WakeMed warns dispute with United Healthcare could force patients out of network
WakeMed has warned patients that negotiations have “stalled” with insurance giant United Healthcare, a dispute that could force them “out-of-network” and lead to higher bills.
In a Wednesday statement, WakeMed officials said they have worked with United for nearly a year, but the company so far is “unwilling to agree to a new, reasonable contract.”
The current agreement expires on Nov. 15, meaning WakeMed patients could be forced out-of-network this fall without a new deal by the deadline. Patients who seek medical care with physicians, hospitals and pharmacies listed out-of-network with their insurers typically pay higher bills.
In its statement, WakeMed said United denies reimbursement for its patients’ medical care at two to three times the rate of any other insurer — often after the care has been delivered.
“United Healthcare believes they have the right to determine the necessity of an individual’s medical care,” said the WakeMed statement. “We disagree. UnitedHealthcare is not part of the care team. We believe a patient’s need for medical care should be determined by the patient and their doctor, not by an insurance company. Ultimately, this is about making sure our patients get the benefits they are entitled to and that their care decisions are based on medical need — not corporate profit.”
What United HealthCare said about WakeMed
United Healthcare presented a different version of events thus far:
“We are working to renew our network relationship with WakeMed so our members can continue accessing care at affordable, market-competitive rates,” said a statement to The N&O. “Unfortunately, WakeMed has not yet provided a single comprehensive proposal, even with less than two months left on our current agreement. Instead, they’ve stalled discussions and are repeating a pattern of putting North Carolinians in the middle of negotiations while spreading misinformation, as they’ve done with multiple insurers in recent years. We remain committed to reaching an agreement and are asking WakeMed to join us at the table to move this forward.”
The ongoing discussions adds to uncertainty in the Triangle while both Duke and UNC Health has sent similar notice to patients about ongoing disputes with major insurers — Duke with Aetna and UNC with Cigna.
As open enrollment approaches, both health systems are facing fall deadlines for those contracts.
WakeMed, meanwhile, assured patients the end of the contract will not affect clinic visits to its primary care practices or providers. Patients can still seek emergency room treatment regardless of insurance status.
This story was originally published September 24, 2025 at 4:12 PM.