AARP Michigan is committed to supporting Michiganders affected by the contract dispute between Humana and Trinity Health. As of January 1, 2025, Humana Medicare Advantage members in Michigan have lost in-network access to Trinity Health's providers, hospitals and facilities. This disruption could significantly impact many individuals, especially older adults and those with ongoing health conditions who rely on Trinity Health for their care.
In Michigan alone, approximately 1.35 million individuals are enrolled in Medicare Advantage plans, and Humana is one of the largest providers in the state. While the exact number of Humana members affected by this dispute is not publicly available, it's estimated that over 100,000 Humana Medicare Advantage members across several states, including Michigan, are facing disruptions to their in-network access due to this dispute. These numbers underscore the scope of the issue, particularly in Michigan, where a large percentage of Medicare beneficiaries are enrolled in Medicare Advantage plans.
Whether you're looking to continue your care with Trinity Health providers, explore other insurance coverage or seek support, you have options.
Request Continuity of Care
One of the most important actions you can take is to request continuity of care from Humana. Continuity of care allows you to continue receiving care from your current healthcare provider, even if they are out of network, for a period of time.
Appeal Out-of-Network Changes
If you require care from Trinity Health and are billed at out-of-network rates, you may be able to appeal these charges, especially if continuing care with your existing provider is medically necessary.
Explore Special Enrollment Periods (SEPs)
If losing access to your provider is no longer workable and you need to switch to a different plan, you may qualify for a Special Enrollment Period (SEP). This allows you to change your plan outside of the usual open enrollment period.
Consult the Michigan Medicare Medicaid Assistance Program (MMAP)
If you're unsure about your options or need assistance navigating your choices, the Michigan Medicare Medicaid Assistance Program (MMAP) is a valuable resource. MMAP provides free, unbiased assistance to Medicare beneficiaries in Michigan.
Review Open Enrollment Periods
The Medicare Open Enrollment Period (October 15 to December 7 each year) is the time when Medicare beneficiaries can make changes to their coverage. If you missed this period and are affected by the Trinity Health disruption, consider whether you qualify for other enrollment opportunities like Special Enrollment Periods.
Contact the Michigan Department of Insurance and Financial Services (DIFS)
If you are encountering problems with your insurance coverage or are unable to resolve issues with Humana, the Michigan Department of Insurance and Financial Services (DIFS) can offer assistance.
Stay Informed and Advocate for a Resolution
While AARP Michigan encourages both Humana and Trinity Health to come to a swift resolution, it's important to stay informed about any updates on the issue.
Keep track of updates from Humana and Trinity Health regarding any changes to the dispute. Reach out to both organizations for more information on how the dispute is being resolved. Whether through direct communication or by staying informed, this can help to ensure that your voice is heard during these negotiations.