NEWAYGO, Mich. — FOX 17 took a trip to Newaygo on Friday to speak with a woman who has Humana Insurance about the future of her coverage. She's been on dialysis for nearly 12 years.
She says she doesn't qualify for a kidney transplant.
From Grand Rapids to Muskegon, people who have Humana Medicare Advantage Insurance like Dianna Welch are no longer in network at Trinity Health. That means there's no longer a contract between Humana and Trinity with pre-negotiated rates.
“They don’t wanna pay nothing this year. Dialysis told me that. They did not renew the contract,” Dianna Welch said.
People who have Humana Medicare Advantage, like Dianna, are affected.
“The big companies have got ya, coming or going,” Dianna said.
The changes cause a big problem for her, since she goes to Trinity Health Muskegon from Newaygo three times weekly for dialysis. She says she's hopeful she'll be able to find other coverage.
FOX 17 spoke with Dr. Remu Tipirneni from the University of Michigan Institute for Healthcare Policy and Innovation, who directed us to a free resource for people facing issues right now due to changes.
But Dianna's biggest concern right now is getting to and from appointments.
“See, I take a 'commission on aging' van to dialysis when I go. But Humana and my Medicaid was paying for it. Now Humana don’t want to pay for it. If Humana don’t, Medicaid’s not going to do it,” Dianna said.
In reality, Dianna says it's out of her limited social security budget to cover gas money to and from Muskegon for dialysis.
“There ain’t nothing I can do, if they don’t want to do it, they don’t have to. They don’t want to pay the price that the hospitals and the doctors want,” Dianna said.
Dr. Tipirneni says these issues happen.
“It’s unfortunately common why these things happen. Everybody’s trying to work from their angle. I think the challenge is patients get caught up in the mix,” Dr. Tipirneni said.
Humana issued FOX 17 the following statement:
"Humana strives to provide access to high-quality healthcare for our health plan members while minimizing out-of-pocket costs. We continue to have good-faith discussions with Trinity Health and remain open to renewing the contract if it’s fair to both sides. Humana maintains a strong network of high-performing providers that will help ensure our members continue to receive high-quality, effective, and affordable care. We understand that changing health care providers can be difficult, and we will work with our Medicare Advantage members to help them select new in-network providers to ensure their care is not interrupted. We encourage our members to call the Humana Customer Care phone number on the back of their membership card if they need personal assistance. Please note that the change in network participation will have no impact on Humana’s Medicare Supplement insurance plan policyholders."
Trinity Health issued FOX 17 the following statement:
"We previously shared that Trinity Health was working hard to reach a fair agreement with Humana. Unfortunately, Trinity Health 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. For months, we've worked diligently to find common ground, but Humana has not shared our sense of urgency to ensure your access to Trinity Health 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 Trinity Health.
"For more information, including ways to protect your ability to affordably access Trinity Health in 2025, regardless of our status with Humana, visit TrinityHealthMichigan.org/Humana [trinityhealthmichigan.org]."
Dianna remains hopeful that she'll find coverage, and soon.
“Not much I can do. Just get by,” Dianna said.
Michigan
Trinity Health no longer included in Humana's network
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