Humana Negotiations
Humana has stopped negotiations and forced St. Peter’s Health Partners out of network effective January 1, 2025
Patients with Humana Medicare Advantage Plans can still make changes
Medicare Advantage plan members can make changes to their existing plan, disenroll from their current plan, switch to a new plan or return to Original Medicare during the Medicare Advantage Open Enrollment Period. It runs from January 1 to March 31. This is a separate enrollment opportunity from the Medicare Advantage Annual Enrollment Period that ended in December. If you decide to make a change, you can explore other plan options, and your new plan benefits will be in effect for the rest of the year. We work with many health plans, including:
- Trinity Health Plan New York (formerly MediGold; an affiliate of St. Peter’s Health Partners)
- Traditional Medicare
- Aetna
- Anthem Blue Cross
- Capital District Physicians' Health Plan
- Emblem Health
- Fidelis Care
- Highmark Blue Shield of Northeastern New York
- MVP Health Plan
- Nascentia Health
- United Healthcare
- VNS Choice
Learn more and find plans at medicare.gov.
Continuity of Care: If you are currently receiving ongoing treatment, please call the number on the back of your Humana insurance card to inquire about Continuity of Care. You may be able to continue receiving in-network care during this transition.
If Humana denies your Continuity of Care request and you are currently undergoing treatment at St. Peter’s Health Partners and enrolled in a Medicare Advantage benefit plan, you can file a complaint with the Centers for Medicare and Medicaid Services by calling 800-985-3059.
Patients with a PPO plan may have out of network benefits
Call the number on the back of your Humana insurance card to inquire about out of network benefits and your share of costs.
We know how important it is for you and your family to receive care from the trusted doctors, nurses and staff at St. Peter’s Health Partners. 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. Peter’s Health Partners provides high-quality care in our community while doing our part to make health care affordable – in 2023 alone, we've invested more than $125 million. 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.
For months, we've worked diligently to find common ground with Humana to ensure your access to St. Peter’s Health Partners remains uninterrupted. We rely on fair payment from health insurers so we can sustain the high-quality care patients like you depend on and need.
We will not give up trying to reach a fair agreement with Humana. Below is important information for you to know, including how to tell Humana that your health care and relationship with St. Peter’s Health Partners is important.
Frequently Asked Questions
Unfortunately, St. Peter’s Health Partners will no longer be included in Humana’s network on January 1, 2025. This impacts patients who are covered by a Humana Medicare Advantage plan for the 2025 benefit year. Below, we’ve provided in-depth information to help our patients understand how this may affect them:
A: St. Peter’s Health Partners has been working diligently to secure a new agreement with Humana that more appropriately covers the true cost of the care we provide to patients with a Humana Medicare Advantage plan.
At this time, our existing agreement has expired. Unfortunately, St. Peter’s Health Partners will no longer be included in Humana’s network on January 1, 2025. This impacts patients who are covered by a Humana Medicare Advantage plan for the 2025 benefit year. This means you may pay more out-of-pocket for the health care services you receive through St. Peter’s Health Partners moving forward.
A: Patients who receive health insurance coverage through Humana Medicare Advantage plan are affected. Humana no longer includes St. Peter’s Health Partners in your provider network on January 1, 2025.
A: All St. Peter’s Health Partners hospitals, facilities, and employed providers are impacted by these contract negotiations.
Medical Group Providers
- St. Peter’s Health Partners Medical Associates
- Samaritan Hospital Clinics and Providers
- St. Peter's Hospital Clinics and Providers
- Sunnyview Rehabilitation Hospital Providers
- Trinity Health Anesthesia Group of New York
Hospitals, Facilities & Services
- St. Peter’s Hospital
- Samaritan Hospital
- Sunnyview Rehabilitation Hospital
- Eddy Memorial Geriatric Center
- Eddy Heritage House Nursing & Rehabilitation
- Eddy Village Green at Beverwyck
- Eddy Village Green at Cohoes
- Our Lady of Mercy Life Center
- Schuyler Ridge Residential Healthcare
- St. Peter’s Nursing & Rehabilitation Center
- Eddy Visiting Nurse & Rehabilitation Association
- Empire Home Infusion Services including Northeast Home Medical Equipment
- The Community Hospice
A: We will not give up trying to reach a fair agreement with Humana. We know how important it is for you and your family to continue receiving care from the trusted doctors, nurses, and staff at St. Peter’s Health Partners. Your voice can make a difference. Call Humana and tell them your access to quality health care is more important than their profits.
A: No, our out-of-network status only affects patients covered by a Humana health plan. St. Peter’s Health Partners is in-network with many health plans, found here.
A: 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 St. Peter’s Health Partners.
Patients with a PPO plan may have out of network benefits
Call the number on the back of your Humana insurance card to inquire about out of network benefits and your share of costs.
A: If you are already admitted to the hospital prior to January 1, 2025, you will be covered at in-network rates through the end of your inpatient stay.
A: We understand some patients may have appointments scheduled on or after January 1, 2025. If this is the case, you should call Humana at the number on the back of your health insurance card to determine whether they will cover your procedure through Continuity of Care provisions.
Patients with a PPO plan may have out of network benefits.
Call the number on the back of your Humana insurance card to inquire about out of network benefits and your share of costs.
A: You should always seek emergency care at the location closest to you if you believe you are experiencing a medical emergency. Regardless of our status with Humana, your care will be considered in-network until you are stabilized.
A:
- 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 St. Peter’s Health Partners.
- Call the number on the back of your insurance card and urge Humana to keep your in-network access to St. Peter’s Health Partners and its doctors.
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If you enrolled in Medicare Advantage for the 2025 benefit year, you can still look for coverage between January 1 - March 31, 2025 and select a Medicare Advantage plan that best fits your health care needs. Contact your insurance agent or visit medicare.gov for plan options.
We work with many health plans including:
- Trinity Health Plan New York (formerly MediGold; an affiliate of St. Peter’s Health Partners)
- Traditional Medicare
- Aetna
- Anthem Blue Cross
- Capital District Physicians' Health Plan
- Emblem Health
- Fidelis Care
- Highmark Blue Shield of Northeastern New York
- MVP Health Plan
- Nascentia Health
- United Healthcare
- VNS Choice
- WellCare
- If you have Humana Medicaid, you can visit https://www.cms.gov or call (212) 616-2200] to review your options.
What You Can Do
There are ways to protect your ability to affordably access St. Peter’s Health Partners 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.
- 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 St. Peter’s Health Partners.
- Call the number on the back of your insurance card and urge Humana to keep your in-network access to St. Peter’s Health Partners and its doctors.
- If you enrolled in Medicare Advantage for the 2025 benefit year, you can still look for coverage between January 1 - March 31, 2025, and select a Medicare Advantage plan that best fits your health care needs. We work with many health plans including:
- Trinity Health Plan New York (formerly MediGold; an affiliate of St. Peter’s Health Partners)
- Traditional Medicare
- Aetna
- Anthem Blue Cross
- Capital District Physicians' Health Plan
- Emblem Health
- Fidelis Care
- Highmark Blue Shield of Northeastern New York
- MVP Health Plan
- Nascentia Health
- United Healthcare
- VNS Choice