Mercy Health, a leading health system in Toledo, is alerting patients who have Humana Medicaid and Medicare Advantage health plans they may lose access to their Mercy Health providers by the end of the year, following months of contract negotiations.
If an agreement is not reached by December 1, Mercy Health hospitals, physicians, urgent care centers, ambulatory surgery centers and other care sites in Toledo will be considered out-of-network for Humana Managed Medicaid and Medicare Advantage members, potentially impacting more than 12,000 patients. Access to emergency department services will always be available to patients for covered emergency services, regardless of network status.
“We recognize that patients who rely on Managed Medicaid or Medicare Advantage often face unique challenges and may be among the most vulnerable in our communities,” said Bob Baxter, president, Mercy Health-Toledo. “When reimbursement rates are not sustainable and claims are frequently denied, it creates uncertainty and barriers to care for these patients and their families. We remain committed to resolving these negotiations thoughtfully and working to protect our patients from any gaps in their access to care.”
Patients may continue to access Mercy Health providers and facilities as they always have. They remain in-network with all other major health plans, and patients are encouraged to stay informed, explore their coverage options, and contact Humana at the number on the back of their insurance card to learn more about their benefits and what it could mean if Mercy Health becomes out-of-network.
Mercy Health will continue to keep patients informed as negotiations evolve. For more detailed information about providers and facilities that may become out of network, visit mercy.com/humana-updates.
