What to know about UW Medicine and Aetna’s split

UW Medicine and Aetna were unable to reach a contract agreement for UW Medicine to remain an in-network provider covered by Aetna Medicare plans. Negotiations between insurance companies and health care providers are fairly common, but the parties being unable to come to an agreement on continuing those contracts is rare.

The contract ended on May 31, 2025. The two parties disagreed over payment rates; UW Medicine said Aetna wasn’t keeping up with rising costs, and Aetna said UW was asking for too much money.

The parties are still talking and could reach a new agreement. UW is providing updates.

What you should know if you’re an Aetna-insured patient

• You might have to pay more or change doctors. Since UW Medicine is no longer in Aetna’s network, your costs for care there could go up a lot — even the full bill. You may need to find a new doctor or provider who is in Aetna’s network if the costs are too high.
• Emergency care is still covered. You can still go to a UW Medicine emergency room (in an emergency situation). The federal No Surprises Act protects you from surprise bills in these cases, even if the hospital is out-of-network.
• You may qualify for continued care during transition. If you’re pregnant or in ongoing treatment (cancer treatment, for example), you may be able to keep seeing your UW provider for a short time. To apply, call the number on your Aetna card and ask for a “transition-of-care” form for each doctor you see.

What you can do now

• Apply for transition-of-care if you’re eligible.
• Find a new provider in Aetna’s network if you’re not eligible or can’t afford out-of-network costs.
• Pay out-of-pocket if you’re able, but this will likely cost more.
• Reschedule upcoming appointments if you want to wait and see how things play out.

More info for Medicare subscribers

Medicare Advantage plans can change their provider networks at any time.

Medicare Advantage plans are regulated by the federal Centers for Medicare and Medicaid Services (CMS), which means the OIC can’t compel the parties to come to an agreement.

However, there’s a provision in the Medicare rules that may allow a “special enrollment period” to change plans in the event there’s a significant change in your plan’s provider network. These special enrollment periods are evaluated on a case-by-case basis.

To request a change, call Medicare at 1–800- MEDICARE (that’s 1–800–633–4227) and request a special enrollment period. Be prepared to tell them what new plan you want.

More on Medicare’s special enrollment periods (Click “Other exceptional circumstances all the way at the bottom of the page)

If you’re in the middle of a treatment plan with UW Medicine, Aetna has provided info on how to request Transition of Care coverage (available for a limited time).

From Aetna:

“Members can get a Transition of Care request form by calling the phone number on the back of their member ID card. Transition of Care coverage requests are subject to approval by Aetna.”

How to contact the parties involved

Call the number on your Aetna insurance card for help with coverage and transition-of-care, and visit UW’s site or contact their billing team with any questions.