Important Information Impacting Humana Medicare Advantage Insurance Plans

Humana and Northern Regional Hospital Updates

What is happening?

After careful consideration and evaluation, Northern Regional Hospital has decided to exit Humana Medicare Advantage plans.

As of January 1, 2025, Northern Regional Hospital and its affiliated providers will no longer be “in-network” with Humana Medicare Advantage health insurance plans. This means services at our facilities will be considered out-of-network for Humana Medicare Advantage plans, which may affect your out-of-pocket costs.

These changes will not impact your benefits for the remainder of 2024 and you can continue to access care at Northern Regional Hospital as you normally would.

For Retired NC State Health Plan Members: Your benefits will remain the same, allowing you to continue seeing your current provider, even if they are out of network.

What can you do:

Consider your health plan options. Please speak with your insurance broker/agent about your options about selecting a plan that best fits your needs during the open enrollment period. If you do not have a broker, you can contact 1-800-MEDICARE or visit Medicare.gov for help identifying and switching to other coverage options. Switching to traditional Medicare or an in-network Medicare Advantage plan will help you avoid higher out-of-pocket costs and ensure continued access to your preferred providers. Northern Regional Hospital is in-network with the following plans for 2025:

UnitedHealthcare Medicare
Aetna Medicare
Blue Medicare

Sentara Medicare
AARP Medicare
Anthem Medicare

Contact our customer service line at 336-783-8909 with any questions or continue to visit this web page ChooseNorthern.org/StayCovered to get the most up-to-date information. We are here to help.

Northern Regional Hospital and its affiliated providers have served this community for over 65 years. We are proud to be named as one of the “Great Community Hospitals” by Becker’s Hospital Review, an honor received by only five hospitals in North Carolina. We have been recognized nationally for our Skilled Nursing Facility, stroke program, and high patient satisfaction scores. The Centers for Medicare and Medicaid Services has given Northern Regional Hospital a 5-star rating, which is the highest possible overall acute care rating.

We are committed to ensuring that you continue to receive the high-quality, compassionate care you need from the providers you know and trust.

What does the termination of the contract with Humana mean for me?

Effective January 1, 2025, Northern Regional Hospital and its affiliated physician practices will no longer be in-network providers for Humana Medicare Advantage plans. This may affect your coverage for services received at our facility.

Why did Northern terminate the contract with Humana?

Humana denies care claims that have already been provided, and our patients may have significantly higher out-of-pocket costs. We believe your need for medical care should be determined by you and your doctor, not an insurance company. The decisions our physicians make about your care are based on best practices and evidence-based medicine. Humana has a demonstrated history of making decisions that often conflict with these best practices.

What should I do if I am currently receiving care?

If you are in an ongoing plan of care, you may request a continuation of your treatment with your current Northern Regional provider. Please discuss this option with your provider’s office and verify your out-of-network benefits.

Should patients with Humana insurance reschedule existing appointments or stop scheduling future appointments?

This change does not impact in-network status for the remainder of 2024 and you can continue to access care at Northern Regional Hospital as you normally would.
Northern Regional Hospital will no longer be “in-network” with Humana Medicare Advantage health insurance plans as of January 1, 2025. This means services at our facilities will be considered out-of-network under your current Humana plan, which may affect your out-of-pocket costs.
However, if you are a Retired NC State Health Plan member, your benefits will remain the same, allowing you to continue seeing your current provider, even if they are out of network.

What if a patient has a medical emergency on or after December 31, 2024?

Patients should always go to the closest emergency department if they are experiencing any type of emergency. Patients will always have in-network access to our emergency department, regardless of network status with Humana, until they are stable and can independently determine if they would like to be transferred to an alternate facility to be covered under in-network rates for the duration of their care.

What if a patient is receiving critical care for a chronic illness that will require care on or after December 31, 2024?

Certain conditions, such as care for chronic or complex illnesses, may be eligible for Continuity of Care which would provide approved patients the opportunity to continue seeing their current care team at in-network rates for a certain period, even if Northern Regional Hospital is out of network with Humana. Patients must apply for Continuity of Care through Humana, and Humana will review and approve or deny those applications on a case-by-case basis.

How does this impact Retired NC State Health Plan members?

Your benefits will remain the same, allowing you to continue seeing your current provider, even if they are out of network.

When can I select new Medicare coverage?

If you missed the December 7, 2024 deadline to select new coverage or would like to make changes to your selected coverage, you can choose new Medicare coverage from January 1, 2025 to March 31, 2025.

What can patients do to stay in-network with Northern Regional Hospital?

Please speak with your insurance broker/agent about your options about selecting a plan that best fits your needs during the open enrollment period. If you do not have a broker, you can contact 1-800-MEDICARE or visit Medicare.gov for help identifying and switching to other coverage options. To receive in-network coverage at Northern Regional Hospital in 2025, you will want to choose a new Medicare Advantage health plan or enroll in traditional Medicare during the open enrollment period beginning October 15, 2024. Northern Regional Hospital is in-network with the following plans for 2025:
• UnitedHealthcare Medicare
• Aetna Medicare
• Blue Medicare
• Sentara Medicare
• AARP Medicare
• Anthem Medicare

Who can I contact if I have questions about my insurance?

If you have questions regarding your insurance or need assistance, please call our Hospital Customer Service at 336-783-8909.

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