Ben J. Mauldin | May 27 2026 13:27

Last Updated: May 27, 2026

 

South Carolina Medicare beneficiaries may soon begin hearing more about ongoing negotiations between MUSC Health and HealthSpring Medicare Advantage plans.

While no final decision has been announced, the situation has raised important questions for seniors who rely on MUSC physicians, hospitals, and specialists throughout South Carolina.

MUSC Health has publicly confirmed that its agreement with Cigna Healthcare is scheduled to expire on June 30, 2026, and that negotiations are ongoing. If a new agreement is not reached, MUSC hospitals and physicians could potentially become out-of-network for some members beginning July 1, 2026.

At this time:

  • Current coverage has not changed
  • Negotiations are still ongoing
  • Patients should continue using their providers as normal unless notified otherwise
  • Medicare members should stay informed as the situation develops

Why This Matters to Medicare Members in South Carolina

For many seniors, access to trusted doctors and hospitals is one of the most important parts of choosing a Medicare plan.

That is especially true in South Carolina, where MUSC Health has expanded rapidly across the state over the past several years.

Today, MUSC serves patients throughout:

  • Charleston
  • Columbia
  • Florence
  • Lancaster
  • Orangeburg
  • Marion
  • Chester
  • Kershaw County
  • Williamsburg County
  • and surrounding rural communities

For many Medicare beneficiaries, MUSC physicians and hospitals are central to their ongoing healthcare needs, including:

  • primary care
  • cardiology
  • orthopedic care
  • cancer treatment
  • surgeries
  • specialty medicine
  • chronic condition management
  • advanced hospital care

If provider participation changes, some patients could potentially experience:

  • higher out-of-pocket costs
  • referral disruptions
  • hospital access limitations
  • specialist changes
  • the need to compare different Medicare Advantage plans during AEP

What “Out-of-Network” Means for Medicare Advantage Plans

Medicare Advantage plans use provider networks made up of contracted doctors, specialists, hospitals, and healthcare systems.

If a provider or hospital becomes “out of network,” how coverage works depends on the specific type of Medicare plan.

HMO Plans

Many HMO plans generally require members to use in-network providers except for emergencies or urgent care situations.

PPO Plans

PPO plans may still allow out-of-network care, but often at higher costs and with different coverage rules.

Because provider networks can change annually, it is important to review:

  • physician participation
  • hospital systems
  • prescription formularies
  • referrals
  • specialist access
  • maximum out-of-pocket costs

before renewing or changing coverage.

Why Reviewing Medicare Coverage Every Year Matters

One of the biggest misconceptions about Medicare Advantage plans is that provider networks and benefits stay the same forever.

In reality, plans can change from year to year, including:

  • provider networks
  • hospital participation
  • prescription drug coverage
  • copays
  • deductibles
  • extra benefits
  • maximum out-of-pocket limits

Many seniors understandably focus on benefits like:

  • dental coverage
  • vision benefits
  • OTC allowances
  • grocery cards

But access to doctors and hospitals is often far more important long term — especially for individuals managing chronic conditions or ongoing specialist care.

The lowest premium is not always the best fit if it disrupts healthcare access.

What HealthSpring Members Should Do Right Now

At this stage, there is no reason to panic or make rushed decisions.

However, South Carolina Medicare beneficiaries should take this as an opportunity to proactively review their healthcare coverage before the Medicare Annual Enrollment Period (AEP).

Helpful steps include:

  • monitoring updates from MUSC and HealthSpring
  • reviewing annual plan notices carefully
  • checking provider directories
  • confirming doctor participation before enrolling
  • reviewing prescription drug formularies
  • comparing available Medicare Advantage options during AEP

Healthcare contract negotiations sometimes result in new agreements before deadlines expire. Still, situations like this highlight why annual Medicare reviews are so important.

Frequently Asked Questions

Is MUSC leaving HealthSpring Medicare Advantage plans?

At this time, MUSC and HealthSpring are still actively negotiating. No final agreement has been announced. However, MUSC has publicly stated that network participation could change if a new agreement is not reached.

Will I lose access to my MUSC doctors?

Currently, members should continue using their doctors as normal unless notified otherwise by their insurance plan or healthcare provider.

What happens if MUSC becomes out of network?

If MUSC providers become out of network:

  • some services may cost more
  • referrals could change
  • access to specialists may become more limited
  • certain HMO plans may no longer cover non-emergency services

PPO plans may still allow out-of-network care, but typically at higher costs.

Can Medicare Advantage networks change every year?

Yes. Medicare Advantage plans can change:

  • provider networks
  • hospital systems
  • prescription formularies
  • copays
  • benefits
  • annual costs

That is why reviewing Medicare coverage yearly is important.

When should I review my Medicare coverage?

Most beneficiaries review their plans during the Medicare Annual Enrollment Period (AEP), which runs from October 15 through December 7 each year.

How can I check if my doctor is in-network?

You can:

  • review the insurance carrier’s provider directory
  • contact your doctor’s office directly
  • verify hospital participation
  • speak with a licensed Medicare agent for assistance

Questions About Your Medicare Coverage?

If you have questions about Medicare Advantage plans, provider networks, MUSC participation, or reviewing your current Medicare coverage before AEP, it may be a good time to compare your options carefully.

👉 https://mauldininsurancegroup.com/contact

You can also learn more at:
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MUSC Medicare Network Updates by Region

If you live in South Carolina and use MUSC providers, you can review local updates by area:

Sources

Last Updated: May 27, 2026 South Carolina Medicare beneficiaries may soon begin hearing more about ongoing negotiations between MUSC Health and HealthSpring Medicare Advantage plans.While no final...