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Local patients with Humana insurance plans may lose in-network coverage for Baptist Health doctors

The image shows a stethoscope and calculator sitting on top of documents related to health care expenses.
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Baptist Health and Humana are trying to strike a deal by late September to prevent potentially disruptive changes to some of their patients’ health care.

Humana and Baptist Health are trying to negotiate a new contract for health insurance coverage by Sept. 22. If they don’t, that will complicate things for many patients in Kentucky and Southern Indiana.

Right now, people with health insurance through Humana’s Medicare Advantage plans get in-network coverage when they see Baptist Health Medical Group’s doctors or advanced practice clinicians.

So do people who receive Humana’s commercial insurance plans through their employer.

But that will change after Sept. 22 unless Baptist and Humana agree on a new contract.

If the Louisville-based organizations don’t strike a deal, Baptist Health Medical Group will no longer be an in-network provider for Humana’s Medicare Advantage and Commercial Group accounts.

That means many patients with those Humana plans would need to find in-network health care providers elsewhere. They may have to pay more out-of-pocket if they keep seeing their Baptist Health Medical Group providers.

Some patients may be eligible for continued Humana insurance coverage of their treatment by a Baptist physician — at in-network rates or at higher, out-of-network rates — but they need to contact Humana to see if they qualify for either of those options.

In statements to LPM News, Humana and Baptist both said they hope to reach an agreement that maintains Baptist Health Medical Group’s in-network status.

The Medical Group includes over 1,100 doctors and advanced practice clinicians in Kentucky and Southern Indiana. They provide services for a wide range of specialties, from primary care to osteopathic medicine and more.

No matter how the negotiations turn out, Baptist said all its hospitals will still be in-network with Humana.

Subhed: What led to this point? And what happens next?

In the company’s statement, Humana said it received notice from Baptist in June that the health system intended to end Baptist Health Medical Group’s current agreement for Humana’s Medicare Advantage members and Commercial Group accounts.

Since then, Humana said it has been negotiating with Baptist.

“We understand that changes regarding one’s healthcare can be difficult and, if we are unable to reach a new agreement, we will work with our Medicare Advantage and Commercial Group members to help them transition to another physician,” the company said.

Baptist’s director of public relations, Kit Fullenlove Barry, said in a statement that their team is working to secure a new agreement with Humana.

Barry noted that Humana is gradually discontinuing its employer-sponsored medical insurance plans.

“To that end, while we are working to reach a new agreement with Humana for all our Medical Group patients — including commercial patients during this transition — we are prioritizing seniors with Medicare Advantage plans at this time,” she said.

Barry also said they’re working hard to ensure there’s no disruption in medical care for patients.

People can check Baptist’s website for updated information on the developing situation. The health system recommends patients contact Humana directly to learn how their coverage may be affected. They can call the number on the back of their insurance card.

Humana likewise encouraged people to call their customer care team if they need assistance.

Morgan is LPM's health reporter. Email Morgan at mwatkins@lpm.org.