Humana and Baptist Health agree to restore in-network access for local patients to doctors


Humana and Baptist Health agree to restore in-network access for local patients to doctors

Patients with Humana health insurance will soon benefit from lower in-network rates at Baptist Health Medical Group, which includes over 1,100 physicians and advanced practice clinicians in Kentucky and Southern Indiana. After six months of negotiations, Baptist has reached a new deal with Humana, allowing patients to regain in-network coverage starting in April.

Last September, many patients lost their in-network coverage with Baptist’s medical group, affecting those with Medicare Advantage plans through Humana or those whose employers provided Humana’s commercial insurance. This forced patients to either seek in-network healthcare providers elsewhere or pay higher out-of-pocket fees if they continued to see a clinician within the Baptist Medical Group.

One of the main concerns that Baptist had expressed was around Medicare Advantage plans, which were provided by Humana and other insurers, routinely denying or delaying payments for medical services recommended by patients’ doctors. As a result, the medical group had also gone out-of-network with UnitedHealthcare and Wellcare’s Medicare Advantage plans in January, as indicated by a chart on their website.

While Baptist has faced challenges with certain insurance plans, the new agreement with Humana is a positive development for patients with Humana health insurance. The news release on Thursday announced the restored in-network coverage, providing patients with more options and potentially lower out-of-pocket costs when seeking care from Baptist Health Medical Group. This story may be subject to updates as the situation progresses.

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