Humana Negotiations

Important information for patients with Humana health insurance

We continue to negotiate for a fair agreement but remain far apart with Humana, despite our best efforts, Humana has continued to delay progress and has yet to offer a proposal that meets St. Joseph’s Health’s needs. If we cannot reach an agreement before January 1, 2025, Humana may force St. Joseph’s Health hospital, facilities, and doctors out-of-network.

 

Humana’s current reimbursement does not adequately cover the true cost of care we provide. We are asking Humana to do its part to protect the care our patients, Humana members, deserve. St. Joseph’s Health is committed to providing high-quality patient care, which depends on fair payment from insurers.

 

We know this situation is stressful, and we're working tirelessly to reach an agreement with Humana, but we need Humana to put patients first. Thank you for your continued trust in St. Joseph’s Health; we'll keep you informed as negotiations progress.

 

We believe Health Comes First 

We know how important it is for you and your family to receive care from the trusted doctors, nurses and staff at St. Joseph’s Health. As a not-for-profit, local care provider, we work tirelessly to care for our patients and communities. We also continue to reduce costs and implement efficiencies to ensure we can continue providing top-quality care to our patients. We are asking health insurers to put patients first just like we do. Without them doing their part, access to care is at risk. St. Joseph’s Health provides high-quality care in our community while doing our part to make health care affordable – in 2023 alone, we've invested more than $56 million. Meanwhile, Humana has made it increasingly difficult for us to invest in the medical innovations, technologies, and programs patients rely on by delaying patient care or refusing to pay for care altogether. As one of the nation’s largest and most profitable health insurers, we need Humana to protect patient care and access. We are asking Humana to put patient health over their wealth. For us, Health Comes First. 

Frequently Asked Questions

You deserve access to high-quality health care

At St. Joseph’s Health, we believe our community members deserve options for high-quality care, and we are proud to be one of New York’s most trusted health care providers. That’s why we’re working to protect our ability to serve patients for generations because health comes first.  

 

If you do not find the answers to your negotiation-related questions on this site, please contact us directly via this website through our contact us page or call our patient line at (315) 370-4598. This website will be updated as our negotiations continue, so please check back for the most up-to-date information.   

A:        For now, nothing changes. You should continue to visit St. Joseph’s Health hospital, facilities, and physicians as you normally would. We are working hard to reach a new agreement before January 1, 2025 to avoid care disruption, but we need Humana to join us and put patients first. 

 A       St. Joseph’s Health is negotiating with Humana for a new agreement that appropriately covers the cost of the care we provide patients with Humana Medicare Advantage health plans. Our current contract will expire January 1, 2025. Negotiations are a routine part of doing business, and we are working to improve our relationship with Humana. As one of the nation’s largest and most profitable health insurance companies, Humana has made it increasingly difficult for St. Joseph’s Health to invest in the medical innovations, technologies, and programs patients rely on by delaying patient care or refusing to pay for care altogether.

A:        As a trusted local care provider, we work tirelessly to care for our patients and communities. We also continue to reduce costs and implement efficiencies to ensure we can continue providing top-quality care to our patients. But we can’t continue to do it alone. We cannot maintain access to the care and services patients depend on and need without a fair agreement from Humana.

A:        Our current agreement expires effective January 1, 2025.

A:        As we approach open enrollment season, St. Joseph’s Health wants to ensure that patients are fully informed about their options for 2025. Our goal is to secure a contract with Humana and minimize disruption to our patients’ care. However, we believe it is crucial to keep our community aware of the situation, should we encounter difficulties in reaching a fair agreement with Humana. 

A:        Patients with Humana Medicare Advantage health plans will be impacted.   

A:        All St. Joseph’s Health hospital, facilities, and employed providers are impacted by these contract negotiations.  

 

  • Joseph’s Health Hospital and all associated facilities and locations

  • Joseph’s Health Hospital Clinics and Providers

  • Joseph’s Physicians

 

A: While our negotiations with Humana continue, you can take these steps to protect your access to in-network care with St. Joseph’s Health 

  • If you are eligible for Medicare Advantage, the Annual Enrollment Period ends on December 7th and you can continue looking for plans through that time, even if you have already made a selection. We work with many health plans, including: 

    • Trinity Health Plan New York (formerly MediGold; an affiliate of St. Joseph’s Health)

    • Traditional Medicare

    • Fidelis Care

    • MVP Health Plan

    • Nascentia Health

    • United Healthcare 

    • WellCare

  • Never delay care. You will always have in-network access to our emergency department. Regardless of our network status with Humana, you should always visit the closest emergency department if you experience a medical emergency.

  • If you're receiving ongoing treatment, call the number on the back of your Humana insurance card to receive more information about Continuity of Care—you may be able to continue in-network care at St. Joseph’s Health.  

  • If you receive insurance through your employer, ask about health plans that include St. Joseph’s Health. Your employer may be able to provide you with secondary health plan coverage that includes access to your trusted caregivers. 

  • If you are dually-enrolled - Call 1-800-MEDICARE (1-800-633-4227) to learn about available plans, including those that have continued access to your trusted providers.

  • Call the number on the back of your insurance card and express how this negotiation is impacting your access to the providers and services you know and trust at St. Joseph’s Health.

A:        We work with many other health plans offering Medicare Advantage products that will give you in-network access to St. Joseph’s Health for the 2025 benefit year:

  • Trinity Health Plan New York (formerly MediGold; an affiliate of St. Joseph’s Health)

    • Traditional Medicare

    • Fidelis Care

    • MVP Health Plan

    • Nascentia Health

    • United Healthcare 

    • WellCare

A:        If you are already admitted to the hospital before January 1, 2025, you will be covered at in-network rates through the end of your inpatient stay.  

A:        We understand that some patients may have appointments scheduled on or after January 1. If possible, you should call your provider’s office to request that the appointment or procedure be rescheduled before January 1. If you are unable to reschedule your appointment or choose to keep your appointment, you may have to pay higher out-of-pocket costs for your care with St. Joseph’s Health if Humana forces us out of its provider network.  

A:        Patients will always have in-network access to our emergency rooms, regardless of our status with Humana. If you experience an emergency, you should always visit the nearest emergency room. Patients needing emergency care can receive in-network treatment until the patient is stable.  

A:        For the most up-to-date information, we encourage you to contact us by visiting sjhsyr.org/humana or call our patient hotline at (315) 370-4598.

What You Can Do 

There are ways to protect your ability to affordably access St. Joseph’s Health in 2025, regardless of our status with Humana. Consider the following: 

  • If you are eligible for Medicare Advantage, the Annual Enrollment Period ends on December 7th and you can continue looking for plans through that time, even if you have already made a selection. We work with many health plans, including: 

    • Trinity Health Plan New York (formerly MediGold; an affiliate of St. Joseph’s Health)

    • Traditional Medicare

    • Fidelis Care 

    • MVP Health Plan

    • Nascentia Health

    • WellCare 

    • United Healthcare 

  • Never delay care. You will always have in-network access to our emergency department. Regardless of our network status with Humana, you should always visit the closest emergency department if you experience a medical emergency.

  • If you're receiving ongoing treatment, call the number on the back of your Humana insurance card to receive more information about Continuity of Care—you may be able to continue in-network care at St. Joseph’s Health.  
  • If you are dually-enrolled - Call 1-800-MEDICARE (1-800-633-4227) to learn about available plans, including those that have continued access to your trusted providers.

  • Call the number on the back of your insurance card and express how this negotiation is impacting your access to the providers and services you know and trust at St. Joseph’s Health.