Humana Insurance Update

Tanner will be out-of-network for Humana Medicare Advantage PPO on Jan. 1, 2025

At Tanner, our mission has always been to provide quality healthcare services to the communities we serve throughout west Georgia and east Alabama.

To help us fulfill that mission, we aim to partner with a robust network of providers and insurers based on our shared commitment to patient-centered care.

However, after recent attempts to renegotiate our arrangements with Humana’s Medicare Advantage health plan, we will be unable to reach a resolution.

Therefore, beginning on Jan. 1, we will no longer participate in Humana’s Medicare Advantage PPO health plan.

This change affects Humana members using Tanner Health hospitals, facilities and Tanner Medical Group practices. Below is a list of impacted Tanner services and frequently asked questions.

If you would like to change your plan, Medicare’s open enrollment is from Oct. 15 to Dec. 7, 2024.

At this time, we continue to participate in Original Medicare and Medicare Advantage plans from Aetna, Cigna, Clover Health and Pruitt Health, among others.

Patients may continue participating in Humana MA PPO plans and use Tanner providers but may experience higher out-of-pocket expenses. These out-of-pocket expenses may include higher deductibles, copayments, coinsurance, etc.

To minimize the impact on your care, we have included below detailed information about what actions you can take to limit any disruption in your care.

If you would like to have your medical records forwarded to a new provider, contact your Tanner Medical Group office or Tanner facility to have them forwarded to a new provider or arrange to pick them up in person.

Thank you for your patience and for trusting us with your health care.

Frequently Asked Questions

When is the termination effective?

The Tanner Health – Humana contract will terminate effective Jan. 1, 2025.

What if I want to use Tanner’s services at in-network benefits?

Medicare’s Open Enrollment period is Oct. 15 – Dec. 7, 2024, and everyone with Medicare has the opportunity to make changes to their health plan coverage beginning Jan. 1, 2025. This is an opportunity for you to select a plan whose provider network meets your expectations. Tanner currently participates in the following Medicare plans: Original Medicare, Aetna Medicare Advantage, Cigna Healthcare Medicare Advantage, Clover Health Medicare Advantage and Pruitt Health Premier Medicare Advantage plans. Many local insurance agents can assist you in this enrollment process, or changes can be made on the Medicare.gov website.

What action is necessary on my part if I choose to continue to be covered by a Humana MA PPO plan? After the termination date, Humana MA PPO patients may experience higher out-of-pocket expenses by utilizing Tanner at out-of-network benefit coverage. These out-of-pocket expenses may include higher deductibles, copayments, coinsurance, etc. Contact Humana at the number on your insurance card to inquire about out-of-network benefit coverage.

Contact Humana at the number on your insurance card to find an in-network provider to continue receiving care without disruption. When you’ve identified a new provider, you may contact the Tanner provider or facility at the number on the enclosed sheet to arrange for your medical records to be forwarded to the provider.

Does Tanner accept any other Medicare plans?

Tanner currently accepts other Medicare-related plans, including:

• Original Medicare
• Aetna Medicare Advantage Cigna Medicare Advantage
• Clover Health Medicare Advantage
• Pruitt Health Premier Medicare Advantage
• Blue Cross and Blue Shield of Alabama (Tanner/Alabama providers only)

What if I have a medical emergency?

If you have a medical emergency, immediately visit the nearest emergency department. If you use a Tanner Health System emergency department, we will evaluate your condition to determine if you have a medical emergency and provide treatment.

What if I receive inpatient treatment at a Tanner hospital on the Termination Date?

If you are receiving inpatient treatment on January 1, 2025, the Tanner providers will be covered by Humana during your admission until the date of discharge.

What if I am a patient currently undergoing medical treatment?

If you are undergoing treatment, you may qualify for a Continuity of Care exception. You should contact Humana and initiate the process to verify if your medical condition is covered under continuity of care benefits. This would allow you to receive treatment from Tanner and be covered by Humana at the in- network benefit level for a specified time.

The service or specialist I use isn’t on the enclosed list. What should I do?

You may use a Humana in-network service or a community-based medical provider Tanner does not operate. These providers evaluate their participation in health plans on their own basis and may still be an in-network provider of the Humana health plan. However, if those providers refer you to any Tanner facility or Tanner- employed provider for treatment or evaluation, you may experience higher out-of-pocket expenses by utilizing Tanner at out-of-network benefit coverage. These out-of-pocket expenses may include higher deductibles, copayments, coinsurance, etc. If you have questions, contact your medical provider.

I still have questions — with whom can I speak?

Contact Humana if you have any further questions or concerns. You can contact Humana using the customer service number on your health insurance card.

Tanner Services and Practices That Will Be Out-of-Network for Humana Medicare Advantage PPO on Jan. 1, 2025

These facilities and medical practices will no longer be a network participating provider with the Humana Medicare Advantage PPO health plan beginning Jan. 1, 2025.

Tanner Hospitals and Services:

Tanner Medical Center/Carrollton – 770-812-9666

Tanner Medical Center/Villa Rica – 770-812-3000

Higgins General Hospital – 770-812-2000

Tanner Medical Center/East Alabama – 256-357-2111

Willowbrooke at Tanner and other PHP and IOP locations – 770-812-3266

Willowbrooke Counseling Center – 770-812-8863

Tanner Boutique – 770-812-8338

Tanner Breast Health – 770-812-9280

Tanner Cancer Care/Roy Richards, Sr. Cancer Center – 770-812-9824

Tanner Home Health – 770-834-5438

Tanner Hospice Care – 770-214-2355

Tanner Imaging Center – 770-812-5979

Tanner MS Center/Atlanta – 770-812-3828

Tanner MS Center at Tanner Medical Center/Villa Rica – 770-812-3515

Tanner Center for Sleep Disorders – 770-812-9146

Tanner Advanced Wound Center – 770-812-5605

West Georgia Endoscopy Center – 770-214-2800

West Georgia Surgery Center – 470-729-5200

West Georgia Infusion Center – 770-812-8498

West Georgia Urology Center – 770-834-6988

Tanner Medical Group Practices:

Buchanan Medical Clinic – 770-646-8281

Carrollton Ear, Nose and Throat – 770-832-1488

Carrollton Obstetrics and Gynecology – 770-214-2229

Carrollton Surgical Group – 770-834-3336

Comprehensive Breast Care Center – 770-812-5886

Infectious Diseases of West Georgia – 770-812-5837

Northwest Georgia Oncology Centers – 770-333-2220

Primary Care of Bremen – 770-537-6500

Tallapoosa Family Healthcare – 770-812-2800

Tanner Family Healthcare of Franklin – 706-675-6949

Tanner Healthcare for Children – 770-812-8640

Tanner Healthcare for Women – 770-214-2121 (Carrollton); 770-812-3850 (Villa Rica)

Tanner Heart & Vascular Specialists – 770-812-9326

Tanner Neurology – 770-812-3631

Tanner Pain Management – 770-812-5720

Tanner Primary Care at Mirror Lake – 770-812-3839

Tanner Primary Care at the Birches – 770-812-5678

Tanner Primary Care of Carrollton – 770-812-5831

Tanner Primary Care of Roanoke – 334-863-2141

Tanner Primary Care of Wedowee – 256-357-2188

Tanner Primary Care of West Paulding – 770-812-3866

Tanner Radiation Oncology – 770-812-9824