The open enrollment period for Medicare Advantage 2026 coverage began Wednesday, Oct. 15. One of Western New York’s largest health insurance providers will not include Roswell Park Comprehensive Cancer Center as part of its in-network coverage. But those eligible for Medicare Advantage need to research carefully before simply choosing an alternative provider.
Dr. Candace Johnson, chief executive officer at Roswell Park, sat with Buffalo Toronto Public Media to discuss the decision by Independent Health to exclude the cancer treatment hospital from in-network coverage. She offered her explanation as to the policy change, stating there had been no discussion or negotiation.
“This was just something that they informed us of, that they were taking the individual Medicare Advantage members, and they were going to essentially tier us out, because they were going to increase the costs to the patients so much, the out-of-pocket costs that they were going to incur if they went to Roswell Park,” she said. “We just didn't feel like that was something that we would do to our patients, because in many instances, this was two to three times or more of what the patient would have to spend.”
The policy change affects between 5,500 and 6,000 patients, according to Johnson.
A spokesperson for Independent Health provided a written statement on behalf of the provider Wednesday: “Independent Health values our relationship with Roswell Park and the care that it provides to our members. We had been working with Roswell Park Comprehensive Cancer Center on a new agreement effective January 1, 2026, for our individual Medicare Advantage plans.
Unfortunately, despite our willingness to have Roswell Park and its providers in our network, the hospital rejected the structure of our offer. Our offer to have Roswell Park as an in-network provider still stands in the hopes it reconsiders its decision.”
In an earlier statement, released October 1, Independent Health stated: "While Roswell Park will not participate with our 2026 individual Medicare plans, it will remain participating with our group Medicare plans as well as Commercial, State and Self-funded lines of business.
“Our individual Medicare Advantage members will continue to have access to a wide network of oncology providers, including Buffalo Medical Group, Catholic Health, Great Lakes Cancer Care Collaborative (this covers ECMC, Kaleida/GPPC, UBMD, WNY Urology, and Windsong), and Wilmot Cancer Institute (at Strong Memorial Hospital)."
Independent Health is not alone in excluding Roswell Park from individual Medicare Advantage users for 2026. Among the 69 different Medicare Advantage plans offered by numerous health insurance providers, 32 of them do not include Roswell Park as in-network. Highmark Western and Northeastern New York includes Roswell Park in seven of 13 options. United Healthcare, like Independent Health, excludes the center from in-network in all of its options for 2026.
But with Independent Health being among the largest providers in Western New York, it is they who have gained attention for the matter. State Senator Patrick Gallivan has urged Roswell Park and Independent Health to work out an agreement, but Johnson does not anticipate one.
“There have been no further talks about this. The issue is, is that we would have to keep these individuals in-network. We would have to agree to these exorbitant charges that patients would have to bear, and we just couldn't do that,” she said.
Open enrollment for Medicare Advantage remains open until December 7.
Dr. Johnson speaks of federal healthcare cuts – no worries about research, for now
Following discussion about changes to Medicare Advantage coverage by health insurance providers for 2026, BTPM asked Johnson about whether federal spending cuts earlier this year and federal funding now disputed amidst a government shutdown might impact cancer research projects happening at Roswell Park.
“We've been very fortunate,” she said. “NCI, the National Cancer Institute, and federal funding for cancer research. Everybody gets cancer on both sides of the aisle, and we've been very fortunate because to date, we've not lost any grant funding as a result of the federal issues. We're nervous a little bit about going forward, but our investigators, our physicians and scientists have been submitting grants to many different foundations and government agencies and other places. We’re optimistic that we'll get through this.”
Johnson also acknowledged the financial support raised from public efforts, including Ride for Roswell, the 11 Day Power Play, and individual community campaigns.
