MEDICARE AND OTHER ADVANTAGE PLANS

Dear Valued Patients and Families,

I wanted to inform you of a recent development between Jackson County Memorial Hospital (JCMH) and the insurance plan called Humana, which includes Humana Medicare Advantage.

Many of you recently received letters informing you that your doctor and/or JCMH is no longer in-network.  This is true, and as of 11/14/22 Humana will no longer offer JCMH as a provider for your care in this plan.

Our decision to not accept Humana’s contract terms and payment practices was not taken lightly. All healthcare providers must have a fair and equitable contract administered consistently.  While we made every effort toward conciliation, we were not able to achieve this with Humana. 

As of November 14, 2022, JCMH and all of our providers will be considered out-of-network providers with Humana.

We are also considered out-of-network providers with any Advantage policies such as Aetna, Blue Cross Blue Shield Advantage, United Healthcare Dual Complete, Medicare Gold, and AARP Medicare Advantage.

All patients who qualify for Medicare benefits have the option of choosing Traditional Medicare. If you want to continue using JCMH as an in-network provider or facility, you will need to change your enrollment to Traditional Medicare.  You can call 1-800-MEDICARE to enroll.  Open Enrollment begins October 15 and runs through December 7. You can only enroll during this time period.

Another option is to contact the Medicare Assistance program for seniors. They can assist with questions. The telephone number is 1-800-763-2828, or you can find information online at https://www.oid.ok.gov/consumers/information-for-seniors/senior-health-insurance-counseling-program-ship/

What does this mean to you as a patient? To continue with your current insurance with our clinic or hospital as an out-of-network provider, you may have a different out-of-pocket cost. You could contact your Humana representative to discuss your out-of-network benefits.

We understand the importance of the relationship you have with your doctor and your hospital, and we want to protect that connection. We aren’t happy about the situation and are sorry about any inconvenience this may cause. 

Sincerely,

Steve Hartgraves, JCMH President and Chief Executive Officer