Some remain confused, frustrated after Baptist Health and Humana reach agreement

Although it will present new opportunities for patients, some people who use Baptist Health for their medical needs are concerned and frustrated after the health care system and insurance company Humana reached a deal to gain accept Humana Medicare Advantage Plans at all Baptist Health locations beginning April 1.

In late September, Baptist Health and Humana were unable to reach a contract agreement, resulting in the health care provider ceasing to accept preferred provider organization and health maintenance Organization Humana Medicare Advantage Plans.

In January, Baptist Health stopped accepting Well Care Advantage plans and United Healthcare Advantage plans.

Previously, a person with a Humana Medicare Advantage Plan might have had the option to go to a Baptist Health facility or provider to receive care, but unless it was an emergency, it would have been considered out of network. Patients who were out of network would have had to pay more for health care visits.

On Thursday, Baptist Health issued a statement that reads in part: "We are committed to improving the health of our communities and our goal is to ensure every patient gets the high-quality, timely care needed. This agreement with Humana helps us achieve this goal, and ensures continued access to Baptist Health providers, hospitals and clinics. "

In the comment section of a WPSD Local 6 Facebook post about the agreement, several people voiced their concerns and frustrations.

"Well, that's great. Most of us who had Humana had to go out and switch to something else. Especially if we was seeing anyone at Baptist," Shirley Crotzer Nichols said.

"After people switched doctors, cool story," Jason Bogard said.

Payton Arant owns Payton and Associates Insurance Agency in Murray, Kentucky. She said she isn't sure why disagreements between health care providers and insurers are so common when it comes to contract negotiations, but it likely comes down to one thing.

"I just know that this is gonna' happen. It's usually about money. I know that they're all wanting the best," Arant said. "Doctors don't wanna' lose their patients, you know, the insurance companies also want to help."

Arant advises those with questions to talk to someone local.

"I think just find a local agent if they don't already have one and start there, because really you just gotta' see, even if you need to change — a lot of times people think they need to change ... half the time I don't recommend it," said Arant.

Advantage Plans work as follows: a person has Medicare and pairs it with another insurance provider such as Aetna, Humana, United Healthcare or Wellcare, and then Medicare pays the provider so that when the person needs medical care, it falls under the insurance provider's jurisdiction.

Those who need to change Medicare Advantage selections can do so until March 31, according to Baptist Health.

For more information, visit Baptist Health's website at https://tinyurl.com/557u83jb.