What is UnitedHealthcare doing with its Medicare Advantage plans?

UnitedHealthcare is dropping plans that cover 600,000 members, primarily in less managed products such as PPO offerings, due to a federal civil fraud investigation and rising costs.

Why is UnitedHealthcare making these changes to its Medicare Advantage plans?

UnitedHealthcare is facing a federal civil fraud investigation into how it records diagnoses, which can lead to extra payments for its Medicare Advantage plans. Additionally, the company cites rising care use and rate cuts, with Medicare Advantage members increasing their utilization of healthcare services, contributing to "elevated outpatient spend."

How will these changes impact UnitedHealthcare's Medicare Advantage business?

UnitedHealthcare's decision to drop plans covering 600,000 members will significantly reduce the size of its Medicare Advantage offerings, as the company seeks to address the "continued cost trend and funding pressures" and "support margin recovery."

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UnitedHealthcare Cuts 600,000 from Medicare Advantage Amid Fraud Probe

6 Aug

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Summary

UnitedHealthcare faces federal civil fraud investigation
Dropping plans covering 600,000 members, mostly PPO offerings
Rising costs and utilization contributing to "elevated outpatient spend"

UnitedHealthcare Cuts 600,000 from Medicare Advantage Amid Fraud Probe

As of August 7th, 2025, UnitedHealthcare, the largest provider of Medicare Advantage plans in the United States, has announced it is dropping plans that collectively cover 600,000 people. This decision comes as the company faces a federal civil fraud investigation into how it records diagnoses, which can lead to extra payments for its Medicare Advantage plans.

According to UnitedHealthcare's health insurance division CEO Tim Noel, the plans being dropped are primarily those in which seniors have more choices on health care providers, such as PPO offerings. Noel cited rising care use and rate cuts as contributing factors, stating that UnitedHealthcare's Medicare Advantage members are increasing the number of doctors' visits, tests, specialists, and emergency room visits, "contributing to elevated outpatient spend."

In response to "the continued cost trend and funding pressures, and the need to support margin recovery," UnitedHealthcare has made "significant adjustments to benefits" across its Medicare Advantage plans.

Disclaimer: This story has been auto-aggregated and auto-summarised by a computer program. This story has not been edited or created by the Feedzop team.