Humana Advantage Q & A:

A1: VCU Health has made the difficult decision to end our contract with Humana Medicare Advantage plans effective January 31, 2025. We have been in discussions for several months asking Humana to address our concerns, specifically declines in payment and growing administrative demands around authorizations, denials, and appeals. Unfortunately, we have been unable to come to agreement with Humana. In addition, Humana continues to exclude VCU Health from its transplant network although we are the largest transplant provider in the state.

A2: VCU Health will be out of the Humana Medicare Advantage Network effective January 31, 2025. It is important to know that nothing changes between now and January 31, 2025. You can and should continue to see your VCU Health providers in the same way you do today. However, if we do not reach a new agreement with Humana before January 31, 2025, your access to VCU Health will be impacted. Humana may no longer pay for your care at VCU Health, or you may have higher out of pocket costs if they do.

A3: All Humana Medicare Advantage plans are impacted by this termination including Humana HMO, PPO, C-SNP, and Regional PPOs plans. Sample ID Cards and Plans listed below:

A4: All VCU Health facilities and providers are affected by this termination, including:

• Adult Outpatient Pavilion
• Children’s Hospital of Richmond at VCU
• MCV Physicians
• New Kent Emergency Center
• VCU Health Ambulatory Surgery Center, LLC
• VCU Health Community Memorial Hospital
• VCU Health Tappahannock Hospital
• VCU Massey Comprehensive Cancer Center
• VCU Medical Center

For a complete listing of our locations visit our Locations Page.

A5: Yes, this will apply to all VCU Health professional providers including; clinicians, physicians, and nurse practitioners, physical/occupational therapists and behavioral health providers.

A6: If we do not reach a new agreement with Humana before January 31, 2025, your access to VCU Health will be impacted. Humana may no longer pay for your care at VCU Health, and as a result you might have higher out of pocket costs.

A7: If you have already received transplant evaluation services or have been transplanted, we will continue to support your healthcare needs, despite our out of network status. If you have questions or want to know more about how this affects your transplant care, talk to your transplant financial counselor. For all other potential transplant patients please reach out to your Humana representative or access the link below to identify available in-network Humana transplant providers near you. We regret that this has become necessary and will alert you if there is any change in our status.

Humana National Transplant Network and Specialty Health Services Locator

A8: You have options: If you would like to maintain access to VCU Health hospitals and physicians for your Medicare covered services, you may consider changing plans during the Annual Open Enrollment period, which runs from October 15 to December 7, 2024. During this time, you can enroll in a Medicare Advantage plan, you can switch from one Medicare Advantage plan to another, or you can return to original Medicare.

A9: Yes, VCU Health participates in most other Medicare Advantage networks including Anthem, United Healthcare, Sentara, Aetna, Cigna and Molina.

A10: Humana Medicare Advantage members who are currently in an ongoing treatment program may qualify for Continuity of Care exception that will allow you to temporarily maintain in-network benefits (after January 31, 2025) through completion of your treatment course. However, Humana must ultimately approve exceptions.

A11: Any patient needing emergency care can still seek treatment at any of the VCU Health Emergency Departments, regardless of their insurance status.

A12: Yes. If you would like to keep your Humana Medicare Advantage plan, we can assist you in moving your care to a non-VCU Health provider.

A13: VCU Health continues to participate with all Medicare Supplement Plans, so this termination will have no impact on your coverage or benefits through your Humana Medicare Supplement. Sample Humana Medicare Supplement Card:

A14: No, VCU Health System remains fully participating with Humana Military/Tricare.

A15: HELP IS AVAILABLE: If you need help finding the Medicare plan that is right for you, please contact the Virginia Insurance Counseling and Assistance Program (VICAP) at 1-800-552-3402. Trained volunteers can assist you. If you have questions about this notice, VCU Health customer service is available to help you Monday through Friday between 8:30 a.m. and 4 p.m. at 1-888-803-0082. Remember, right now, nothing is changing. VCU Health remains in the Humana Medicare Advantage network until January 31, 2025, so you have time to consider your options.

A16: We have dedicated this website to ensure you have the most up-to-date information. If you do not find the answers you are looking for, or you want to know more, VCU Health customer service is available to help you Monday through Friday between 8:30 a.m. and 4 p.m. at 1-888-803-0082.