Humana

For now, nothing changes. You should continue to visit Mount Carmel hospitals, facilities, and physicians as you normally would. We are working hard to reach a new agreement before January 1, 2025 to avoid care disruption, but we need Humana to join us and put patients first.

Mount Carmel is negotiating with Humana for a new agreement that appropriately covers the cost of the care we provide patients with Humana Medicare Advantage plans. Our current contract will expire January 1, 2025. Negotiations are a routine part of doing business, and we are working to improve our relationship with Humana. As one of the nation’s largest and most profitable health insurance companies, Humana has made it increasingly difficult for Mount Carmel to invest in the medical innovations, technologies, and programs patients rely on by delaying patient care or refusing to pay for care altogether.

As a trusted local care provider, we work tirelessly to care for our patients and communities. We also continue to reduce costs and implement efficiencies to ensure we can continue providing top-quality care to our patients. But we can’t continue to do it alone. We cannot maintain access to the care and services patients depend on and need without a fair agreement from Humana.

Our current agreement expires effective January 1, 2025.

As we approach open enrollment season, Mount Carmel wants to ensure that patients are fully informed about their options for 2025. Our goal is to secure a contract with Humana and minimize disruption to our patients’ care. However, we believe it is crucial to keep our community aware of the situation, should we encounter difficulties in reaching a fair agreement with Humana.

Patients with Humana Medicare Advantage health plans will be impacted.

All Mount Carmel hospitals, facilities, and employed providers are impacted by these contract negotiations.

While our negotiations with Humana continue, you can take these steps to protect your access to in-network care with Mount Carmel:

• If you are eligible for Medicare Advantage, the Annual Enrollment Period ends on December 7th and you can continue looking for plans through that time, even if you have already made a selection. We work with many health plans, including: 
  • Mount Carmel Health Plan (MediGold)
  • Anthem Medicare Advantage
  • Medical Mutual Medicare Advantage
  • UnitedHealthcare Medicare Advantage
• Never delay care. You will always have in-network access to our emergency department. Regardless of our network status with Humana, you should always visit the closest emergency department if you experience a medical emergency.
• If you're receiving ongoing treatment, call the number on the back of your Humana insurance card to receive more information about Continuity of Care—you may be able to continue in-network care at Mount Carmel.  
• If you receive insurance through your employer, ask about health plans that include Mount Carmel. Your employer may be able to provide you with secondary health plan coverage that includes access to your trusted caregivers. 
• If you are dually-enrolled - Call 1-800-MEDICARE (1-800-633-4227) to learn about available plans, including those that have continued access to your trusted providers.
• If you have Humana Medicaid, also known as Healthy Horizons, you may be able to choose other health care coverage that allows you to access Mount Carmel. Visit www.cms.gov.ohio or call 1-800-342-0553 to see if you can change your plan.  
• Call the number on the back of your insurance card and express how this negotiation is impacting your access to the providers and services you know and trust at Mount Carmel. 
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If you are already admitted to the hospital before January 1, 2025, you will be covered at in-network rates through the end of your inpatient stay.

We understand that some patients may have appointments scheduled on or after January 1. If possible, you should call your provider’s office to request that the appointment or procedure be rescheduled before January 1. If you are unable to reschedule your appointment or choose to keep your appointment, you may have to pay higher out-of-pocket costs for your care with Mount Carmel if Humana forces us out of its provider network.

Patients will always have in-network access to our emergency rooms, regardless of our status with Humana. If you experience an emergency, you should always visit the nearest emergency room. Patients needing emergency care can receive in-network treatment until the patient is stable.

For the most up-to-date information, we encourage you to contact us by visiting www.mountcarmelhealth.com/Humana or call our patient hotline at (614) 782-1888.