Humana and The Ohio State University settled their contract dispute, but the outcome splits by plan type rather than resolving cleanly for every member. Medicaid enrollees and people with group Medicare coverage through Humana keep access to Ohio State’s hospitals and doctors. Individual Medicare Advantage members do not: their coverage becomes out of network starting October 1, 2026, even though the broader contract fight is over.
A Split Contract: Medicaid and Group Medicare Stay In, Individual Advantage Does Not
Humana’s own newsroom statement, titled “Humana and The Ohio State University Reach Network Agreement,” lays out the terms plainly: the insurer and the health system reached a deal that keeps Humana Medicaid members and Humana group Medicare members in network with Ohio State facilities, named specifically as The Ohio State University Wexner Medical Center, The James Cancer Center and OSU’s affiliated physicians. But the same statement carries a separate line for a third category of member, marked “Individual Medicare Advantage: Out-of-network effective October 1, 2026.” The statement does not publish a count of how many individual Medicare Advantage members that affects.
Sorting a split network outcome: the Open Enrollment calendar and the 42-page decision kit help an individual Medicare Advantage member confirm exactly which category a plan falls into and when a replacement plan needs to be locked in. Work through both tools in The 2027 Medicare Open Enrollment Decision Kit.
The October 1 Network Cutoff for Individual Medicare Advantage Members
For a Humana individual Medicare Advantage member who has been seeing a doctor at Ohio State’s Wexner Medical Center, The James Cancer Center or another affiliated site, October 1, 2026 is the date that matters, regardless of the fact that Humana and Ohio State are no longer in a contract dispute overall. Humana’s statement frames the individual Medicare Advantage line item separately from the Medicaid and group Medicare terms, meaning the agreement the two organizations reached does not cover that population the way it does the others. The statement’s most recent update is dated September 4, 2026, after an initial July 2, 2026 posting, and it still shows the October 1 date as the operative one for individual Medicare Advantage coverage.
Transition Help and Continuity of Care for Members Mid-Treatment
Humana’s statement says affected individual Medicare Advantage members will get “personalized assistance to transition to other in-network providers,” and it separately addresses people already under a course of treatment: members with certain medical conditions “may continue receiving treatment from their provider and to be covered by Humana at the same in-network level of benefits for a specific period.” The statement does not define which conditions qualify or how long that specific period runs, and it points members with questions to the toll-free customer service number on the back of their Humana ID card, available 8 a.m. to 6 p.m. Monday through Friday. For a member without a qualifying condition, going out of network on October 1 typically means paying a larger share of the bill, or the full bill, for care received at Ohio State facilities, since individual Medicare Advantage plans generally pay far less, if anything, for care outside their contracted network.
What Humana Says About the Agreement
Two Humana executives are named in the company’s statement. Adam Sayer, Humana’s market president, said “Humana is focused on preserving access to care for our members,” and added that the company is “pleased to continue our relationship with The Ohio State University,” a comment tied to the portions of the deal that keep members in network. Kathie Mancini, president of Humana Healthy Horizons in Ohio, said “For the thousands of Ohioans who rely on Humana Healthy Horizons, we are grounded in the goal of helping them achieve their best health,” a statement specific to the Medicaid population the agreement preserves. Neither executive’s quote addresses the individual Medicare Advantage segment losing in-network status directly, and the statement does not include a comment aimed at that group specifically.
Why the Plan-Type Distinction Matters Going Into October
The practical effect is that a Humana member’s plan type, not just the insurer’s name, now determines whether Ohio State stays reachable in network. A member enrolled in a Humana Medicaid plan or a group Medicare plan through a former employer can continue treatment at Ohio State without a network change. A member who bought an individual Humana Medicare Advantage plan on their own needs to treat October 1 as an actual network change date, the same as if no agreement had been reached at all for that segment. Humana’s statement remains the controlling record for which category applies, and it is the document the company directs members toward as the date approaches. Members who are unsure which category their own coverage falls into are directed to the same toll-free number on their ID card rather than to a separate lookup tool on Humana’s site, so confirming plan type directly with the insurer is, per Humana’s own statement, the way to resolve any doubt before October 1. The “personalized assistance to transition to other in-network providers” that Humana promises individual Medicare Advantage members is described only in general terms in the statement, without naming which specific in-network hospitals or physician groups in central Ohio a displaced member would be steered toward, leaving that detail to the individual conversations Humana says it will have with affected members.
The Gap a Split Network Agreement Leaves for One Group of Members
A network deal that keeps some Humana members in at Ohio State while cutting off individual Medicare Advantage members on October 1 leaves that one group with an unfinished decision: whether to stay in a plan that no longer reaches a familiar hospital system or move to one that does before the window to switch closes.
The 2027 Medicare Open Enrollment Decision Kit includes a provider call script for verifying a hospital’s network status directly and a cost calculator spreadsheet for comparing what a switch would mean for costs, drugs and doctors.
Compare the options before the individual Medicare Advantage network change takes hold in The 2027 Medicare Open Enrollment Decision Kit.
This article was produced with AI assistance and checked against the primary source 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.
