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Humana Medicare Advantage plan Update
Beginning May 1, 2025, Essentia Health will no longer schedule appointments for patients who are covered by Humana Medicare Advantage plan.
What This Means for You
As part of this change, if you are insured by Humana’s Medicare Advantage plan, beginning May 1, we will no longer schedule appointments for you at Essentia.
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
If you plan to stay with Humana’s Medicare Advantage plan, you have other options for your care. Please contact Humana to find a new care provider who is in Humana’s network.
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.
The best time to switch to a Medicare plan that covers care provided at Essentia Health is during Medicare Advantage Open Enrollment period.
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 is Essentia Health no longer an in-network provider for Humana Medicare Advantage plan?
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. -
Are there exceptions?
- Essentia Health will continue to provide care for Humana’s Medicare Advantage plan patients within our hospital emergency rooms. Patient care remains our top priority in emergency situations, and this will remain unchanged regardless of insurance status.
- Patients with any Humana group Medicare plan will be allowed to seek care at Essentia Health on an out-of-network basis. If you have a group Medicare plan, your insurance card will say “Humana Medicare (Employer PPO)” or “Humana Medicare (Group PPO)” at the top of the card.
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I have a group Humana plan, do these changes impact my coverage at Essentia?
Patients with any Humana group Medicare plan will be allowed to seek care at Essentia Health on an out-of-network basis. If you have a group Medicare plan, your insurance card will say “Humana Medicare (Employer PPO)” or “Humana Medicare (Group PPO)” at the top of the card.
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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?
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?
As a part of this change, if you are covered by Humana’s Medicare Advantage plan, you will not be able to schedule appointments at Essentia on or after May 1, 2025, on an out-of-network or self-pay basis. We encourage you to contact Humana to find another care provider within Humana’s network.
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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 period. Changes made during open enrollment take effect the month after enrollment.
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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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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.
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How do I choose another health care provider?
Please contact Humana directly to understand which health systems, hospitals, clinics and doctors are in Humana’s Medicare Advantage plan network.
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