Humana
An Important Update on Your Access to Care
Updated 10/17/2023
As a valued patient of Baptist Health, you may have recently received notification regarding the status of your insurance coverage administered through Humana.
For the past several months, Baptist Health has been engaged in discussions with Humana to secure a new contract and protect your in-network access to Baptist Health Medical Group providers. Unfortunately, we have been unable to come to an agreement and Baptist Health Medical Group is out of Humana’s network for Medicare Advantage and employer-sponsored commercial plans as of September 22, 2023.
As a result, Humana no longer considers Baptist Health Medical Group physicians or advanced practice clinicians in-network for coverage and you may incur a higher cost when obtaining services from Baptist Health Medical Group providers.
It is important to note, this only impacts Baptist Health Medical Group. Baptist Health hospitals remain in network for Humana patients.
Additionally, this does not impact our Medicaid or TRICARE patient populations.
Continuity of Care
You may be eligible for Humana out-of-network benefits or have access to coverage through a supplemental or secondary network through what is called “Continuity of Care.” Only Humana can provide you with information on whether you qualify.
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 you qualify for continued care with your Baptist Health Medical Group doctor. Without approved continuity of care or supplemental benefits for Humana, you may have to pay more to see your Baptist Health Medical Group physician starting on September 22, 2023.
What You Can Do
- Call Humana at the number on the back of your insurance card if you need assistance learning more about your plan’s out-of-network benefits.
- For patients with Medicare Advantage, the Annual Enrollment Period starts October 15. For a list of Medicare Advantage plans Baptist Health accepts, download a PDF version of our status chart.
- Continue to check this website for ongoing updates.
As caregivers, nothing is more important than ensuring our patients have access to the care they need, when they need it. We remain committed to working with Humana in good faith and will continue to advocate in the best interest of our patients.
Thank you for your continued trust in Baptist Health.
We are committed to keeping you informed about our progress. To that end, we are providing answers to some Frequently Asked Questions.
Frequently Asked Questions
Baptist Health has been working with Humana to secure new contracts. Unfortunately, we have been unable to come to an agreement and Baptist Health Medical Group is out of Humana’s network for Medicare Advantage and employer-sponsored commercial plans as of September 22, 2023.
We have been working to secure a new contract with Humana, and it is an ongoing process. Unfortunately, we have been unable to come to an agreement and Baptist Health Medical Group is out of Humana’s network for Medicare Advantage and employer-sponsored commercial plans as of September 22, 2023. (This does not affect your in-network access to Baptist Health hospitals or to the medical group in Madisonville. Also, Humana Medicaid and TRICARE plans are not affected .)
The out-of-network situation affects any Baptist Health Medical Group physician or advanced care provider in Indiana, Kentucky and Illinois, except for those in Madisonville. All Baptist Health hospitals remain in network with Humana.
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.
All Baptist Health hospitals will remain in-network with Humana, so inpatient services within the hospital offering physical therapy and occupational therapy are considered in network.
Baptist Health Urgent Care and Physical Therapy locations (located outside the hospital) that are staffed by Baptist Health Medical Group physicians and clinicians will be out of network with Humana Medicare Advantage and employer-sponsored plans effective September 22, 2023. Patients might be responsible for more out-of-pocket costs. Occupational Medicine locations are not affected.
We recommend you call Humana at the number on the back of your insurance card to understand if you qualify for continued care or have out-of-network benefits that may help cover services provided by a Baptist Health Medical Group provider.
The most common Humana plans are:
- Humana Choice PPO
- Humana Honor PPO
- Humana Value Plus PPO
- Humana USAA Honor PPO
- Humana Gold Plus HMO
Please be aware that this list may not include every Humana plan. Only Humana can confirm if the potential out-of-network situation will affect your particular plan.
The most common networks are:
- Medicare PPO/Employer PPO Plus
- Humana Gold Choice Network PFFS
- National Medicare HMO or SNP
- Medicare PPO
- Gold Plus HMO KY
- Gold Plus Dual Eligible SNP KY
- HMO - Kentucky Public Pension Authority (KPPA) and Humana POS
- Humana - TeamCare - Central States Teamsters H&W
- Humana - USW-UAW Retiree VEBA
Please be aware that this list may not include every Humana network. Only Humana can confirm if the potential out-of-network situation will affect your particular plan’s network.
Even though Humana has announced it is exiting the commercial business and will no longer offer employer-based plans, there may be some still-existing commercial plans that may be affected. To determine if you are impacted, you should call the number on the back of your Humana insurance card. Only Humana can confirm if the out-of-network situation will affect your particular plan’s network. If you receive your insurance through your employer, you can ask your employer’s Human Resources department for more information.
We want to make sure you know your options for treatment as of September 22, 2023. You may be eligible for out-of-network benefits or have access to coverage through a supplemental or secondary network or through what is called “Continuity of Care.” Only Humana can provide you information on whether you qualify.
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 you qualify for continued care with your Baptist Health Medical Group doctor. Without approved continuity of care or supplemental benefits from Humana, you may have to pay more to see your Baptist Health Medical Group physician as of September 22.
You may be eligible for out-of-network benefits or have access to coverage through a supplemental or secondary network or through what is called “Continuity of Care.” Only Humana can provide you information on whether you qualify.
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 you qualify for continued care with your Baptist Health Medical Group doctor. Without approved continuity of care or supplemental benefits from Humana, you may have to pay more to see your Baptist Health Medical Group physician.
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.
If you have an upcoming visit or procedure with a Baptist Health Medical Group provider starting September 22, 2023, we recommend you call Humana at the number on the back of your insurance card to understand if you qualify for continued care with your Baptist Health Medical Group doctor.
All Baptist Health hospitals will remain in-network with Humana. However, Baptist Health Medical Group doctors and other clinicians will be out of network with Humana Medicare Advantage and employer-sponsored plans effective September 22, 2023.
When a patient receives care in our hospitals that involves a Baptist Health Medical Group provider – and that care is not covered as emergent or continuation of care – then the professional claim for the care provided by the Medical Group provider will be considered out-of-network and the patient might be responsible for more out-of-pocket costs.
We recommend you call Humana at the number on the back of your insurance card to understand if you qualify for continued care or have out-of-network benefits that may help cover services provided by a Baptist Health Medical Group provider.
If you are experiencing a medical emergency, it is important to go to the nearest emergency room. Insurance companies are required to pay for any emergency services at in-network rates.
If you are experiencing a medical emergency, please go to the nearest emergency room. Insurance companies are required to pay for any emergency services at in-network rates.
Insurance companies are required by law to continue paying for treatment at in-network rates for patients with certain medical conditions through a program called “Continuity of Care.” Examples of situations that may qualify for Continuity of Care include pregnancy, chronic medical conditions, and ongoing and active medical treatment such as chemotherapy or dialysis, or home healthcare services. It's important to note that only Humana can determine if you qualify. To learn more, call the number on the back of your insurance card.
It is an ongoing process. We remain committed to working with Humana in good faith and will continue to advocate in the best interest of our patients.