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 community benefits. 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.

Important information for patients with Humana health insurance

St. Mary’s is negotiating with Humana for new agreements that appropriately cover the true cost of care that we provide to our patients with Humana Medicare Advantage health plans.

Our agreement expires effective January 1, 2025, and impacts in-network access to St. Mary’s hospitals, facilities, and health care providers.

For now, nothing changes. Patients should continue to visit St. Mary’s hospitals, facilities, and physicians as you normally would. Negotiations are a routine part of business, and we are doing our best to reach an agreement to minimize the impact on patients. What’s not routine is the significant impact inflation has had on our cost to provide the high-quality care you expect, we need Humana to do their part to ensure you have access to our care.

Our request to Humana is simple: to be paid fairly and in line with other providers in our market in line with Medicare. We cannot maintain access to the care and services patients depend on and need without fair agreements from commercial health insurers. We need Humana to provide reimbursement that covers the true cost of care.

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.

Humana Negotiations: Patient Frequently Asked Questions

I have a Humana health plan. What does this mean for me?

For now, nothing changes. You should continue to visit St. Mary’s hospitals, facilities, and physicians as you normally would. If Humana does not work with us to reach a fair agreement before January 1, 2025, St. Mary’s will be forced out of network and patients may have to pay more when seeking care with our hospitals, clinics, and providers.

What is happening?

St. Mary’s is negotiating with Humana for new agreements that appropriately cover 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 business, and we are doing our best to reach an agreement to minimize impact to patients. What’s not routine is the significant impact inflation has had on our cost to provide the high-quality care you expect, and we need Humana to do their part to ensure you have access to our care.

Why is this happening?

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. 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 cannot maintain access to the care and services patients depend on and need without a fair agreement from Humana.

When does the contract with Humana end?

Our current agreements will expire effective January 1, 2025.

Which Humana health plans are affected by the negotiations?

Humana’s Medicare Advantage plan is impacted

Which providers and facilities are impacted?

All St. Mary’s hospitals, facilities, and employed providers are impacted by these contract negotiations.

• St. Mary’s Hospital, Athens, Ga.
• St. Mary’s Sacred Heart Hospital, Lavonia, Ga.
• St. Mary’s Good Samaritan Hospital, Greensboro, Ga.
• St. Mary’s Medical Group practices across Northeast Georgia
• St. Mary’s Home Health Care/Hospice Services
• St. Mary’s Outpatient Services Center
• St. Mary’s Wound Care/Infusion Center

What can I do to protect my in-network access to St. Mary’s?

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

• 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.
• 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 have Medicare Advantage plan through Humana, contact MedicareCompareUSA licensed Medicare advisors at MedicareOnDemand.com or call our Medicare insurance helpline toll-free at (855) 562-7230 for options to switch plans during Open Enrollment beginning October 15 – December 7, 2024. We work with many other health plans that will give you in-network access to St. Mary’s for the 2025 benefit year. To view the complete list of insurance plans we accept, visit our accepted insurance page. Please note that we are also in negotiations with Aetna.
   

What if I’m in the hospital when the contract ends?

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.

What if I have an elective procedure scheduled at a St. Mary’s facility on or after January 1, 2025?

We understand that some patients may have appointments scheduled on or after January 1, 2025. If possible, you should call your provider’s office to request that the appointment or procedure be rescheduled before January 1, 2025. 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. Mary’s if Humana forces us out of its provider network.

What if I have an emergency on or after January 1, 2025, and St. Mary’s is out of network?

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.

How can I stay up to date on the negotiations?

For the most up-to-date information, we encourage you to contact us by visiting www.stmarys-health.org/humana or call our patient hotline at (706) 225-8515.

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.
• 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 have Medicare Advantage plan through Humana, contact MedicareCompareUSA licensed Medicare advisors at MedicareOnDemand.com or call our Medicare insurance helpline toll-free at (855) 562-7230 for options to switch plans during Open Enrollment beginning October 15 – December 7, 2024. We work with many other health plans that will give you in-network access to St. Mary’s for the 2025 benefit year. To view the complete list of insurance plans we accept, visit our accepted insurance page. Please note that we are also in negotiations with Aetna.