Optum NJ Goes Out-of-Network With Several Insurance Plans in 2026

Optum Medical has decided to go out-of-network with several insurance companies starting in January 2026. This list includes:

• AmeriHealth commercial plans: Effective Jan. 15

• Cigna/HealthSpring Medicare Advantage: Effective Jan. 31

• All Fidelis plans, including:

  • Commercial-NJ: Effective Jan. 1

  • Managed Medicaid-NJ: Effective Jan. 1

• Horizon (Blue Cross)

  • Dual Special Needs (DSNP): Effective Jan. 15

  • Managed Medicaid: Effective Jan. 15

• Wellpoint (AmeriGroup)

  • Medicare Advantage: Effective Jan. 31

  • Managed Medicaid-NJ: Effective Jan. 31

Optum made headlines just a few months ago when it closed down several offices throughout the state of New Jersey. Many NJ residents with Medicare Advantage plans could be potentially affected.

Sources:

https://patch.com/new-jersey/tomsriver/s/jv1l2/nj-medical-group-optum-to-go-out-of-network-with-many-insurance-companies-next-month?utm_source=local-update&utm_medium=email&utm_campaign=alert&user_email=d854414395fd8a656ffb42ccc4dad5182a2af0d5afb495d2cab8f8687ee6f538&user_email_md5=30fee46347a0b6de86ce8c0e3bfa5f4e&lctg=6357f3c38a19a54ccb01aaa8

https://patch.com/new-jersey/ridgewood/patients-scramble-optum-health-closes-dozens-doctors-offices-around-nj