Healthcare providers in Stanislaus County are preparing for changes in Medicare Advantage coverage as UnitedHealthcare will discontinue three Medicare plans for residents aged 65 and older, as well as certain disabled individuals, effective January 1. Sutter Health notified affected patients on October 1 that the AARP Medicare Advantage HMO through UnitedHealthcare will no longer provide access to Sutter physicians, specialists, and healthcare centers next year. Patients who wish to continue receiving care from Sutter providers will need to select a different Medicare Advantage plan or use basic Medicare.
Sutter Health, which owns Memorial Medical Center in Modesto, stated that approximately 4,100 of its patients in Stanislaus County will be impacted by UnitedHealthcare’s exit from the local Medicare Advantage market. The UnitedHealthcare AARP plans also currently allow patients to see physicians from 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 has identified three other Medicare Advantage plans it accepts in Stanislaus County: Alignment Health My Choice PPO, Sutter Senior Advantage (a SCAN Medicare HMO), and the Health Plan of San Joaquin HMO, which is designed for low-income patients eligible for both Medicare and Medi-Cal. However, the Health Plan of San Joaquin HMO is only available to established patients.
Patients were directed to an online resource for information about accepted Medicare Advantage options in Stanislaus and other counties. The letter from Sutter also recommended that patients consult with licensed insurance agents or Sutter customer service representatives to understand their options and find suitable plans.
Currently, nine insurers offer Medicare-approved Advantage plans in Stanislaus County. Some of these plans provide access to Kaiser Permanente medical offices and hospitals, AllCare physicians, or Central Valley Medical Group. In 2025, monthly premiums for these government-subsidized plans will range from zero to $97.
Medicare Advantage plans include annual limits on copayments and other out-of-pocket expenses and cover prescription drugs, dental, hearing, and vision services.
The annual fall enrollment period for Medicare runs from October 15 to December 7. During this time, eligible individuals can make changes to their coverage and are advised to ensure their chosen plan includes their preferred doctors and prescription drug coverage before enrolling.
The total number of patients affected by UnitedHealthcare’s decision has not been disclosed. Sutter clarified that these changes do not impact employer-sponsored Medicare plans it accepts, such as UnitedHealthcare Medicare Advantage plans through CalPERS and large employers.
The Health Insurance Counseling and Advocacy Program in Modesto will host an informational event at the Stanislaus Veterans Center on October 17 at 9 a.m. The event will address changes to Medicare programs, premium costs, and benefits for 2026.
