Important Information for Patients with Humana Insurance

Ephraim McDowell Health has worked diligently to reach a new agreement with Humana that would preserve our patients’ in-network access to local healthcare services. Unfortunately, despite our continued efforts, we have not been able to reach an agreement that provides fair and sustainable reimbursement for the care our hospitals, clinics, and providers deliver.

Humana is a national, publicly traded insurance company accountable to its shareholders. Ephraim McDowell Health is a locally governed, nonprofit health system accountable to the communities we serve. Ephraim McDowell Health reinvests the payments it receives—supporting local physicians and Associates, maintaining essential healthcare services, purchasing lifesaving technology, and ensuring patients can receive care close to home.

At its core, this disagreement is about whether healthcare dollars will support care in our community or contribute to a national insurance company’s profits.

We understand this news may create uncertainty for our patients and families. Our priority is helping you understand what this change may mean for your care and the options available to you. We remain committed to negotiating in good faith and are prepared to reach an agreement with Humana that protects patient access and supports the continued availability of high-quality healthcare close to home.

What you can do now

Frequently asked questions

Why is Ephraim McDowell Health leaving Humana’s network?

Ephraim McDowell Health is seeking fair, market-based reimbursement that reflects the cost of providing high-quality care and is reasonably consistent with what other health plans pay for the same services.

Humana reported approximately $129.7 billion in revenue and $1.2 billion in net income for 2025. Meanwhile, hospitals and healthcare providers across Kentucky continue to face significant increases in the costs of medical supplies, medications, technology, and the workforce needed to care for their communities.

Ephraim McDowell Health cannot accept reimbursement that threatens our ability to sustain essential local services while healthcare dollars and insurance profits leave our community. Fair reimbursement from insurance companies is necessary to maintain local access to the care our patients and families depend upon.

When will Ephraim McDowell Health become out of network?

Unless a new agreement is reached, Ephraim McDowell Health will become out of network for Humana Medicare Advantage plans beginning February 1, 2027.

We will continue working toward an agreement and will provide updates if the situation changes.

What does “out of network” mean for me?

Depending on your specific Humana plan, receiving nonemergency care from an out-of-network hospital, clinic, or provider may result in:

• Higher out-of-pocket costs
• Changes in where you receive covered care
• Additional authorization or coverage requirements

Every insurance plan is different. We encourage patients to call the number on the back of their Humana insurance card to confirm their benefits and understand how this change may affect them.

Can I continue receiving care from Ephraim McDowell Health?

Yes. Patients may continue receiving care from Ephraim McDowell Health, although their cost-sharing and coverage may change depending on their Humana plan and the services received.

Patients should contact Humana before receiving scheduled, nonemergency services to understand their coverage and potential financial responsibility. Our patient financial services team is also available at (859) 239-3499 to help patients understand their options.

What if I am currently undergoing treatment?

Some patients receiving an ongoing course of treatment may qualify for continuity-of-care protections that allow them to continue receiving services at in-network benefit levels for a limited period.

This may apply in circumstances such as:

• Active cancer treatment
• Pregnancy
• Recent surgery or hospitalization
• Treatment for a serious or complex condition
• Other ongoing courses of care

Eligibility is determined by Humana and the terms of the patient’s health plan. Patients should contact Humana using the number on the back of their insurance card and ask about continuity-of-care or transition-of-care benefits.

What should I do if I have a scheduled appointment or procedure?

Please do not cancel or delay needed care without first speaking with your healthcare provider and Humana.

Call the number on the back of your Humana insurance card to confirm whether your appointment or procedure will be covered and what costs may apply. You may also contact Ephraim McDowell Health at (859) 239-3499 for assistance.

What happens if I need emergency care?

If you believe you are experiencing a medical emergency, call 911 or go to the nearest emergency department. Patients should never delay emergency care because of an insurance network concern.

Does this affect all insurance plans?

No. This change applies only to Humana Medicare Advantage Plans. Ephraim McDowell Health’s agreements with other insurance companies are not affected.

Because Humana offers multiple types of coverage, patients should review their insurance card or contact Humana to determine whether their particular plan is affected.

What insurance plans does Ephraim McDowell Health accept?

Ephraim McDowell Health still accepts the following Medicare plans:

What can patients do?

Patients may contact Humana using the number on the back of their insurance card and let the company know that continued in-network access to Ephraim McDowell Health is important to them.

Patients who are currently receiving treatment should also ask Humana whether they qualify for continuity-of-care benefits.