MultiCare to Exclude Certain Medicare Advantage PPO Plans in 2026

MultiCare, a Tacoma-based health system operating hundreds of clinics and hospitals in the Puget Sound region, will stop accepting certain Medicare Advantage PPO plans starting in 2026.

This shift will affect fewer than 15,000 patients who currently have these plans, who will lose in-network access to MultiCare's facilities. The health system is refocusing on Medicare Advantage HMO plans to enhance care coordination within its network, which aligns with HMO models that restrict coverage to specific provider networks but generally allow for more managed care compared to PPOs.

This change occurs during the Medicare open enrollment period, which runs through December 7, allowing beneficiaries to select or switch plans for the upcoming year. Medicare Advantage plans, sold by private insurers but approved by the government, bundle various coverages such as prescription drugs, dental, and vision, but often limit provider choice compared to traditional Medicare.

MultiCare has partnered with independent Medicare advisory agencies to assist affected patients in navigating plan changes and ensuring continuity of care during the transition. This strategic adjustment by MultiCare reflects broader trends of health systems optimizing provider networks for controlled quality and cost management under Medicare Advantage programs.