We want to ensure we can continue to offer you and your family the high-quality care you expect and deserve, which is why we are sharing an important update regarding current negotiations with Humana that may affect you or your loved ones.
WHAT IS HAPPENING?
Unfortunately, what Humana pays our doctors, nurses and caregivers is not adequate to account for the cost of providing safe, quality care. By failing to offer sustainable reimbursement rates and address persistently high claims denial rates, Humana may be putting your in-network access to the Mercy Health facilities and providers you know and trust at risk.
If we do not reach an agreement before December 1, 2025, Mercy Health will be considered an out-of-network provider for our patients in Ohio and Kentucky who have Managed Medicaid or Medicare Advantage health insurance through Humana.
**Humana Military is excluded.
**Medicare Supplemental plans are not impacted.
WHAT DOES THIS MEAN FOR YOU?
Nothing changes for now and you can continue to access our providers as you always have.
If an agreement has not been reached before December 1, we strongly encourage you call Humana at the number on the back of your insurance ID card to learn more about your out of network benefits – and what it means for you if your care team goes out of network.
Certain conditions, such as care for chronic or complex illnesses, may be eligible for Continuity of Care that would provide approved patients the opportunity to continue seeing their current care team at an in-network benefit basis, even if Mercy Health is out of network with Humana. Note – if you are denied approval for continued care, you can contact Centers for Medicare & Medicaid Services at 1-800-633-4227 to file a complaint.
Access to our Emergency Department facilities will always be available to patients for covered emergency services, regardless of network status.
WHAT CAN YOU DO NOW?
Explore your options. Mercy Health remains in-network with all other major health plans.
WHEN CAN I MAKE A CHANGE?
The Medicare enrollment period extends October 15-December 7 nationwide. Changes made during the enrollment period will be effective January 1, 2026.
The annual Medicaid enrollment period in Ohio extends November 1-30. You can request to change your current plan at any time for “just cause”.
The annual Medicaid enrollment period in Kentucky is open year-round.
WHO CAN HELP ME MAKE A CHANGE?
Your broker
Centers for Medicare & Medicaid Services at 1-800-633-4227
Medicare Advantage patients: the Ohio Senior Health Insurance Information Program at 1-800-686-1578 or the Kentucky Senior Health Insurance Information Program at 1-877-293-7447
We promise to continue doing our part and work hard to reach an agreement with Humana on behalf of our patients and the communities we serve – so nothing comes between you and your caregivers.