New Bern, N.C.-based CarolinaEast Medical Center has officially exited Blue Cross Blue Shield of North Carolina’s Medicare Advantage network while extending its participation in UnitedHealthcare’s Medicare Advantage plans through the end of the year.
According to a updated payer list from CarolinaEast Health System, the hospital is no longer in-network with Blue Cross Blue Shield of North Carolina Medicare Advantage plans effective July 1. CarolinaEast Medical Center will remain in-network with UnitedHealthcare Medicare Advantage through Dec. 31, after which it also will exit that network.
The changes apply only to CarolinaEast Medical Center. CarolinaEast Physicians will remain in-network with both Medicare Advantage plans, and traditional Medicare is unaffected.
The update follows the hospital’s May announcement that it planned to terminate both Medicare Advantage contracts, citing “burdensome payment policies, denials and reimbursement delays” that it said had become “financially and operationally unsustainable.”
At the time, CarolinaEast said negotiations with UnitedHealthcare were ongoing. The Dec. 31 termination date suggests the two sides reached a temporary agreement extending the contract for an additional six months.
“CarolinaEast Medical Center has decided to no longer take Blue Medicare Advantage for its hospital facility, beginning July 1, 2026. They have indicated that the hospital will be out-of-network for all Medicare Advantage plans, not just Blue Cross and Blue Shield of North Carolina (Blue Cross NC) Medicare Advantage plans,” Blue Cross and Blue Shield of North Carolina said in a statement on its website. “This is a disappointing outcome, but we value our long-standing relationship with CarolinaEast and remain open to welcoming the hospital back into our network in the future if they change their decision.”
CarolinaEast’s dispute with the commercial payers is part of a broader trend of hospitals and health systems reevaluating Medicare Advantage contracts over concerns about prior authorization requirements, claim denials and reimbursement delays.
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