Protecting your health care.
At St. Joseph Health, we believe every patient deserves access to high-quality health care from the doctors and nurses they know and trust. St. Joseph Health has been working with Humana to reach a new contract agreement that puts patients’ needs first and protects their access to the health care services they trust.
If Humana does not agree to a new contract with St. Joseph Health, Humana Medicare Advantage plans will no longer consider St. Joseph Health in network beginning January 1, 2025. This means if patients have a Humana plan next year, Humana may require patients to change doctors or receive care from a different health system.
As a mission-driven, nonprofit health system, we work hard to ensure we can always meet our patients’ changing health care needs. Responsible agreements with insurance companies like Humana allow us to attract and retain health care professionals, bring new services to the community, invest in new technology and maintain our facilities.
What patients can do today:
- Call Humana at the number on the back of your insurance card. Ask that Humana work with St. Joseph Health to protect your in-network access to the care you need and deserve.
- View a list of plans we participate in on our website.
We are still negotiating with Humana, and nothing will change before January 1, 2025. Patients should keep the appointments and procedures they have scheduled with St. Joseph Health hospitals and our providers. Please do not delay routine health screenings, procedures or tests vital to your health.
In an emergency, patients may go to any hospital, no matter if it is in their plan’s network or not, and their care will always be covered.
Protecting Access and Choice
If Humana does not agree to a new contract with St. Joseph Health, Humana Medicare Advantage plans will no longer consider St. Joseph Health in network beginning January 1, 2025. This means if patients have a Humana plan next year, Humana may require that patients change doctors or receive care from a different health system.
St. Joseph Health’s goal:
- Continue caring for our patients.
- Embody our mission and ensure we can always meet our patients’ changing health care needs.
- Ensure our ability to continue to provide quality services now and in the future.
Humana’s position:
- Records billions of dollars in profits. Humana, a publicly traded company, records very high profits like other insurance companies. In 2023, Humana recorded $106 billion in profits.
- Current reimbursements do not cover the total cost of care at St. Joseph Health facilities.
- Deny and delay coverage of medically necessary care, putting patients in potentially life-threatening circumstances.
Responsible agreements with insurance companies allow us to attract and retain health care professionals, bring new services to the community, invest in new technology and maintain our facilities.
St. Joseph Health strongly desires to continue caring for our patients and community.
FAQs: Our negotiations with Humana
St. Joseph Health has been working with Humana to reach new contract agreements that put patients’ needs first and ensures their continued in-network access to St. Joseph Health doctors, hospitals and services. However, no agreement has been reached.
Hospitals are paid according to contracts negotiated with the insurance company every few years. These contracts allow us to be included in the insurance company’s network (so that we’re “in network” for you), and the details of the contract govern the amount we are paid, the way claims are processed, and how prior authorizations are handled. We are seeking to secure better terms and fair rates for the care we provide.
It’s important to know that this negotiation is not only about reimbursement rates. We are asking Humana to provide relief from some of their poor practices of denying payments and delaying care, which has threatened our ability to serve them effectively. Many of our patients with Medicare Advantage plans, like Humana, are finding that their plans often delay or deny care that their physicians deem necessary, leaving them unable to get the care they need. And if patients continue with the care that’s been recommended, Medicare Advantage often refuses to pay for it.
If Humana does not agree to a new contract with St. Joseph Health, Humana Medicare Advantage plans will no longer consider St. Joseph Health in network beginning January 1, 2025.
Yes, patients will still be able to access care from St. Joseph Health. However, Humana will consider St. Joseph Health doctors, nurses and services out-of-network and may require that you pay more, change doctors or receive care from a different health system.
In the event of an emergency, patients may go to any hospital. Emergency care is always covered in network. Insurance companies are legally required to cover true emergency department care at an in-network benefit level.
St. Joseph Health is working with Humana in good faith to reach a new agreement that protects patients’ in-network access to essential services.
- Call Humana at the number on the back of your insurance card. Ask that Humana work with St. Joseph Health to protect your in-network access to the care you need and deserve.
- View a list of plans we participate in on our website.
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