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Thursday, August 31, 2023

Baptist Health warns Humana Medicare Advantage policyholders that they could be out of network if negotiations don't work out

Humana Inc. and Baptist Health are negotiating a new contract for patients with Medicare Advantage policies from the Louisville health insurer, and the hospital chain is warning policyholders that Baptist Health providers will be out of Humana's network unless an agreement is reached by Sept. 22.

The issue would not affect hospital services, just doctors and other clinicians at Baptist Health facilities, the company says, adding, "Because insurance coverage varies based on the specific plan you have, we recommend you call Humana at the number on the back of your insurance card to understand if your plan and provider are affected. . . . Only Humana can confirm if the potential out-of-network situation will affect your particular plan’s network."

Humana Medicare Advantage policyholders undergoing treatment for certain medical conditions from a Baptist Health provider will continue to be covered at in-network rates under a program called “Continuity of Care.” These include pregnancy, chronic medical conditions, and treatment such as chemotherapy or dialysis, or home health services. "It's important to note that only Humana can determine if you qualify," Baptist Health says. "To learn more, call the number on the back of your insurance card."

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