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 Holy Cross Health’s needs. If we cannot reach an agreement before January 1, 2025, Humana may force Holy Cross Health 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. Holy Cross 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 Holy Cross 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 Holy Cross 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. Holy Cross Health provides high-quality care in our community while doing our part to make health care affordable – in 2023 alone, we've invested $1,846,857. 

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 Holy Cross Health, we believe our community members deserve options for high-quality care, and we are proud to be one of Florida’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 by calling our patient line at 954-866-0799. This website will be updated as our negotiations continue, so please check back for the most up-to-date information.   

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

A:        For now, nothing changes. You should continue to visit Holy Cross Health 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. 

 

Q:          What is happening?  

A:        Holy Cross Health is negotiating with Humana for a new agreement that appropriately covers the cost of the care we provide patients with Humana Medicare Advantage/Medicaid 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 Holy Cross Health to invest in the medical innovations, technologies, and programs patients rely on by delaying patient care or refusing to pay for care altogether.

            

Note: All Holy Cross Health primary care providers will be considered out of Humana’s network beginning January 1, 2025—regardless of our negotiation outcome with Humana.

 

Q:          Why is this happening? 

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.

 

Q:        When does the contract with Humana end? 

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

 

Q:        Why are you notifying members now?

A:        As we approach open enrollment season, Holy Cross 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. 

 

Q:        Which Humana health plans are affected by the negotiations? 

A:        Patients with Humana Medicare Advantage and Medicaid (aka Humana Healthy Horizons) health plans will be impacted.   

 

Q:       Which providers and facilities are impacted? 

A:       Holy Cross Health: the hospital, facilities, and employed providers are impacted by these contract negotiations.  
 

           •    Holy Cross Health 
           •    Holy Cross HealthPlex 
           •    Holy Cross Urgent Care  
           •    Holy Cross Medical Group 
           •    Physicians Outpatient Surgery Center

 

Q:        What can I do to protect my in-network access to Holy Cross Health?  

A:        While our negotiations with Humana continue, you can take these steps to protect your
            access to in-network care with Holy Cross 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. Contact Fairhaven Insurance Solutions licensed Medicare advisors at MedicareOnDemand.com/holycross or 855-241-3497, TTY 711 for options to switch plans during the Annual Enrollment Period. 

  You also are allowed an additional change during the Open Enrollment Period Jan 1 - March 31, 2025.  

  We work with many health plans, including: 

• AVMED (excluding Medicare One)
• CAREPLUS (Hospital, select Specialists, Surgery Center)    
• CIGNA MA
• HEALTHSUN (Hospital and Specialists)
• MEDICA (excludes Urgent Care)
• MULTIPLAN
• POSITIVE (AHF/Ryan White)
• PREFERRED CARE PARTNERS (excludes Urgent Care)
• SIMPLY (Hospital only)
• SOLIS (excludes Urgent Care)  
• UNITED HEALTHCARE  (excludes Urgent Care)
• WELLCARE (excludes Urgent Care)
   

• If you have Humana Medicaid, also known as Humana Healthy Horizons, you may be able to choose other health care coverage that allows you to access Holy Cross Health. Visit CMS.gov or call Florida State Medicaid Managed Care at 1-877-711-3662 to see if you can change your plan.  

• 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 Holy Cross Health.
   

• If you receive insurance through your employer, ask about health plans that include Holy Cross 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 Holy Cross Health.
   

Q:        What other health plans will keep Holy Cross Health in my network next year?

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

• AVMED  (excluding Medicare One)

• CAREPLUS (Hospital, select Specialists, Surgery Center)    

• CIGNA MA 

• HEALTHSUN (Hospital and Specialists)

• MEDICA (excludes Urgent Care) 

• MULTIPLAN

• POSITIVE (AHF/Ryan White)

• PREFERRED CARE PARTNERS (excludes Urgent Care) 

• SIMPLY (Hospital only)

• SOLIS (excludes Urgent Care)  

• UNITED HEALTHCARE  (excludes Urgent Care)

• WELLCARE (excludes Urgent Care)
   

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

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.  

 

Q:        What if I have an elective procedure scheduled at a Holy Cross Health facility on or after January 1, 2025? 

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 Holy Cross Health if Humana forces us out of its provider network.  

 

Q:        What if I have an emergency on or after January 1 and Holy Cross Health is out of 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.  

 

Q:          How can I stay up to date on the negotiations? 

A:        For the most up-to-date information, we encourage you to contact us by visiting this page, holy-cross.com/Humana, or calling our patient hotline at (954) 866-0799.

 

What You Can Do

There are ways to protect your ability to affordably access Holy Cross 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. You also are allowed an additional change during the Open Enrollment Period Jan 1 - March 31, 2025. We work with many health plans, including: 

• AVMED (excluding Medicare One)
• CAREPLUS (Hospital, select Specialists, Surgery Center) 
• CIGNA MA 
• HEALTHSUN (Hospital and Specialists) 
• MEDICA (excludes Urgent Care) 
• MULTIPLAN 
• POSITIVE (AHF/Ryan White) 
• PREFERRED CARE PARTNERS (excludes Urgent Care)  
• SIMPLY (Hospital only) 
• SOLIS (excludes Urgent Care)  
• UNITED HEALTHCARE (excludes Urgent Care)  
• WELLCARE (excludes Urgent Care)
 

Contact Fairhaven Insurance Solutions licensed Medicare advisors at www.medicareondemand.com/HolyCross or 855-241-3497, TTY 711 for options to switch plans during the Annual Enrollment Period.

• 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 undergoing treatment for a chronic condition, call the number on the back of your Humana insurance card to request a Continuity of Care form. This will help ensure that you can continue receiving in-network care at Holy Cross Health for a limited time but requires Humana’s approval.

• 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 Holy Cross Health.