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Humana Medicare Advantage plan Update
Beginning Jan. 1, 2025, Essentia Health will no longer accept Humana Medicare Advantage plan insurance.
What This Means for You
As part of this change, if you are insured by Humana’s Medicare Advantage plan, we will not schedule any appointments for you after Dec. 31, 2024.
Like other health care systems, Essentia has been reviewing Medicare Advantage plans to make sure they have your best interest in mind. We found Humana’s Medicare Advantage plan delays and denies care at twice the rate of other Medicare providers. This causes delays in getting the care you need and deserve. It can be both frustrating and stressful.
Next Steps
We know that the relationships you have with members of your care team are important to you. We would like to continue caring for you. We hope that you will consider switching to another Medicare plan in which Essentia Health is listed as an in-network care provider.
Medicare Open Enrollment
The best time to switch to a Medicare plan that covers care provided at Essentia Health is during the annual Medicare Open Enrollment period, Oct. 15, 2024 - Dec. 7, 2024.
Medicare Plans Covered
Medicare plans that cover care provided at Essentia Health include:
- Medica
- Essentia Care
- UCare
- Blue Cross Blue Shield of Minnesota
- Blue Cross Blue Shield of North Dakota
- HealthPartners
- Security Health
- UnitedHealthcare
- Traditional Medicare
Frequent questions and answers
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Why won't Essentia Health be an in-network provider for Humana Medicare Advantage plan in 2025?
We believe that you deserve prompt access to the care that you need. We have found that Humana requires too many prior authorizations and denies care too often. Too many prior authorizations and denials cause hardships for our patients. -
What Humana plans are affected by this change?
This Humana insurance plan is affected by this change:
- Humana Medicare Advantage plan
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I have a Medicare Supplement (Medigap) or a part D plan through Humana. Will my insurance still be accepted in 2025?
Yes. This change does not affect patients who have Humana Medicare Supplement (Medigap) or part D insurance, because all Medicare Supplement and part D plans rely on traditional Medicare as the primary bill payer when you need care.
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If I choose to stay with Humana’s Medicare Advantage plan, how long do I have to seek care at Essentia Health before my health insurance coverage ends?
Essentia will continue to be considered in-network until Dec. 31, 2024. As a part of this change, if you are covered by Humana’s Medicare Advantage plan, Essentia Health will no longer schedule appointments for you that occur after Dec. 31, 2024.
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What happens to appointments that I have already scheduled in 2025?
At the end of the year, we will contact patients who have not switched to a Medicare plan that includes Essentia Health in its network. If you have not changed plans, we will cancel any appointments that are scheduled after Dec. 31, 2024.
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I plan to continue to seek care at Essentia Health in 2025, what do I need to do to make sure my care and/or procedures are still covered?
We know that your relationships with your physicians and advanced practice providers are important to you. If you are covered by Humana, we hope you will find a different Medicare plan that has Essentia Health in its network. These include Medica, EssentiaCare, UCare, Blue Cross Blue Shield of Minnesota and North Dakota, HealthPartners, Security Health, UnitedHealthcare, traditional Medicare and Medicare supplemental plans.
You may choose to work with an insurance broker, visit www.medicare.gov or call 1-800-MEDICARE, (1-800-633-4227) for assistance.
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Are there any exceptions?
If you do not make changes in your Medicare coverage, we will continue to care for you in our hospital emergency rooms. Patient care is our top priority in emergency situations, and this will not change.
Patients who are insured by a Humana Group Medicare plan can access care at Essentia Health on an out-of-network basis in 2025.
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If I decide to choose a new provider for my Medicare plan, when should I do this?
The best time to make changes in your Medicare plan is during Medicare open enrollment. For 2025, the Medicare open enrollment will be Oct. 15, 2024, through Dec. 7, 2024. Changes made during open enrollment take effect on Jan. 1, 2025.
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Who can help me change my Medicare plan?
There are three ways that you can shop and compare Medicare plans:
- If you have worked with an insurance broker or advisor in the past, they may be able to help you. You can also find a new Medicare broker.
- If you want to review plan options on your own, Medicare.gov may be helpful. You may also call 1-800-MEDICARE (1-800-633-4227).
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Which Medicare plans cover care at Essentia Health?
Insurance providers that include Essentia Health in their Medicare plan network include Medica, Essentia Care, UCare, Blue Cross Blue Shield of Minnesota and North Dakota, HealthPartners, Security Health, UnitedHealthcare, traditional Medicare and Medicare supplemental plans.
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What are the differences between traditional Medicare and Medicare Advantage plans? I thought I could go to any provider with my Medicare plan.
With traditional Medicare, you can see any provider who accepts Medicare.
Medicare Advantage plans typically have a network of specific doctors, clinics and hospitals that have contracted with your insurer to provide care. These plans often offer additional coverage and benefits that traditional Medicare does not cover.
Need Help Choosing a New Medicare Insurance Plan?
Contact a local insurance broker
Compare plans at www. Medicare.gov or call 1-800-MEDICARE (1-800-633-4227)
State Resources:
Minnesota Senior Linkage Line:
1-800-333-2433
Senior Linkage Line
North Dakota State Health Insurance Counseling Program (SHIC):
1-888-575-6611
insurance.nd.gov
Wisconsin State Health Insurance Assistance Program (SHIP):
1-800-242-1060
www.dhs.wisconsin.gov