Lake County, Colorado, has one hospital, and it is about to go out of network for Humana’s Medicare Advantage members. St. Vincent Health in Leadville will end its participation in the Humana Medicare Advantage network on Jan. 1, 2027. Members of those plans have until Dec. 7, the last day of Medicare’s fall enrollment period, to pick different coverage.
The decision applies to Humana Medicare Advantage only. St. Vincent says Original Medicare patients and members of other Medicare Advantage plans are not affected, and it already stays out of Humana’s commercial plans. Humana Medicare Advantage members can still be seen at the hospital after Jan. 1, but as an out-of-network provider.
That matters more in Lake County than in a city with three or four competing hospitals. A member there has no second Lake County hospital to switch to, so the question for each Humana member is whether to keep the plan and accept out-of-network rules at the local hospital, or move to a plan that still contracts with it.
The people who have to decide are Humana Medicare Advantage members who live in or near Lake County and use St. Vincent for emergencies, imaging, lab work, outpatient visits or follow-up care. Each should look at the plan’s 2027 notice, then check whether any plan on the market for next year lists St. Vincent as in network before Dec. 7.
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Why a single-hospital county changes the math
St. Vincent describes itself in its notice to patients as the only hospital serving Lake County. In most places, an out-of-network hospital is an inconvenience because another one is close. Here, the local emergency room, lab and outpatient departments are all inside the one building that is leaving the network.
Chief Executive Officer Bubba Bartlett signed the letter. It points to “ongoing challenges” with the Humana plan. The hospital’s FAQ lists administrative requirements, coverage delays, denials and reimbursement practices, and says money is an important part of the decision but not the only factor.
What out-of-network status can mean at the front desk
The hospital says the change “may affect the patient’s out-of-pocket costs and the way services are covered.” It does not publish a dollar figure, because the cost depends on each member’s plan. Humana members who want a number have to ask Humana what their plan pays for an out-of-network hospital stay, an outpatient procedure or a scan.
Emergency care is handled separately. St. Vincent tells patients to call 911 or come to its emergency department, which is open around the clock, and says “insurance questions should not prevent someone from seeking emergency medical attention.” The cost questions come after the visit, not before it.
Members with care already on the calendar for after Dec. 31 are told to call the hospital’s patient financial counselor at 719-486-0230, extension 205. That covers scheduled surgeries, infusions, imaging and repeat therapy visits that cross into the new year.
Questions to put to Humana before choosing
The hospital’s FAQ tells patients to contact Humana directly about specific plan benefits and network status, and it does not name which Humana plans are affected. A member should therefore ask Humana by plan name whether the change applies, and get the answer for the exact plan printed on the member card.
Three questions cover most of it. What does the plan pay when a member is admitted to an out-of-network hospital? Does outpatient care at St. Vincent, such as lab work or imaging, carry a higher copay or coinsurance? Do referrals or prior authorizations change for out-of-network visits? Writing the answers down makes a later comparison with another plan far easier.
Where a Humana member can look for a different plan
The fall window runs Oct. 15 to Dec. 7, 2026, and changes made in it take effect Jan. 1. The government’s Medicare Plan Finder lets a member enter a ZIP code, doctors and drugs and see which 2027 plans are offered in the county. The hospital’s FAQ says that a plan’s hospital, primary care doctor and specialist network, its prescription coverage, its deductibles and copays and its prior authorization rules all belong on the comparison list.
Free counseling is available through Colorado’s State Health Insurance Assistance Program. St. Vincent lists 719-471-2096 for a local appointment and 1-888-696-7213 toll-free. The hospital also suggests a licensed Medicare broker for plan comparisons.
Primary care doctors and specialists matter as much as the hospital. A doctor who admits patients to St. Vincent, or who refers patients there for tests, may face different rules under a new plan, so the doctor’s own network status should be checked alongside the hospital’s.
Could a member go back to Original Medicare?
Original Medicare keeps St. Vincent in reach, since the hospital says those patients are unaffected. The catch is Medigap, the supplemental coverage that fills in the gaps. Medicare.gov says a person who switches from Medicare Advantage to Original Medicare has a guaranteed right to buy certain Medigap plans in some situations, with an application window that runs from 60 days before Medicare Advantage coverage ends to 63 days after it. Outside those situations, Medicare.gov says, “there’s no federal guarantee that an insurance company will sell” a Medigap policy.
The page does not say that a hospital leaving a network is one of the situations that triggers the right. A member leaning toward Original Medicare should ask the Colorado counselors, and the Medigap insurer, whether a guaranteed right applies before dropping the Humana plan.
Humana member in Lake County, what happens by Dec. 7?
Staying put is a choice with a price attached. Switching is a choice with a deadline attached.
A member who waits past Dec. 7 stays in a plan whose only local hospital is out of network for all of 2027.
The 2027 Medicare Open Enrollment Decision Kit puts the choice on paper. It includes a cost calculator spreadsheet that compares plans on cost, drugs and doctors, a prescription-by-plan comparison, a provider call script for asking a plan whether a hospital is in network, and the Open Enrollment calendar.
Run the Lake County Humana-versus-other-plans cost spreadsheet before Dec. 7 →
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.
