivering care.” Fidelis countered that “the rates Northwell is seeking significantly exceed those paid to comparable providers.” This reimbursement dispute — hospitals demanding more, insurers pushing back — is the same dynamic driving network exits across the country in 2026.
What this means for you: If you are on a Fidelis Care Medicare Advantage plan, do not assume your Northwell access is intact without verifying. Call Fidelis at 1-888-FIDELIS and confirm your specific doctor’s current network status. Emergency care remains covered at Northwell emergency departments regardless of contract status.
The Carriers That Currently Maintain Strong Northwell Relationships
Not every carrier has had a falling out with Northwell. Here’s the current status of the major Medicare Advantage carriers available to Farmingdale and Nassau County residents:
✅ AETNA — Strong In-Network Relationship
Aetna Medicare Advantage maintains an active, stable contract with Northwell Health in 2026. The relationship covers Northwell’s physician network, hospitals, and ancillary facilities throughout Nassau and Suffolk Counties. With over 15,740 Nassau County enrollees, the Aetna Medicare Elite PPO is the single most popular Medicare Advantage plan in Nassau County — and Northwell access is a significant reason why.
Aetna’s PPO structure also gives members the flexibility to see providers at both Northwell and NYU Langone without a referral, which is particularly valuable for Farmingdale residents who may have specialists at more than one system.
Important note: Always verify your specific physician against Aetna’s current 2026 network directory before assuming coverage. While Aetna’s overall Northwell relationship is strong, individual provider participation can vary — particularly for physician groups versus hospital facilities.
ANTHEM BLUE CROSS BLUE SHIELD (formerly Empire BCBS) — In-Network
Anthem maintains an active network relationship with Northwell Health. Their Medicare Advantage 2 HMO-POS earned the only 5-star CMS rating available on Long Island for 2026. Northwell and Anthem have a documented history of direct contracting arrangements, and Anthem’s network on Long Island is among the most stable available to Nassau County Medicare enrollees.
UNITEDHEALTHCARE — In-Network (with important caveats)
UHC maintains a network relationship with Northwell Health in New York, and Northwell is generally accessible to AARP Medicare Advantage members through UHC’s HMO-POS plans in Nassau County. However, two important caveats apply:
First, UHC removed their Regional PPO plans from this market for 2026, which historically offered the broadest provider access. The remaining HMO-POS structure requires more careful network verification.
Second, UHC’s network depth on Long Island is not as strong as it is nationally or in other markets. While major Northwell hospitals are generally in-network, individual physician participation can be more limited in Nassau and Suffolk Counties compared to other UHC markets. Always verify your specific doctors — not just the hospital system.
HEALTHFIRST — In-Network (verify individual providers)
Healthfirst maintains a relationship with Northwell providers in the New York area. However, their network strength on Long Island is considerably more limited than in the five boroughs. Farmingdale residents should verify each specific physician before enrolling, as Healthfirst’s Long Island network is thinner than what you’d find in Queens or Brooklyn.
The Bigger Picture: Why This Is Happening Everywhere
What’s happening with Northwell and these carriers is not a local story. It’s a national crisis playing out in your backyard.
Across the country in 2025–2026, health systems have been leaving Medicare Advantage networks at an unprecedented rate. Becker’s Hospital Review documented 23 major health systems dropping Medicare Advantage plans in 2026 alone. Mount Sinai went out of network with Anthem in January. NewYork-Presbyterian and UnitedHealthcare were headed toward a network exit in June without a new agreement. Mayo Clinic left UHC and Humana MA plans nationally. The list goes on.
The reason is always the same: Medicare Advantage plans pay hospitals less than traditional Medicare — and hospitals are reaching their limit.
MedPAC’s June 2026 analysis found that while Medicare Advantage plans receive an additional $2,664 per enrollee above their estimated costs from the federal government, they use that money to fund supplemental benefits and profit margins rather than passing it through to providers. Hospitals look at what they receive from Medicare Advantage versus what they receive from traditional Medicare and increasingly conclude the math doesn’t work.
For you, the consumer, the impact is direct and personal. The plan that promised you access to Northwell’s world-class cardiac care may no longer be honoring that promise.
The Medigap Solution: Why Network Instability Makes the Case
This is where I want to be direct with you, because it’s what I’d tell a family member.
If your Northwell access matters to you — if you’ve built a relationship with a specific cardiologist, oncologist, orthopedist, or primary care physician at Northwell over the years — there is a coverage option that will never put that relationship at risk: Medigap (Medicare Supplement).
With a Medigap plan, you keep Original Medicare as your primary coverage. Any doctor or hospital in the country that accepts Medicare accepts your Medigap plan. No networks. No contracts to renegotiate. No carrier deciding unilaterally that Northwell costs too much.
If Wellcare and Northwell have a dispute, it doesn’t affect you. If HealthSpring exits, it doesn’t affect you. If any carrier and any hospital can’t agree on reimbursement rates next year, it doesn’t affect you. Your Plan G or Plan N card works everywhere Medicare is accepted — today, and every year going forward.
The trade-off is premium. In New York, Plan G runs $372.50/month through UHC — the lowest available carrier on Long Island. That’s real money. But for someone managing a serious condition with a trusted specialist at Northwell, the math may favor the certainty of Medigap over the risk of Medicare Advantage network instability.
New York also gives you a right most states don’t offer: you can switch from Medicare Advantage to Medigap at any time of year, without medical underwriting, regardless of your health. If you’re currently on a Wellcare, HealthSpring, or Fidelis plan and need to make a change, that door is open to you right now.
What To Do If Your Plan Has Lost Northwell Access
Step 1: Confirm your plan. Check the front of your insurance card. If it says Wellcare, HealthSpring (formerly Cigna), or Fidelis Care, and you have Northwell doctors — read the rest of this carefully.
Step 2: Do not assume continuity. The temporary continuity of care protections that exist for Wellcare and Fidelis are not automatic. They require active authorization from the carrier for each service. A scheduled appointment is not guaranteed coverage. Call your carrier before your next Northwell visit.
Step 3: Know your Special Enrollment Period rights. CMS rules allow Medicare Advantage members to request a Special Enrollment Period when their plan makes a significant network change that affects their access to care. If Northwell is your provider and your plan dropped Northwell, you may qualify to change plans outside of the normal Annual Enrollment Period. The specifics depend on timing and circumstances — call me and I will walk you through your eligibility.
Step 4: Consider your long-term options. If your doctor is at Northwell and Northwell network stability is important to you, this is the moment to evaluate whether Medicare Advantage is the right long-term structure for your situation, or whether Medigap’s unconditional provider freedom is worth the higher monthly premium.
Step 5: Call before you act. Changing Medicare plans mid-year has rules. Don’t cancel, disenroll, or make any changes without speaking with a licensed independent broker who can review your specific situation and walk you through the options without pressure.
Quick Reference: Northwell and Medicare Plans in 2026
Carrier | Northwell Status (Medicare Advantage) | Notes |
Aetna | ✅ In-Network | Strong, stable relationship — most popular plan in Nassau County |
Anthem BCBS | ✅ In-Network | 5-star CMS rating, strong Long Island network |
UnitedHealthcare | ✅ In-Network (verify) | Verify individual physicians — LI network thinner than national |
Healthfirst | ✅ In-Network (verify) | Verify each provider — stronger in boroughs than Long Island |
Wellcare | ❌ Out of Network as of July 1, 2026 | Continuity of care through Aug 29 with authorization |
HealthSpring (formerly Cigna) | ❌ Out of Network since Jan 1, 2026 | Full termination — all hospitals, ancillaries, physician groups |
Fidelis Care | ⚠️ Out of Network as of July 15, 2026 | Negotiations were ongoing at publication — verify current status at northwell.edu/fidelis-update |
Medigap (any plan) | ✅ Always In-Network | No network restrictions — works wherever Medicare is accepted |
Note: Emergency services remain covered at Northwell emergency departments for all carriers regardless of network status. Network status reflects information available as of June 2026. Always verify current network participation directly with your carrier before scheduling non-emergency care.
Frequently Asked Questions
It depends on your carrier. Aetna, Anthem, and UnitedHealthcare currently maintain Northwell network relationships in 2026. Wellcare, HealthSpring, and Fidelis Care have all terminated or are terminating their Northwell contracts. If you’re on Wellcare or Fidelis, contact your carrier immediately. If you’re on HealthSpring, Northwell has been out-of-network since January 1, 2026.
That depends on your specific plan. The Northwell location at 475 Main St is an outpatient facility. Whether it is in-network for your plan depends on your carrier’s contract with Northwell. Wellcare, HealthSpring, and Fidelis do not currently have active network contracts with Northwell. Aetna, Anthem, and UHC generally do — but always verify for your specific plan
After August 29, you will be responsible for out-of-network cost-sharing for most Northwell services. Some patients with chronic conditions (cancer, diabetes) may be supported in continuing care, but this is not automatic. Emergency services remain covered. You should contact Wellcare and also explore whether you qualify for a Special Enrollment Period to change plans.
According to Northwell’s official update, Fidelis Care Medicare Advantage patients were considered out-of-network as of July 15, 2026. However, negotiations between Northwell and Fidelis were still reported as ongoing as of late May 2026. The situation may have changed. Check northwell.edu/fidelis-update for the current status, or call Northwell’s patient line at (516) 856-8489. Emergency care remains covered at all Northwell emergency departments.
Possibly. CMS has provisions for Special Enrollment Periods when a plan makes a significant mid-year change affecting your access to care. The eligibility, timing, and process vary by situation. Call me directly — 631-358-5793 — and I will review your specific circumstances at no charge.
Yes. Completely. A Medicare Supplement plan works alongside Original Medicare, which means any provider who accepts Medicare accepts your coverage — regardless of what contract negotiations are happening between any carrier and any hospital system. Northwell accepts Original Medicare. A Medigap plan adds coverage for the gaps. No network restrictions, no contract disputes, no surprises. In New York, you can switch from Medicare Advantage to Medigap at any time of year without medical underwriting.
Generally yes, but with important nuances. UHC maintains a network relationship with Northwell in New York, and major Northwell hospitals are generally accessible to Nassau County AARP Medicare Advantage members. However, UHC’s individual physician network on Long Island is thinner than in other markets, and UHC removed their Regional PPO plan from this area in 2026. Always verify your specific doctors against UHC’s current plan directory before enrolling or scheduling care.
Call my office immediately — 631-358-5793. Depending on your situation, you may qualify for a Special Enrollment Period to change plans, continuity of care protections that allow you to finish a course of treatment, or options to switch to Medigap with no underwriting. Do not simply pay the out-of-network bill and assume nothing can be done. There are often options — but they are time-sensitive.
I'm Here to Help ,No Charge, No Pressure
I’ve been helping Long Island residents navigate Medicare from my Melville office for 18 years. I know these hospital systems. I know these carriers. I’ve watched these network negotiations unfold in real time and I’ve helped clients find new plans, invoke SEP rights, and protect their access to the doctors they trust.
If you’re worried about your Northwell coverage, call me. I’ll look at your specific plan, your specific doctors, and your specific situation — and I’ll give you an honest answer about what your options are.
That conversation is always free.
Paul Barrett, CMIP The Modern Medicare Agency 📞 631-358-5793 ✉️ medicare@paulbinsurance.com 🌐 paulbinsurance.com 📍 445 Broad Hollow Rd, Melville, NY 11747
Serving Farmingdale, Nassau County, and Long Island since 2007
Related reading:
- Medicare Advantage Plans in Farmingdale, NY: Your Honest 2026 Local Guide
- Medicare Supplement Plans in Farmingdale, NY: 2026 Rates and What NY’s Rules Mean for You
- Medicare Supplement vs. Medicare Advantage: The Honest Side-by-Side
- When Is the Best Time to Switch Medicare Supplement Plans?
- Medicare in Farmingdale: Why Your County Matters
Primary sources:
- Northwell Health — Official Wellcare Network Update
- Northwell Health — Official Fidelis Care Update
- Becker’s Hospital Review: 23 Health Systems Dropping Medicare Advantage in 2026
- MedPAC June 2026 Report to Congress
- Medicare.gov Plan Finder
- HealthSpring broker communication — direct notification of Northwell network termination, effective December 31, 2025
Disclaimer: The Modern Medicare Agency is not connected with or endorsed by the United States government or the federal Medicare program. Network participation status reflects information available as of June 2026 and is subject to change. Contract negotiations between carriers and health systems are ongoing — always verify current network status directly with your carrier before scheduling non-emergency care. We do not offer every plan available in your area. Contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
