Our Commitment to Keeping Care Local, Accessible, and Affordable
At South Shore Health, we’re proud to provide expert, compassionate care, right here in our community – 24 hours a day, 7 days a week.
We're committed to keeping care local, accessible, and of the highest quality, all while maintaining affordable care and offering advanced and specialized services that are often unavailable at other community hospitals.
In addition, we continue to meet the growing needs of a broader community in the wake of numerous healthcare challenges and hospital closures in our region.
As a community-based health system, it’s vital that we remain financially stable to ensure we're here for the long term to keep care local, accessible, and affordable.
With that stability in mind, we periodically engage in negotiations with insurers to seek fair and reasonable payment that reflects the value and quality we deliver.
Potential Changes for Select Patients
At times, negotiations are unsuccessful, with insurers unwilling to offer our Health System fair and reasonable payment for the high-quality care we provide.
As a result, these insurers choose to remove South Shore Health from their networks, potentially impacting your patient experience.
While we continue to engage with insurers in hopes of reaching an agreement, this page features information for patients affected by specific insurance changes, as well as answers to frequently asked questions about insurance changes.
Information for UnitedHealthcare patients >>
Information for Tufts Health Direct Plan patients >>
General information for patients >>
We're dedicated to supporting patients during any periods of transition.
For detailed information on your coverage options going forward, please contact your insurer directly by calling the number on your member ID card.
Important Information for UnitedHealthcare Patients
South Shore Health will no longer be considered in-network for UnitedHealthcare Medicare Advantage plans.
The effective date of this change is:
December 31, 2025, for South Shore Hospital, South Shore Health hospital-based services in Massachusetts, and South Shore VNA
May 1, 2026, for doctors and providers at South Shore Medical Center
October 15, 2026, for Health Express urgent care
After these dates, UnitedHealthcare Medicare Advantage will no longer accept South Shore Health – including all doctors, nurse practitioners, and physician assistants at all of our locations, along with our hospital services – as part of its coverage for patients.
We continue to negotiate with UnitedHealthcare regarding their employer-sponsored plan options.
At this time, we have reached an agreement to extend our contract to February 1, 2026.
We will provide updates about the status of these negotiations as they become available.
If you are scheduled for South Shore Hospital-based care, including scheduled surgical procedures, lab testing, or radiology services, after December 31, 2025, your appointments will be cancelled.
If you are scheduled for appointments at South Shore Medical Center after May 1, 2026, your appointments will be canceled.
In addition, any visits after October 15, 2026, at any of our Health Express urgent care locations will not be accepted for payment by UnitedHealthcare.
Patients can obtain laboratory services, including blood draws and lab panels, at South Shore Hospital’s lab. However, these services may result in greater out-of-pocket expenses if our lab is considered out-of-network for your insurance plan.
For UnitedHealthcare Medicare Advantage members, while your South Shore Medical Center physician will be in-network through May 1, 2026, South Shore Hospital’s laboratory will not be in-network with UnitedHealthcare Medicare Advantage plans effective December 31, 2025.
We strongly recommend that you contact your insurance provider to confirm whether South Shore Hospital’s lab services are covered under your plan to avoid unexpected out-of-network costs.
We understand that you may have UnitedHealthcare Medicare Advantage PPO coverage, which often includes out-of-network benefits.
However, UnitedHealthcare has made changes to their network, and our hospital is no longer included.
As a result, we are unfortunately unable to accept any Medicare Advantage plan members, except in emergencies.
We apologize for any inconvenience this may cause, and we encourage you to contact your insurance provider for help finding an in-network hospital or to discuss your coverage options.
Medicare may authorize Special Enrollment Periods (SEPs) for affected members in certain circumstances.
If an SEP is available to UnitedHealthcare Medicare Advantage members in Massachusetts, you can switch to Original Medicare or to a different Medicare Advantage plan that includes South Shore Health’s hospital, physicians, and services in network (including labs, imaging, and rehabilitation).
The change would be immediate once your new plan is effective, without waiting for the usual annual enrollment window.
Medicare’s Annual Open Enrollment period runs from October 15 to December 7 each year, with any changes taking effect January 1. During this time, you may switch to a Medicare plan that covers South Shore Health.
For assistance with your Medicare options and plan choices, please contact the Serving the Health Insurance Needs of Everyone (SHINE) Program counselors at 1-800-963-5337 for personalized guidance and information.
You may receive a letter from UnitedHealthcare about any available SEPs and Open Enrollment. If you do not receive a letter, contact UnitedHealthcare by calling the number on your ID card or visiting their website.
Yes, South Shore Health participates with Medicare and will continue to accept all UnitedHealthcare Medigap plan types.
We will not be in-network for any of UnitedHealthcare’s Medicare Advantage plans.
If you are a member of a Medicare Advantage plan through UnitedHealthcare and want to retain your doctors and hospital at South Shore Health, you may consider changing your plan to another insurance carrier or contacting the Serving the Health Insurance Needs of Everyone (SHINE) Program counselors at 1-800-963-5337 for personalized guidance and information.
If you have questions about how these changes will affect you, please contact UnitedHealthcare by calling the number on your member ID card.
For UnitedHealthcare Medicare Advantage patients:
For free, unbiased insurance counseling for Medicare beneficiaries and their caregivers in Massachusetts, contact the Serving the Health Needs of Everyone (SHINE) Program at 1-800-243-4636.
The UnitedHealthcare website features more information about Medicare coverage options. Learn more >>
The Medicare website features a plan comparison tool that allows you to explore your Medicare coverage options. Learn more >>
Important Information for Tufts Health Direct Plan Patients
We have reached an agreement on the key terms for a new contract covering all Point32Health product lines, including Tufts Health Direct, starting January 1, 2026. The agreement is pending finalization of formal contract language and official signatures.
Tufts Health Direct patients will receive an updated notice regarding their ability to continue to use the services of South Shore Health after December 31, 2025.
Frequently Asked Questions about Insurance Changes
As a community-based health system, South Shore Health provides the same high-quality care as other hospitals but at a lower cost, right here in our community – 24 hours a day, 7 days a week.
South Shore Health needs to be financially stable to ensure we are here for the long term to care for the residents of the communities we serve.
Unfortunately, certain insurers have been unwilling to offer our health system fair and reasonable payment for the high-quality care we provide.
As a result, they end their contract with us (called a termination) and no longer cover the care we provide patients with that type of insurance.
As a result of the termination of our contract with your insurer, we were forced to cancel all appointments with our providers and the health system scheduled for beyond the contract termination date.
View a list of insurances we currently accept. >>
Please note that while we make every effort to keep this list current, plan names and benefits change frequently.
We encourage you to call your insurer to learn the details of your plan's benefits.
If you have an employer-sponsored plan, you may have an opportunity to change your plan option to include South Shore Health’s hospital and physicians during the normal annual employer benefits election process. Please consult your employer's Human Resources department for more information.
View a list of insurances we currently accept. >>
If you have a plan through the Massachusetts Health Connector, you may opt to switch to another plan that covers South Shore Health during the Health Connector’s Open Enrollment Period, which runs from November 1 to January 1 each year, with changes taking effect January 1. You can review your options via mahix.org or by contacting the Financial Counseling Department at South Shore Health at 781-624-4329 for assistance from Certified Application Counselors.
If you have a Medicare Advantage plan, you may qualify for a Special Election Period (SEP) due to this change. This means you could switch to Original Medicare or to a different Medicare Advantage plan that includes South Shore Health’s hospital, doctors, and services in its network (including labs, imaging, and rehabilitation). Please contact your insurer directly to see if you qualify and to learn about effective dates for any new coverage.
Additionally, Medicare’s Annual Open Enrollment Period runs from October 15 to December 7 each year, with any changes taking effect January 1. During this time, you may also switch to a Medicare plan that covers South Shore Health. South Shore Health partners with several Medicare Advantage plans, including Blue Cross Blue Shield of Massachusetts, Aetna, and others.
For assistance with Medicare options and plan choices, please contact the Serving the Health Insurance Needs of Everyone (SHINE) Program counselors at 1-800-963-5337 for personalized guidance and information.
Yes, South Shore Health participates with Medicare and will continue to accept all Medigap plan types.
If you are a member of a Medicare Advantage plan through your insurer and want to retain your doctors and hospital at South Shore Health, you may want to consider changing your plan to another insurance carrier (see participating insurance company list).
You can also contact the Serving the Health Insurance Needs of Everyone (SHINE) Program counselors at 1-800-963-5337 for personalized guidance and information.
Please discuss this with your current provider to ensure you have an adequate amount of your medication on hand as you establish care under another physician during this transition.
If you have a South Shore Health MyChart account, you can use MyChart to request the necessary prescription refills.
You will be able to get one refill for your prescription at the discretion of your physician (between a 30- and 90-day supply) to ensure you have enough medication during any transition process.
Please speak to your current care team, including your primary care provider, about alternative options for hospital-based care.
In addition, you can contact your insurance company for guidance on in-network facilities in your area.
South Shore Hospital will always provide emergency care to anyone, no matter what insurance you may have. Emergency Department visits will still be covered by your insurance plan.
Hospitals in Massachusetts are required to provide emergency care to all patients, regardless of their insurance status. If you are experiencing a medical emergency, you will receive the necessary treatment at our Emergency Department.
Please contact your insurer to determine what providers are available within your network.
In some circumstances, your insurer may allow you to continue care with your physician or another practitioner if your insurer determines that you are in an active course of treatment.
Please contact your insurance company to inquire about in-network hospitals or birthing centers.
If you are having a medical emergency involving pregnancy, please call 9-1-1. We will provide you with the necessary medical treatment in our Emergency Department.
South Shore Health does accept direct payment from patients, and all payment should be paid in full prior to service.
Please contact our Patient Access Team at 781-624-3424 for any assistance.
Please contact your insurer for more information.
In certain circumstances, your insurer may determine that you can continue care with your current provider if your medical circumstances warrant such an approval.
You can request your medical records through our Medical Records Department. To learn more about the request process, please click here.
You can also contact our Medical Records Department by calling 781-624-8235.
There will be a nominal fee of $6.50 for the processing records requests.
Any physician or medical professional who is employed with Dana-Farber or the Brigham health systems is still considered in-network with your insurer.
If there need to be any changes to any of your services, the necessary care coordinator will assist with those changes to ensure consistency in your treatment.
Please contact your insurer to determine which physicians and hospital services are covered under your insurance plan.
A care coordinator will assist you with all required services, if needed, to ensure consistency in your treatment.
Mammograms, ultrasounds, MRIs, and bone density services provided by South Shore Health will no longer be covered and will need to be scheduled elsewhere.
Please contact your insurer to determine which specific physicians and services are covered under your insurance plan.
CT scan services will be covered, and any physician or medical professional who is employed with Dana-Farber or the Brigham health systems is still considered in-network with your insurer.
A care coordinator will assist you with changes to any services if needed to ensure consistency in your treatment.
Medical Records
Accepted Insurances
While we make every effort to ensure our list is current, plan names and benefits change frequently.
We encourage you to call your insurer to learn the details of your plan's benefits.
