Humana’s individual Medicare Advantage plans stopped covering Ohio State University Wexner Medical Center and The James Cancer Hospital at in-network rates on October 1, according to Ohio State. Patients who stay in those plans still get in-network rates through December 31, 2026. After that, anyone who wants to keep seeing Ohio State doctors has to be in a different plan on January 1, 2027.
The two sides announced the split on July 2, when Humana said it had reached an agreement for its Medicaid and group Medicare plans but not for individual Medicare Advantage. Ohio State has not announced a deal for the individual plans. Hoodline, citing NBC4, reported that Ohio State estimates roughly 26,000 Humana patients in central Ohio are touched by the change, a figure that also covers Medicaid members.
The people who face a decision are Humana members who bought an individual Medicare Advantage plan on their own and use Ohio State primary care, a specialist, or The James for cancer care. They have until December 7 to move, and a smaller window that closes this week.
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Which Humana members are affected
Only individual Medicare Advantage plans are out of network. Ohio State says Humana Medicaid and Humana group Medicare Advantage, the kind offered through an employer or retirement program, stay in network and need no change for 2027. Humana says the same group and Medicaid deal covers 2026 and 2027.
Anyone unsure which type they hold can look at the Humana card or call the number on the back and ask whether the plan is individual or group Medicare Advantage. Ohio State also runs a community information line at 866-316-0476. Retirees in an employer plan should ask the plan administrator before changing anything, Hoodline reported.
What members lose after December 31
Ohio State says patients currently in treatment can keep seeing their physician through December 31, 2026, and should keep scheduled appointments, tests and procedures through that date. After it, a visit to Wexner Medical Center, The James or an Ohio State-affiliated doctor would be out of network under the plan.
Humana says some members with certain medical conditions may qualify to keep treatment with their current provider at the same in-network benefit level for a set period. It points members to the number on the back of the ID card, open 8 a.m. to 6 p.m. Monday through Friday. Emergency care is covered at the in-network level even at a hospital outside the network, the insurer says.
Humana Market President Adam Sayer said in the company’s statement that “Humana is focused on preserving access to care for our members.” The statement does not say Ohio State will return to the individual plans.
The December 7 deadline and the October 31 window
Medicare’s yearly Open Enrollment runs October 15 through December 7. During that time people can switch Medicare Advantage plans, change drug coverage, or move to Original Medicare. Coverage starts January 1, and the plan must receive the request by December 7.
Ohio State’s page also lists a one-time special election period through October 31, 2026. A change made by then takes effect November 1, which would move a patient out of the Humana plan before the year-end cutoff. That window closes four days from now.
Anyone who misses December 7 still has a second chance. Medicare says people already in a Medicare Advantage plan can use Medicare Advantage Open Enrollment, January 1 through March 31, to switch plans or return to Original Medicare. Coverage then begins the first of the month after the plan gets the request. By that point, though, Ohio State care would already be out of network under the Humana plan.
Where Ohio State is still in network
Ohio State says patients do not have to change doctors. Its health system takes Original Medicare and more than 30 other Medicare Advantage plans, and the list is on its insurance page. Hoodline reported that Original Medicare and Medigap plans are also accepted.
Ohio State has done this with another insurer before. It stopped accepting Anthem Medicare Advantage on January 1, 2025, which an Ohio State spokesperson said affected an estimated 28,000 patients. Plan networks can change after enrollment, and a doctor listed in the plan directory in October can be gone by the next year.
Free, unbiased help is available. Ohio State directs patients to its partner Chapter, which offers no-cost counseling at 866-571-0136 or askchapter.org/osu. Hoodline lists the Ohio Senior Health Insurance Information Program at 1-800-686-1578 and Medicare’s Plan Finder is the official tool for comparing 2027 plans by doctor and drug.
Is the current plan worth keeping?
The question for each Humana individual member is concrete. Is the Ohio State doctor or cancer team worth more than anything the plan saves on premiums and drug costs? Another plan that covers Ohio State may cost more or cover fewer drugs, and Original Medicare brings a different set of rules.
Ohio State’s guidance is to keep appointments through December 31 while reviewing options, and the deadline to act is December 7.
Switching before Ohio State goes out of network?
A Humana member who does nothing by December 7 starts January with the same plan and a primary care doctor, specialist or cancer team that is out of network. The in-network rates Ohio State is honoring end on December 31.
The 2027 Medicare Open Enrollment Decision Kit includes a provider call script and the Open Enrollment calendar, so a member can confirm a doctor is in a new plan’s network before switching. It also has a cost calculator spreadsheet that compares plans on cost, drugs and doctors, with a prescription-by-plan comparison for the medicine list.
Get the doctor call script and plan cost calculator for the Humana switch →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
