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Humana Medicare & Medicaid Insurance Contract Expiration on Dec. 31, 2024

MUSC Health’s contract with Humana Medicare Advantage and Medicaid Healthy Horizons Insurance expires Dec. 31, 2024.

MUSC Health is committed to providing exceptional care. MUSC offers complete care by investing in our physician network, virtual care and state of the art capabilities. We value the trust and confidence you and your family have placed in MUSC Health in allowing us to provide that care. To do this, we want to work with partners who are as committed to that high standard as MUSC Health. This leads to difficult decisions when insurance companies prioritize profits over patients. MUSC Health's contract with Humana Medicare Advantage and Medicaid Healthy Horizons Insurance will end on Dec. 31, 2024. When our contract with Humana ends, patients may pay more out of pocket to see their MUSC Health doctor or use a MUSC Health hospital. If you stay with Humana, you may have to switch doctors or hospitals.

Humana Medicare Advantage and Medicaid Healthy Horizon’s Insurance plan member patients who wish to use MUSC Health Hospital services or MUSC doctors and providers will no longer pay lower in-network costs. They will have to pay higher out-of-network costs or even 100% of costs out-of-pocket. MUSC has been working with Humana for the last two years regarding our contract and has serious concerns over important issues with claims not being paid and problems getting authorizations when our patients need care. Humana is aware of our concerns and has not made any meaningful adjustments. Care delayed is care denied when you or your loved one need it most. Meanwhile when you or your loved one wait, Humana publicly reported income of $918 million dollars in the 2nd quarter of 2024. This is profit from paying providers less than Medicare would pay for the same service.

Frequently Asked Questions

What are my options, or my patients’ options, when the Humana contract ends with MUSC Health?

We encourage patients to select an insurance plan during open enrollment that has a contract for 2025 with MUSC Health so that they can continue to care with MUSC Health. 

How can patients make that change?

To change your Medicare Advantage plan selection to include your MUSC Health physicians and hospitals during the open enrollment process:

I have a Medicare supplemental plan through Humana. Is that plan affected?

No. Supplemental plans are not included in the termination. The termination only impacts Medicare Advantage plans and Medicaid Health Horizons plans.  

I am covered by Tricare. How will this affect me? 

This change will not impact those covered by Tricare.

Why aren’t you negotiating with Humana to reach a resolution?

We have been working with Humana for the last two years to reach a resolution. The company is aware of our concerns and has not made any meaningful adjustments. Care delayed is care denied when you or your loved one need it most.

In an emergency, can I still go to an MUSC Health hospital’s emergency room?

Yes, true emergency care will always be paid for at an in-network benefit level by Humana.

What if I need ongoing treatment?

If you require ongoing treatment or already have a procedure scheduled, you could be eligible for Continuity of Care benefits with Humana for a defined period of time. Those eligible for continuity of care in-network are those in active treatment for pregnancy, chronic disease, and life-threatening conditions such as cancer. Should the need arise for you to initiate a continuity of care request, visit Humana’s website for the online form or call Humana Member Services listed on the back of your card.

What other plans do you accept?

For a list of insurance plans accepted by MUSC Health, please visit Insurance Plans Accepted at MUSC Health.

What if I have more questions?

Email us at planquestions@musc.edu.