Intercoastal patients lose Aetna Medicare Advantage coverage

After Nov. 30, patients who have an Aetna plan and use Intercoastal Medical Group will have to change doctors or get new coverage.

By Michael Harris
| 3:30 p.m. October 20, 2025

One of Intercoastal Medical Groups offices at 965 Beneva Road in Sarasota. Aetna is dropping Intercoastal Medical Group from its Medicare Advantage plan coverage.

Sarasota
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Intercoastal Medical Group patients in Sarasota and Manatee counties enrolled in an Aetna Medicare Advantage plan recently received notice the insurance company has dropped the medical group from its coverage beginning Dec. 1.

What it means is patients with any of the eight Aetna Medicare Advantage plans who see the 110 doctors at any of the five Intercoastal Medical Group sites will have to reschedule their December appointments for November or change companies and wait until after the new year.

"Basically, Aetna dropped us, end of story," Intercoastal CEO Geoffrey Simon said. "A lot of the patients believe that this is a negotiating tactic between us and Aetna. I want to be clear, this is not a negotiating tactic. There is no 11th hour solution to us being in the network."

After Dec. 1, visits will be classified "out-of-network," and those patients may have to pay full price.

Medicare patients with Aetna have a long-term solution since they are able to switch to another insurance company that includes Intercoastal doctors in its 2026 plans during the Annual Enrollment Period, which runs from Oct. 15 through Dec. 7 each year.

"I want to keep the doctors I have," said Sarasota resident Mike Sisti, who has had his Aetna Medicare Advantage plan for nearly 10 years. "So I will go with a supplement or another MA plan."

Michael Sisti, a local author, has an Aetna Medicare Advantage plan and goes to doctors at Intercoastal Medical Group. Aetna is dropping Intercoastal starting Dec. 1.

Simon's advice is go with United Healthcare, which will offer seven Medicare Advantage Plans in 2026 and six Dual Special Needs plans for those with qualifying Medicaid. Intercoastal accepts all United Healthcare plans, Simon said.

There are other companies such as Humana and Cigna, however, each plan is different, and Intercoastal may not accept a particular plan.

But the best bet Simon says is go with a Medicare Supplement plan.

"Traditional Medicare with a supplement would be the best," Simon said. "The reason why we have contracts with Medicare Advantage companies is that we have a wide range of economic circumstances for our patients, and you know, there are patients that can't afford a Medicare Supplement."

Supplement vs. Advantage plans

Medicare patients have the choice during enrollment periods of getting a supplement or advantage plans.

Medicare Supplements — also called Medigap policies — are paid each month in addition to a Medicare recipient's Part B premium. For example, in 2026, a 65-year-old man with a Medicare Supplement Plan G can pay as little as $198 a month with their Part B premium of $206.50 for a total of $504.50. In the case of a supplement, if a patient sees a doctor or doctors during the year, they pay a roughly $257 deductible for the year, and once that deductible is met, there is no cost to see a doctor or specialist. With a supplement, a patient can see any doctor who accepts Medicare assignment. No network involved.
Medicare Advantage plans are private health insurance plans that have a contract with the federal government to provide Medicare-covered benefits and have no to little cost for enrollment and offer benefits such as prescription drug coverage, vision and dental as well as benefit cards that allow patients to purchase over the counter items or in some cases, groceries. Some Medicare Advantage plans also offer a "Part B reduction" which reduces the Part B premium by as much as $185 a month for 2026.

For more information on supplement and advantage plans and the list of plans offered in Sarasota and Manatee counties, go to Medicare.gov.

Fortunately for Sisti, he does not have an appointment with Intercoastal in December.

"I've just had appointments with both my cardiologists and my primary care, and so both of those take place next year," Sisti said.

Complicated communication

Intercoastal said the communication from Aetna came as a surprise, and there are some nuances to what it means for patients that has been confusing.

Specifically, Aetna said it is not dropping all Intercoastal doctors.

"Intercoastal Medical Group specialists remain in-network for Aetna Medicare members for the next several years, but their primary care providers will not be in-network for Medicare members as of December 1, 2025," an Aetna statement sent to The Observer reads.

But according to Simon, that is not the case. Only some specialists will remain designated as in-network for Aetna Medicare patients.

"The statement is not completely true," Simon said, "because our primary care physicians were terminated, and some of our specialists were terminated. They basically cherry-picked the contract."

In some cases, the Center for Medicare Services (CMS) will allow a "Special Election Period" where someone can get coverage for December only before the new enrollment period begins. But those are only for unique cases.

Simon did say Intercoastal Medical Group continues with Aetna plans that are non-Medicare or employee plans.