MUSC Health’s contract with Humana Medicare Advantage & Humana Healthy Horizons Medicaid expires June 30, 2025

MUSC Health’s contract with Humana Medicare Advantage and Humana Healthy Horizons Medicaid expires June 30, 2025.

MUSC Health is committed to providing exceptional care. We have worked with Humana to address how claims are reviewed and paid by Humana, but we remain concerned about the number of denials of necessary treatment plans ordered by our physicians. These denials cause unnecessary delays in treatment as well as anxiety for patients.

Our doctors will always advocate for the treatment that is best for you. Our goal for our patients is to provide the best care in the timeliest manner. MUSC Health firmly believes that health care decisions are best made between a doctor and a patient.

Frequently Asked Questions

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

During an open enrollment or choice period, we encourage patients to select an insurance plan that has a contract with MUSC Health so that they can continue care with MUSC Health.

How can patients make that change?

Medicare Advantage

• Talking to your insurance broker
• Visiting the CMS website site for managed care enrollment: CMS-Managed-Care
• Calling CMS at 1-800-633-4227

MUSC Health participates with the following Medicare Advantage programs

• Medicare A & B (aka Traditional Medicare)
• Aetna Medicare
• AllWell by Absolute Total Care
• BCBS Medicare
• Cigna Medicare
• Clover Health
• United Healthcare
• Wellcare

You may have also received a letter from Humana, assigning you to a different in-network provider that is not part of MUSC Health. You can change this choice during your Medicare Open Enrollment.

Healthy Horizons Medicaid

If you are a Humana Healthy Horizons Medicaid member, and you are in your choice period, you can switch plans through South Carolina Healthy Connections Choices by calling 877-552-4642, Monday through Friday, from 8 AM to 6 PM. TTY users can call 877-552-4670. If you are not in your choice period, you may submit a request to switch health plans if Humana is not able to assign you to another doctor in your area.

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.  

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.

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?

It is also important to know that if you have certain medical conditions or are currently undergoing active treatment with MUSC Health, Humana will work with you and MUSC Health to coordinate care with your same doctor for up to ninety (90) days or until Humana can find you a new provider. If you have questions about this process, please contact Humana Medicare Member Services line at 800-457-4708 (TTY: 711) or Humana Healthy Horizons Medicaid Member Services line 866-432-0001 (TTY: 711). .

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.