Humana Negotiations: Out of Network

Important information for Patients with Humana Health Insurance

Unfortunately, Loyola Medicine will no longer be included in Humana’s network on Jan. 1, 2025. This impacts patients who are covered by Humana Medicare Advantage or dually enrolled with Medicare/Medicaid health plans for the 2025 benefit year.

For months, we've worked diligently to find common ground with Humana to ensure your access to Loyola Medicine 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. We know how important it is for you and your family to continue receiving care from the trusted doctors, nurses and staff at Loyola Medicine. Below is important information for you to know, including how to tell Humana that your health care and relationship with Loyola Medicine is important.

You deserve access to high-quality health care

At Loyola Medicine, we believe our community members deserve options for high-quality care and we are proud to be one of Illinois’ 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 directly via this website through our “contact us” page or call our patient hotline at 708-553-0044. This website will be updated as our negotiations continue, so please check back for the most up-to-date information.

Frequently Asked Questions

Unfortunately, Loyola Medicine will no longer be included in Humana’s network on Jan. 1, 2025. This impacts patients who are covered by a Humana Medicare Advantage or dually enrolled with Medicare/Medicaid health plans for the 2025 benefit year. Below, we’ve provided in-depth information to help our patients understand how this may affect them:

Q:       What is happening?

A:        Loyola Medicine 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 Humana Medicare Advantage or dually enrolled with Medicare/Medicaid health plans.
At this time, our existing agreement has expired. Unfortunately, Loyola Medicine will no longer be included in Humana’s network on Jan. 1, 2025. This impacts patients who are covered by Humana Medicare Advantage or dually enrolled with Medicare/Medicaid health plans for the 2025 benefit year. This means you may pay more out-of-pocket for the health care services you receive through Loyola Medicine moving forward.

Q:        Who is affected by the negotiation?

A:        Patients who receive health insurance coverage through Humana Medicare Advantage or dually enrolled with Medicare/Medicaid health plans are affected. Humana no longer includes Loyola Medicine in your provider network on Jan. 1, 2025.

Q:        Which providers and facilities are impacted?

A:        Loyola Medicine hospitals, facilities and employed providers are impacted by these contract negotiations, including:

Q:        What is Loyola Medicine doing to reinstate its in-network status?

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 Loyola Medicine. Your voice can make a difference. Call Humana and tell them your access to quality health care is more important than their profits.

Q:        If I’m not covered by a Humana health plan, does this impact my insurance too?

A:        No, our out-of-network status only affects patients covered by a Humana health plan. Loyola Medicine is in-network with many health plans. You may find a list of in-network insurance plans at loyolamedicine.org/for-patients/billing-and-insurance/insurance-information.

Q:        What if you’re receiving ongoing treatment at Loyola Medicine?

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 Loyola Medicine.

Q:        What if I’m in the hospital on/after Jan. 1, 2025?

A:        If you are already admitted to the hospital prior to Jan. 1, 2025, you will be covered at in-network rates through the end of your inpatient stay.

Q:        What if I have an upcoming procedure at Loyola Medicine on/after Jan. 1, 2025?

A:        We understand some patients may have appointments scheduled on or after Jan. 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.

Q:        What if I have a medical emergency on/after Jan. 1, 2025? 

A:        You should always seek emergency care at the closest location 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.

Q:        If my care is impacted, what should I do?

A:        You should:

• 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 Loyola Medicine.
• Call the number on the back of your insurance card and urge Humana to keep your in-network access to Loyola Medicine and its doctors.
• If you receive insurance through your former employer, ask your plan administrator or benefits manager if you have out-of-network benefits and how you can continue your in-network access and treatment relationship with Loyola Medicine.
• If you enrolled in Medicare Advantage for the 2025 benefit year, you may have options. For additional information about your Medicare insurance options, you can contact your insurance agent or use the free, no obligation resources available at MedicareCompareUSA.com or by calling 888-482-4976, TTY 711. 
  You may find a list of in-network insurance plans at loyolamedicine.org/for-patients/billing-and-insurance/insurance-information.
• If you are dually enrolled, call 1-800-MEDICARE (1-800-633-4227) to learn about available plans, including those that offer continued access to your trusted Loyola Medicine providers.

Q:        What if I have more questions?

A:        Call us at 708-553-0044 to speak with someone directly or visit LoyolaMedicine.org/Humana.

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 Loyola Medicine. 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. Loyola Medicine provides high-quality care in our community while doing our part to make health care affordable – in 2023 alone, we've invested $186.6 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. We are asking Humana to put patient health over their wealth. For us, Health Comes First.

What You Can Do

There are ways to protect your ability to affordably access Loyola Medicine 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 Loyola Medicine.
• Call the number on the back of your insurance card and urge Humana to keep your in-network access to Loyola Medicine and its doctors.
• If you enrolled in Medicare Advantage for the 2025 benefit year, you may have options. For additional information about your Medicare insurance options, you can contact your insurance agent or use the free, no obligation resources available at MedicareCompareUSA.com or by calling 888-482-4976, TTY 711. 
  You may find a list of in-network insurance plans at loyolamedicine.org/for-patients/billing-and-insurance/insurance-information.
• If you are dually-enrolled, call 1-800-MEDICARE (1-800-633-4227) to learn about available plans, including those that have offer continued access to your trusted Loyola Medicine providers.