Humana Advantage Out of Network in 2027
At St. Vincent Health, we are committed to caring for you today while ensuring we can continue serving our rural community for generations to come.
As part of that commitment, we regularly evaluate our contracts with health insurance companies. Over time, we have experienced ongoing challenges with the Humana Medicare Advantage plan that have created barriers to patient care and have made it increasingly difficult to provide services in a timely and sustainable manner.
After careful consideration, St. Vincent Health has made the difficult decision to discontinue our participation in the Humana Medicare Advantage network effective January 1, 2027.
We do not take this decision lightly and want our patients who have, or are considering, the Human Advantage Plan to have as much lead time as possible. The Medicare Annual Enrollment Period is October 15–December 7, 2026. We encourage you to begin exploring your Medicare options now.
If you have questions about this change or would like assistance understanding how it may affect your care at St. Vincent Health, please contact our Patient Financial Counselor at 719-486-0230 ext. 205.
Thank you for allowing us to be your healthcare provider. We sincerely appreciate the trust you place in our team, and we look forward to continuing to care for you and your family.
With gratitude,
Bubba Bartlett
Chief Executive Officer
St. Vincent Health
Is St. Vincent Health ending its relationship with Humana?
St. Vincent Health is currently not in network with Humana commercial insurance plans. Our current participation with Humana is limited to Humana Medicare Advantage.
Beginning in 2027, St. Vincent Health will no longer participate as an in-network provider for Humana Medicare Advantage.
Why can’t St. Vincent Health simply continue accepting Humana Medicare Advantage?
As the only hospital serving Lake County, St. Vincent Health has a responsibility to carefully evaluate the financial and administrative impact of every insurance contract. When administrative requirements, coverage delays,
and reimbursement challenges become significant enough to interfere with that responsibility,
we must evaluate whether a contract remains sustainable.
Will Humana Medicare Advantage patients still be able to receive care at St. Vincent Health?
Yes. However, once the change takes effect, St. Vincent Health will be considered out of network under a patient’s Humana Medicare Advantage plan. This may affect the patient’s out-of-pocket costs and the way services are covered. Coverage can vary by plan, so patients should contact Humana directly to understand their specific benefits and options.
Does this mean I need to change my Medicare Advantage plan?
Not necessarily, but patients who want to continue receiving care at St. Vincent Health as an in-network provider should carefully review their Medicare Advantage options during the annual enrollment period.
When should I review my insurance?
We encourage patients to begin reviewing their 2027 Medicare Advantage options during the Medicare Annual Enrollment Period, October 15–December 7, 2026. Enrollments during this time frame become effective on January 1. Do not wait until you need care to find out whether your healthcare providers or hospital are in network.
Is this decision about money?
Financial sustainability is an important part of the decision, but this is about more than reimbursement. Administrative requirements, coverage approvals, denials, delays, and
reimbursement practices all require resources and can affect how efficiently healthcare can be delivered.
Will this affect Medicare patients who do not have Humana Medicare Advantage?
No. This change specifically concerns Humana Medicare Advantage participation.
What if I need emergency care?
If you experience a medical emergency, call 911 or come to the SVH emergency department, open 24/7. Insurance questions should not prevent someone from seeking emergency medical attention.
What is St. Vincent Health doing to protect healthcare access in Lake County?
St. Vincent Health is continuing to invest in the services, people, technology, and partnerships needed to provide sustainable healthcare locally.
What should I consider when choosing a Medicare Advantage plan?
• Whether St. Vincent Health is in network
• Whether their primary care provider and specialists are in network
• Hospital coverage and out-of-pocket costs
• Prescription drug coverage
• Deductibles, copayments, and coinsurance
• Referral or prior authorization requirements
• Access to providers they currently use
• Coverage for services they anticipate needing
Patients should contact the insurance company directly to confirm network participation and benefits for their specific plan.
What if I have an upcoming appointment or procedure?
We hope that we have accounted for your upcoming appointments with this advance notice. Humana Medicare Advantage patients with scheduled care at St. Vincent Health after December 31, 2026 should contact the SVH Patient Financial Counselor at 719-486-0230, ext 205.
Who should I contact if I have questions?
Patients with questions about their specific Humana Medicare Advantage plan should contact Humana directly or speak with a licensed Medicare insurance representative.
To search for a Medicare plans, contact a licensed Medicare broker, or
State Health Insurance Assistance Program (SHIP):
• 719-471-2096 for information or to schedule an appointment
• 1-888-696-7213 to speak to a SHIP counselor toll-free