We believe Health Comes First
Humana Negotiations
Humana has stopped negotiations and forced St. Mary’s out of network effective January 1, 2025
Patients with Humana Medicare Advantage Plans can still make changes
Medicare Advantage plan members can make changes to their existing plan, disenroll from their current plan, switch to a new plan, or return to Original Medicare during the Medicare Advantage Open Enrollment Period. It runs from January 1 to March 31. This is a separate enrollment opportunity from the Medicare Advantage Annual Enrollment Period that ended in December. If you decide to make a change, you can explore other plan options, and your new plan benefits will be in effect for the rest of the year. We work with many health plans, including:
- Aetna - All
- Anthem BCBS - All
- CareSource (Dual Special Needs Only) - HMO
- Cigna Medicare - All
- Clear Spring Health - All
- GA Health Advantage/American Health Plans - HMO
- Medicare - Parts A&B
- PruittHealth Premier – HMO
- United Healthcare – see footnote
- Wellcare – ALL
Note: UHC NonPar with Medicare Select, Medicare Advantage Private Fee-for-Service Plans and Medicare Advantage Medical Savings Account Benefit
See Insurances Accepted By St. Mary's Health Care System in Athens Georgia
Learn more and find plans at medicare.gov.
Continuity of Care: If you are currently receiving ongoing treatment, please call the number on the back of your Humana insurance card to inquire about Continuity of Care. You may be able to continue receiving in-network care during this transition.
If Humana denies your Continuity of Care request and you are currently undergoing treatment at St. Mary’s and enrolled in a Medicare Advantage benefit plan, you can file a complaint with the Centers for Medicare and Medicaid Services by calling 800-985-3059.
Patients with a PPO plan may have out-of-network benefits
Call the number on the back of your Humana insurance card to inquire about out-of-network benefits and your share of costs.
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. Mary’s. 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. Mary’s provides high-quality care in our community while doing our part to make health care affordable – in 2023 alone, we've invested more than $9.5 million in benefits to our communities. 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. We are asking Humana to put patient health over their wealth. For us, Health Comes First.
For months, we've worked diligently to find common ground with Humana to ensure your access to St. Mary’s remains uninterrupted. We rely on fair payment from health insurers so we can sustain the high-quality care patients like you depend on and need.
We will not give up trying to reach a fair agreement with Humana. We know how important it is for you and your family to continue receiving care from the trusted doctors, nurses, and staff at St. Mary’s. Below is important information for you to know, including how to tell Humana that your health care and relationship with St. Mary’s is important.
Frequently Asked Questions
You deserve access to high-quality health care
At St. Mary’s, we believe our community members deserve options for high-quality care, and we are proud to be one of Georgia’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 (706) 225-8515. This website will be updated as our negotiations continue, so please check back for the most up-to-date information.
Frequently Asked Questions
Unfortunately, St. Mary’s Health Care System will no longer be included in Humana’s network as of January 1, 2025. This impacts patients who are covered by a Humana Medicare Advantage plan for the 2025 benefit year. Below, we’ve provided in-depth information to help our patients understand how this may affect them:
Q: What is happening?
St. Mary’s has been working diligently to secure a new agreement with Humana that more appropriately covers the true cost of the care we provide to patients with a Humana Medicare Advantage plan.
At this time, our existing agreement has expired. Unfortunately, St. Mary’s will no longer be included in Humana’s network on January 1, 2025. This impacts patients who are covered by a Humana Medicare Advantage plan for the 2025 benefit year. This means you may pay more out-of-pocket for the health care services you receive through St. Mary’s moving forward.
Q: Who is affected by the negotiation?
Patients who receive health insurance coverage through Humana Medicare Advantage plan are affected. Humana no longer includes St. Mary’s in your provider network on January 1, 2025.
Q: Which providers and facilities are impacted?
St. Mary’s hospitals, facilities, and employed providers are impacted by these contract negotiations.
- St. Mary’s Hospital, Athens
- St. Mary’s Sacred Heart Hospital, Lavonia
- St. Mary’s Good Samaritan Hospital, Greensboro
- St. Mary’s Medical Group, all locations
- St. Mary’s Outpatient Facilities
- St. Mary’s Home Health Care/Hospice/Palliative Care Services
Q: What is St. Mary’s doing to reinstate its in-network status?
We will not give up trying to reach a fair agreement with Humana. We know how important it is for you and your family to continue receiving care from the trusted doctors, nurses, and staff at St. Mary’s. Your voice can make a difference. Call Humana and tell them your access to quality health care is more important than their profits.
Q: If I’m not covered by a Humana health plan, does this impact my insurance too?
No, our out-of-network status only affects patients covered by a Humana health plan. St. Mary’s is in-network with many health plans, found here.
Q: What if you’re receiving ongoing treatment at St. Mary’s?
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. Mary’s.
Patients with a PPO plan may have out of network benefits
Call the number on the back of your Humana insurance card to inquire about out of network benefits and your share of costs.
Q: What if I’m in the hospital on/after January 1, 2025?
If you are already admitted to the hospital prior to January 1, 2025, you will be covered at in-network rates through the end of your inpatient stay.
Q: What if I have an upcoming procedure at St. Mary’s on/after January 1, 2025?
We understand some patients may have appointments scheduled on or after January 1, 2025. If this is the case, you should call Humana at the number on the back of your health insurance care to determine whether they will cover your procedure through Continuity of Care provisions.
Patients with a PPO plan may have out of network benefits.
Call the number on the back of your Humana insurance card to inquire about out of network benefits and your share of costs.
Q: What if I have a medical emergency on/after January 1, 2025?
You should always seek emergency care if you believe you are experiencing a medical emergency at the closest location to you. Regardless of our status with Humana, your care will be considered in-network until you are stabilized.
Q: If my care is impacted, what should I do?
- 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. Mary’s.
- Call the number on the back of your insurance card and urge Humana to keep your in-network access to St. Mary’s and its doctors.
- If you are enrolled in Medicare Advantage for the 2025 benefit year, you can change coverage one time between January 1 - March 31, 2025 to select an alternative Medicare Advantage plan that better fits your health care needs. To view the complete list of insurance plans we accept, visit https://www.stmaryshealthcaresystem.org/for-patients/billing-insurance/accepted-insurance.
- Alternatively, you can contact MedicareCompareUSA licensed Medicare advisors at MedicareOnDemand.com or call our Medicare insurance helpline toll-free at (855) 562-7230 to review options that include St. Mary's providers. We work with many health plans that will give you in-network access to St. Mary’s for the 2025 benefit year.
Q: What if I have more questions?
Call us at (706) 225-8515 to speak with someone directly or visit https://www.stmaryshealthcaresystem.org/humana.
What You Can Do
There are ways to protect your ability to affordably access St. Mary’s in 2025, regardless of our status with Humana. Consider the following:
- 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. Mary’s.
- Call the number on the back of your insurance card and urge Humana to keep your in-network access to St. Mary's and its doctors.
- If you enrolled in Medicare Advantage for the 2025 benefit year, you can still look for coverage between January 1 - March 31, 2025 and select a Medicare Advantage plan that best fits your health care needs. To view the complete list of insurance plans we accept, visit https://www.stmaryshealthcaresystem.org/for-patients/billing-insurance/accepted-insurance.
- Alternatively, you can contact MedicareCompareUSA licensed Medicare advisors at MedicareOnDemand.com or call our Medicare insurance helpline toll-free at (855) 562-7230 to review options that include St. Mary's providers. We work with many health plans that will give you in-network access to St. Mary’s for the 2025 benefit year.