Medicare coverage can be difficult to understand, especially with plans changing every year. Choosing between a Medicare Advantage plan or traditional Medicare is a personal decision. We encourage you to use this page as a resource for information about plans that will be in-network for Endeavor Health and to access the various events available to help determine the option that best meets your unique healthcare needs.
To help you make an informed decision about your healthcare coverage, we want to share important updates to the Medicare Advantage plans Endeavor Health will participate in for 2026.
Medicare Advantage changes for 2026
Beginning Jan. 1, 2026, Endeavor Health primary care providers and specialists will no longer be in-network for Aetna Medicare Advantage plans.
Note: State of Illinois retirees that participate in the Total Retiree Advantage Illinois (TRAIL) MAPD PPO plan, as well as anyone with an Aetna PPO ESA plan will not be impacted by this change. The TRAIL MAPD PPO plan for State of Illinois retirees and Aetna PPO ESA plan will continue to provide broad access to any providers that accept Medicare, including Endeavor Health providers.
This change was made with significant thought and consideration. By partnering with select Medicare Advantage plans, Endeavor Health can invest more in a patient-centered approach to care and our healthcare providers can prioritize your overall health, wellbeing and satisfaction above administrative burdens. Endeavor Health hospital care will still be considered “in-network” for patients on an Aetna Medicare Advantage plan.
We will be contacting patients impacted by this change with a letter and email in August. In addition, we are offering Medicare 101 seminars monthly, and will be providing in-person broker consultations at our Medicare Resource Tables starting in September. You can find information about these events below.
There is more information about Aetna in the FAQs at the bottom of the page.
Endeavor Health will accept traditional Medicare and several Medicare Advantage plans including those from the following insurance companies, in 2026:
- Blue Cross Blue Shield of Illinois
- Essence Healthcare
- Humana
- UnitedHealthcare
Benefits vary by plan and not all plans are available in all regions. Check with the specific insurance company to get comprehensive plan details.
Enrollment support
Access to high-quality healthcare begins with choosing the right insurance. We are here to support you.
Each year, it’s important to understand changes to your in-network coverage as well as other annually occurring changes like prescription coverage, premiums and/or copays and changes to supplemental benefits. These changes could increase your out-of-pocket costs.
For additional enrollment support and to get a complete list of all your Medicare options:
- Reach out to our transition partners at endeavor.benefitscheck.com or by calling (855) 774-9510. BenefitsCheck independent agents can help you understand changes to your current Medicare Advantage insurance coverage and provide you with a personalized plan recommendation based on your unique needs.
- Contact your independent insurance broker.
- Visit the Medicare website at medicare.gov or the Medicare helpline at 1-800-MEDICARE (1-800-633-4227) to explore available plans in your area. TTY users can call (877) 486-2048.
- Contact the Senior Health Insurance Program (SHIP) at (800) 252-8966.
Medicare 101 seminars
Join us to learn more about Medicare Advantage, Medicare supplements, and Part D Plans. This free seminar will cover enrollment periods and deadlines, coverage options and tips for selecting the right plan for your needs.
Starting Feb. 10, classes are held the second Tuesday of every month from 6:30pm-7:30pm at the following locations. Click the links below to register at a location near you.
Virtual Medicare 101 seminar
Starting Feb. 18th, we will be hosting a virtual Medicare 101 seminar the third Wednesday of every month at 6:30 pm. This free seminar allows you to learn about Medicare coverage in the comfort of your own home.
Understanding Medicare
Original or traditional Medicare is healthcare operated and funded by the federal government. It is a health insurance program for people ages 65 and older, or for people with certain medical conditions or disabilities that qualify under government rules. Typically, traditional Medicare pays for 80% of covered healthcare costs and patients pay the remaining 20%. Traditional Medicare does not cover most prescription drug costs or vision, dental, hearing or long-term nursing home health needs.
Medicare Advantage plans are Medicare-approved plans from private companies offering an alternative to traditional Medicare for health and prescription drug coverage. Medicare Advantage plans include Medicare-covered services and may include extra benefits not covered by Medicare, such as dental, vision, hearing and alternative care. Medicare Advantage plans work to limit out-of-pocket costs while providing access to other essential health and wellness benefits.
Want to learn more? Check out these resources:
It is important to understand when you can enroll in Medicare and make changes to your plans. Here’s a breakdown of the different enrollment periods.
If you are already enrolled in traditional Medicare or Medicare Advantage:
- Annual Enrollment Period (AEP)
- From Oct. 15 to Dec. 7 every year, you can make changes to your Medicare plan. This includes switching from traditional Medicare to Medicare Advantage, or vice versa, and enrolling in or changing Part D plans. Any changes made during this period take effect on Jan. 1 of the following year.
- Medicare Advantage Open Enrollment Period
- From Jan. 1 through March 31 every year, individuals enrolled in a Medicare Advantage plan can make a one-time election to go to either another Medicare Advantage plan with or without prescription drug coverage or traditional Medicare. You’ll also be able to enroll in a Medicare prescription drug plan. Your new coverage will start on the first day of the month following the month you make a change.
If you will be enrolling in traditional Medicare or Medicare Advantage for the first time:
- Initial Enrollment Period (IEP)
- This period starts three months before you turn 65 and lasts until 3 months after the month you turn 65. If you enroll during this period, you avoid any late penalties. You can sign up for Medicare Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage) and Part D (prescription drug plan).
Want to learn more? Check out these resources:
Medicare and Medicare Advantage are health insurance programs for people ages 65 and older. You may also be eligible for Medicare earlier if you have a disability, End-Stage Renal Disease (ESRD) or ALS (Lou Gehrig’s disease).
Additional information
- Medicare supplement (Medigap): If you choose traditional Medicare, you can buy a Medigap policy to cover additional costs. However, if you choose a Medicare Advantage plan, you can’t have a Medigap policy at the same time.
- Dual eligibility (Medicare and Medicaid): If you qualify for both Medicare and Medicaid (low-income individuals), you may have access to Special Needs Plans (SNPs), which are Medicare Advantage plans specifically designed for dual-eligible beneficiaries.
Want to learn more? Check out these resources:
Frequently asked questions
Beginning Jan. 1, 2026, Endeavor Health Primary Care Providers and Specialists will no longer be in-network for Aetna’s Medicare Advantage Plan.
No. The TRAIL MAPD PPO plan (also referred to as a PPO ESA plan) allows for broad access to all providers that accept Medicare, including Endeavor Health providers. There is no change to your 2026 coverage and you can continue seeing your Endeavor Health providers with your TRAIL plan.
No. The Aetna Medicare PPO ESA plan allows for broad access to all providers that accept Medicare, including Endeavor Health providers. There is no change to your 2026 coverage and you can continue seeing your Endeavor Health providers with your PPO ESA plan.
Yes, patients can still get in-network rates even if their Primary Care Provider or Specialist is no longer in-network. We recommend calling the phone number on your insurance card to understand your specific coverage and payment responsibilities.
To be treated by an Endeavor Health doctor or advanced practice provider as in-network, you would need to ensure that you are enrolled in a plan where Endeavor Health is in-network by the end of Medicare annual enrollment on Dec. 7, 2025. To explore all your insurance options that maintain your in-network access to Endeavor Health:
- Reach out to our transition partners at endeavor.benefitscheck.com or by calling (855) 774-9510. Benefitscheck independent agents can help you understand the 2026 changes to your current Medicare Advantage insurance coverage and provide you with a personalized plan recommendation based on your unique needs.
- Contact your independent insurance broker.
- Visit the Medicare website at medicare.gov or the Medicare helpline at 1-800-Medicare (1-800-633-4227) to explore available plans in your area. TTY users can call (877) 486-2048.
- Contact the Senior Health Insurance Program (SHIP) at (800) 252-8966.
You should always go to the closest emergency room if you’re experiencing any type of emergency. Patients will always have access to Endeavor Health’s emergency department, regardless of network status, until patients are stable and can independently determine if they would like to be transferred to an alternate facility to be covered under in-network rates for the duration of their care.
Yes. Endeavor Health will continue to schedule office visits and outpatient/elective services for patients on Medicare Advantage plans where Endeavor Health is no longer in-network. We will also continue to bill your insurance for your care. However, out-of-network benefits vary by plan and you may incur higher costs associated with out-of-network care. We recommend calling the phone number on your current insurance card to ask about specific coverage and payment responsibilities.
We are committed to supporting patients and helping them/their families/their brokers select the Medicare Advantage plan that best aligns with their unique healthcare needs. Patients undergoing an active treatment plan for the following covered and approved services will continue to receive continuation of care treatment from Endeavor Health:
- Receiving post-operative care
- Have an urgent/emergency medical condition
- In mid-treatment for a serious medical condition
- Taking high-risk medications that require monitoring
- Require regular infusions
- Taking chronic controlled substances
We recommend calling the phone number on your current insurance card to inquire about eligibility, specific coverage, and payment responsibilities. Patients must apply for Continuity of Care through their insurance company. Your insurance company will review and approve or deny those applications on a case-by-case basis.
You are welcome to keep your appointments with Endeavor Health providers and continue to use all our services, even if Endeavor Health is no longer an in-network provider. However, out-of-network benefits vary by plan and you may incur higher costs associated with out-of-network care. We recommend calling the phone number on your current insurance card to ask about specific coverage and payment responsibilities.
No. As the number of Medicare beneficiaries participating in Medicare Advantage (MA) plans increases — alongside the growing variety of MA plans and products offered — healthcare providers nationwide face new challenges and opportunities to maintain strong clinical, financial and operational performance. That is why Endeavor Health is modifying its participation in several Medicare Advantage health plans. By partnering with select Medicare Advantage plans, Endeavor Health can invest more in a patient-centered approach to care and our healthcare providers can prioritize your overall health, wellbeing and satisfaction above administrative burdens.
Out-of-network refers to a healthcare provider who does not have a contract with a particular health insurance plan. Medicare Advantage plans offer a wide variety of out-of-network benefits. If you use an out-of-network provider, healthcare services could cost more. We recommend calling the phone number on your current insurance card to ask if you have out-of-network benefits, and if your costs are higher to see out-of-network providers.
Changes should be made during the Medicare annual enrollment period, which is Oct. 15 – Dec. 7, 2025. These changes will be effective Jan. 1, 2026.
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