Navigating 2026 Insurance Changes: What Infusion Patients Need to Know
Each year, insurance open enrollment brings updates to networks, benefits, and covered services. But this year, many patients across Oregon are facing a new challenge: several local providers will not be contracted with UnitedHealthcare’s Medicare Advantage network in 2026.
If you receive infusion therapy, these changes can feel confusing — and in some cases, they may put your treatment schedule at risk. Below is what you need to know and how Vital Care of Portland can support you.
Why You May Be Hearing From Your Insurance Company
When a clinic ends a contract with a health plan, the insurance company is required to notify affected members. This often happens through:
Letters sent by mail
Messages posted in your online insurance portal
Phone calls or automated notifications
Updates in your plan’s provider directory
These notices typically explain that your current infusion site will be out of network starting on a specific date (for many patients, January 1, 2026). They may encourage you to establish care with a different provider — but they don’t always explain the full impact on your treatment or financial responsibility.
Transition Periods: What Patients Should Expect
In some cases, insurance plans may offer a short “continuity of care” period. This is a temporary window where they will still cover visits at your existing infusion site while you transition to a new, in-network provider.
Here’s what this usually means:
Coverage may temporarily continue, often for one or two visits.
After that period ends, your treatment will no longer be covered at your current location.
If you continue infusing at an out-of-network site, the plan may deny the claim, leaving you with unexpected bills.
The goal of this transition window is simply to give you time to move your care. It is not a long-term solution.
Why Acting Early Matters
Once your provider becomes out of network, insurance companies can:
Stop authorizing your medication
Require a new prior authorization with a different provider
Deny future infusion claims
Leave you responsible for out-of-network charges, which can be significant
Because prior authorizations, provider referrals, and benefits reviews all take time, patients who wait until January may experience delays in care.
You Always Have a Choice in Where You Infuse
Even when insurance contracts shift, patients maintain the right to select the infusion provider that best fits their clinical and financial needs.
If your current clinic is exiting your insurance network, you do not need to wait until you receive a denial or miss a treatment. You can begin transitioning your care now.
How Vital Care of Portland Can Support You
Our team helps patients navigate insurance changes every day. We can assist with:
Benefit verification to understand what your 2026 plan will cover
Confirming which infusion drugs are preferred by your insurance
Coordinating prior authorizations to prevent gaps in treatment
Working directly with your provider to move your care smoothly
Helping you avoid out-of-network bills and unexpected costs
Most importantly, we ensure your therapy continues without disruption.
If You Received a Notice About 2026 Coverage, We’re Here to Help
Whether you’ve already been contacted by your insurance company or you’re unsure how upcoming changes may affect your infusions, reach out to our team. We can review your plan, explain your options, and guide you through the transition.
📞 971-484-4940
📩 intake@vitalcareofportland.com
🌐 vitalcareofportland.com
Your treatment matters — and we’re here to help ensure you stay on a safe, consistent, and affordable path forward.
