Insurance disputes could force Duke, UNC out of network with insurers
Both Duke Health and UNC Health are warning patients that ongoing disputes with major insurers may force them out of network after a fall deadline passes, an impasse that could lead to higher out-of-pocket expenses.
In a Sept. 3 letter to patients, Duke Health officials said negotiations continue over its contract with Aetna. If a “fair resolution” can’t be reached by Oct. 20, Duke will have to leave the network and most patients will pay more to see its doctors and care teams.
“This is not an outcome we want for you, your family or our community,” said the letter signed by Dr. Thomas A. Owens, executive vice president and Lisa Goodlett, senior vice president of Duke University Health System.
Meanwhile, UNC Health announced in July that its three-year agreement with Cigna expires on Nov. 30, and its patients also face being out-of-network without reaching a “new and fair” plan.
“Leaders at UNC Health have engaged with Cigna regarding the expectations for a new agreement for nearly two years, with the goal of completing these discussions well in advance of the Nov. 30 expiration date,” said a July news release. “Unfortunately, Cigna is not willing to engage in meaningful discussion or commit to patient care that UNC Health requires.”
Cigna denied UNC’s characterization of the negotiations.
“It is disappointing that UNC Health is making inaccurate claims and appears to be stoking fear with our shared patients as a negotiating tactic,” the company said in an emailed statement to The N&O. “Despite the fact that UNC Health is demanding an approximate 32% rate increase over three years, the negotiations are moving forward in good faith to reach a fair and reasonable agreement for all.”
In a Wednesday statement, Aetna officials said they continue to negotiate in good faith.
“We have a responsibility to offer a cost effective, quality provider network to our customers,” said the statement. “Payment to providers participating in our networks directly impacts health care costs and we have an established track record of working collaboratively with health systems in North Carolina toward fair and market-competitive reimbursement. North Carolina has among the highest health care costs in the country and Aetna is unwavering in our effort to protect our North Carolina members from additional escalations in costs.”
What about chronic, long-term care?
Duke told patients this month that those receiving chronic, long-term care such as pregnancy or cancer treatment could qualify for longer but temporary in-network coverage. Officials encouraged patients to call or email Aetna.
UNC suggested patients consider other health insurance plans during the upcoming enrollment period, though it stressed the hope of coming to terms with Cigna.
For UNC updates, go to unchealth.org/records-insurance/insurance.
For Duke updates, see DukeHealthAccessAetna.org.
This story was originally published September 16, 2025 at 5:00 AM.