Northwell and Wellcare Medicare Advantage: What New York Medicare Members Should Know
Northwell and Wellcare Medicare Advantage: What Is Happening?
Some Medicare Advantage members in New York are receiving notices about a possible network change involving Northwell Health and Wellcare Medicare Advantage.
According to Northwell’s Wellcare update, Wellcare Medicare Advantage members may continue scheduled visits with Northwell through July 1, 2026. Northwell also states that from July 1 through August 29, 2026, established Medicare Advantage patients may be able to continue treatment with Northwell clinicians, subject to Wellcare’s approval.
For Medicare members who rely on Northwell doctors, specialists, hospitals, or outpatient facilities, this can be confusing and stressful. Many people choose a Medicare Advantage plan based on whether their doctors and hospitals are in-network. When there is a possible network change with a major health system like Northwell, it is important to understand how these shifts affect various health plans, your overall health coverage, and what steps you should take.
This update is especially important for Medicare members in New York, Nassau County, Long Island, New York City, Manhattan, Queens, Brooklyn, the Bronx, and Staten Island who use Northwell Health for care.
Your Medicare Coverage Is Not Ending
The first thing to understand is that this does not mean your Medicare coverage is ending.
If you are enrolled in a Wellcare Medicare Advantage plan, offered by Centene, your plan is still your Medicare health insurance coverage. The issue is whether Northwell doctors, hospitals, and facilities will continue to participate in the Wellcare Medicare Advantage network.
That distinction matters.
Your insurance plan may continue, but your access to certain Northwell providers may change if Northwell and Wellcare do not reach an agreement. For Medicare Advantage members, provider networks are a major part of how the plan works. A doctor or hospital that is in-network today may not necessarily remain in-network in the future if the contract between the provider and insurance company changes.
Who Should Pay Attention to This Update?
This update is most relevant to people enrolled in a Wellcare Medicare Advantage plan who use Northwell Health for medical care.
You should pay close attention if you:
- See a Northwell primary care doctor
- See a Northwell specialist
- Use a Northwell hospital
- Have upcoming testing, imaging, surgery, or procedures through Northwell
- Receive ongoing care from a Northwell physician
- Use Northwell urgent care or outpatient facilities
- Live in Nassau County, New York City, Queens, Brooklyn, Manhattan, the Bronx, Staten Island, or another part of the New York metro area and depend on Northwell providers
This is also important if you are a caregiver helping a parent, spouse, or family member manage their Medicare, D-SNP, or Medicaid coverage. Many adult children help coordinate healthcare for aging parents, especially when multiple doctors, prescriptions, and appointments are involved.
Why This Matters for Nassau County Medicare Members
Northwell has a major presence across Long Island, and many Medicare beneficiaries in Nassau County rely on Northwell doctors, specialists, and hospitals.
If you live in communities such as Great Neck, Manhasset, Garden City, Mineola, Roslyn, Plainview, Syosset, Port Washington, Woodbury, Hicksville, Massapequa, or other Nassau County areas, you may already use Northwell for preventive care, primary care, cardiology, orthopedics, oncology, imaging, surgery, or hospital care.
For Nassau County Medicare members, a network change can be more than an inconvenience. It may affect whether you can continue seeing a trusted doctor, whether an upcoming appointment is covered, or whether you need to consider another Medicare option.
That is why it is important to review your coverage before the deadline, especially if Northwell is central to your healthcare.
Why This Matters for New York City Medicare Members
This issue may also affect Medicare Advantage members in New York City, including the five boroughs: Manhattan, Queens, Brooklyn, the Bronx, and Staten Island.
Many New York City Medicare beneficiaries use Northwell-affiliated providers, hospitals, specialists, imaging centers, and outpatient locations. If you live in Queens, Brooklyn, Manhattan, the Bronx, or Staten Island and your doctors are connected to Northwell, you should confirm how this update may affect you.
New York City Medicare Advantage plans can vary by borough and county. A plan available in Queens may not have the same provider network as a plan available in Manhattan, Brooklyn, the Bronx, or Staten Island. That means you should not assume that another person’s situation is the same as yours.
Your doctors, hospitals, prescription drug coverage, plan type, and county all matter.
Why Medicare Advantage Networks Matter
Medicare Advantage plans work differently from Original Medicare.
With many Medicare Advantage plans, such as an HMO or PPO, you receive your Medicare benefits through a private insurance company approved by Medicare. These plans often include provider networks. That means the plan contracts with specific doctors, hospitals, medical groups, and facilities.
When your provider is in-network, your care is generally covered according to the plan’s rules and cost-sharing structure. When your provider is out-of-network, your costs may be higher, or the service may not be covered except in certain situations, such as emergency care.
This is why a Northwell and Wellcare Medicare Advantage network issue matters. If Northwell becomes out-of-network, some members may need to make decisions about whether to stay with their current plan, request continuity of care, choose a different provider, or explore other Medicare coverage options when eligible.
Important Dates for Wellcare Medicare Advantage Members
Based on Northwell’s Wellcare update, there are two key dates Medicare Advantage members should understand:
July 1, 2026
Northwell states that Wellcare Medicare Advantage members may continue scheduled visits with Northwell through this date.
July 1 through August 29, 2026
Northwell states that established Medicare Advantage patients may be able to continue treatment with Northwell clinicians through August 29, 2026, subject to Wellcare’s approval.
These dates are important, but they may not apply the same way to every person. Your situation may depend on your plan, your provider, your treatment status, and whether Wellcare approves continued care.
If you have an appointment scheduled with Northwell, do not assume it is automatically covered. Call Wellcare (users with hearing or speech impairments may use TTY services) and your Northwell provider’s office to confirm.
What Does “Established Patient” Mean?
Northwell’s update references established Medicare Advantage patients. In general, an established patient is someone who already has an ongoing relationship with a doctor, clinician, or facility.
However, you should not guess whether you qualify. You should call Wellcare directly and ask whether your specific care situation qualifies for continued treatment after July 1, 2026.
You may want to ask:
- Am I considered an established patient with my Northwell doctor?
- Can I continue treatment with this provider after July 1, 2026?
- Do I need approval from Wellcare?
- Is there a form I need to submit?
- Will my upcoming appointment be covered as in-network?
- What happens after August 29, 2026?
It is also a good idea to call your Northwell doctor’s office and ask how they are handling Wellcare Medicare Advantage patients during this period.
What Is Continuity of Care?
Continuity of care may allow certain patients to keep seeing their current doctor or clinician for a limited period of time even if there is a network change. This is often important for people who are in the middle of active or ongoing treatment.
Continuity of care may be especially relevant if you are:
- Being treated for cancer
- Scheduled for surgery
- Recovering from a hospitalization
- Receiving care for a serious heart condition
- Seeing a specialist regularly
- Undergoing testing or imaging as part of a treatment plan
- Managing a complex or chronic health condition
- Receiving post-acute care or rehabilitation
However, continuity of care is not always automatic. Northwell’s update states that continued treatment during the July 1 through August 29 period is subject to Wellcare’s approval. That means you should contact Wellcare as soon as possible to ask what is required.
Should You Cancel Your Northwell Appointments?
Do not cancel appointments without first checking with both Wellcare and your Northwell provider.
If your appointment is before July 1, 2026, it may still be covered according to the current terms. If your appointment is after July 1, 2026, you should ask whether it will be covered, whether you need approval, and whether your doctor is still considered available to you under your plan.
If you have a surgery, procedure, imaging appointment, infusion, specialist visit, or follow-up appointment scheduled, ask very specific questions. Do not rely only on general statements. Make sure the answer applies to your exact doctor, facility, date of service, and plan.
Should You Change Medicare Plans?
Not automatically.
A possible network change does not always mean you should immediately change Medicare plans. These situations can sometimes be resolved before a final disruption occurs. However, if Northwell access is important to you, this is the right time to review your Medicare coverage carefully.
Before making any Medicare plan change, you should review:
- Your Northwell doctors
- Your preferred hospitals
- Your specialists
- Your prescriptions
- Your pharmacy
- Your monthly premium
- Your copays
- Your out-of-pocket maximum
- Dental, vision, hearing, and other extra benefits
- Whether you are eligible to change plans now
This is especially important in New York because Medicare Advantage plan options are county-specific. The Medicare plans available in Nassau County may differ from the plans available in New York County/Manhattan, Queens County, Kings County/Brooklyn, Bronx County, and Richmond County/Staten Island.
A local Medicare advisor can help you compare your options based on your county, doctors, prescriptions, and healthcare needs.
What If You Want Broader Provider Access?
Some Medicare members become concerned about provider networks when situations like this happen. If keeping access to specific doctors and hospitals is your top priority, it may be helpful to understand the difference between Medicare Advantage and Original Medicare with a Medicare Supplement plan.
With Original Medicare, you can generally see any doctor or hospital that accepts Medicare. A Medicare Supplement plan, also called Medigap, can help pay some of the costs that Original Medicare does not cover.
Medicare Advantage plans may offer lower premiums and extra benefits, but they often rely on provider networks. For some people, that trade-off is worth it. For others, broader provider flexibility may be more important.
There is no one-size-fits-all answer. The right Medicare coverage depends on your doctors, prescriptions, budget, health conditions, travel needs, and comfort with provider networks.
What Wellcare Medicare Advantage Members Should Do Now
If you are a Wellcare Medicare Advantage member and you use Northwell, take these steps:
- Meet with a Medicare Advisor
Plan Medicare advisors are local to Long Island and New York City. - Call your Northwell provider
Ask whether your upcoming appointments are affected. - Ask about approval for continued care
If you are an established patient, ask whether you can continue treatment through August 29, 2026. - Write down names and dates
Keep notes of who you spoke with, when you called, and what they told you. - Review your Medicare options
If Northwell access is important to you, compare your options before making a decision. - Do not wait until the last minute
Medicare plan decisions can take time, especially if you need to review doctors, prescriptions, eligibility, and enrollment rules.
Plan Medicare Can Help New York Medicare Members
If you received a notice about Northwell and Wellcare Medicare Advantage, Plan Medicare can help you understand what it means.
We work with Medicare beneficiaries throughout New York, Nassau County, Long Island, New York City, Manhattan, Queens, Brooklyn, the Bronx, and Staten Island. We can help you review your current Medicare Advantage plan, check your doctors and prescriptions, and understand whether another Medicare option may better fit your needs.
Before changing coverage, it is important to review the full picture. Your doctors matter, but so do your prescriptions, specialists, hospitals, costs, benefits, and enrollment timing.
Bottom Line
The Northwell and Wellcare Medicare Advantage update is important for New York Medicare members who rely on Northwell doctors, hospitals, specialists, and facilities.
If you live in Nassau County, New York City, Manhattan, Queens, Brooklyn, the Bronx, Staten Island, or the surrounding New York area, and you are enrolled in a Wellcare Medicare Advantage plan, now is the time to confirm your provider access.
Do not panic, but do not ignore the notice. Call Wellcare, speak with your Northwell provider, ask about continued care, and review your Medicare options before making any decisions.
Need help understanding your Medicare coverage in New York? Contact Plan Medicare to speak with a licensed Medicare advisor.
