Two nationally known hospital systems are on track to leave the same type of insurance network on the same date: October 1. In Columbus, Ohio State’s Wexner Medical Center loses in-network status with Humana for people who bought a Medicare Advantage plan on their own rather than through a former employer. In New York, NewYork-Presbyterian is set to lose in-network status with UnitedHealthcare for most Medicare Advantage members unless the two sides sign a new contract in the next two weeks. For a retiree with surgery, chemotherapy or a standing specialist appointment at either system, the date lands shortly before Medicare’s annual enrollment window opens, leaving little time to sort out whether next year’s plan still covers the hospital they use.
Humana’s Split Deal With Ohio State’s Wexner Medical Center
Humana and Ohio State’s Wexner Medical Center reached a partial agreement that splits their contract in two: one outcome for group and Medicaid coverage, another for people who buy an individual Medicare Advantage plan on their own. The split means the hospital system does not exit Humana’s network wholesale, but a meaningful slice of its Medicare patients still lose in-network access on October 1.
Humana’s own statement on the dispute, updated September 4, confirms Wexner Medical Center, The James Cancer Center and its affiliated physicians remain in-network for Humana Medicaid and Group Medicare members through 2027, while individual Medicare Advantage members lose in-network access to the same facilities starting October 1. Humana’s FAQ limits continuity-of-care support to members with certain medical conditions who are already receiving treatment, and directs everyone else toward its member services line to find a new in-network provider.
NewYork-Presbyterian’s Contingent Deadline With UnitedHealthcare
NewYork-Presbyterian’s own coverage-change page, last updated August 27, describes a dispute that has not been resolved. The hospital system and UnitedHealthcare have agreed to extend in-network coverage only through September 30, “while negotiations continue,” according to the notice, and no new contract has been announced since. If the two sides do not reach one by that date, NewYork-Presbyterian Hospital, its medical groups and its affiliated facilities become out-of-network for most UnitedHealthcare Medicare Advantage members starting October 1, with people already mid-treatment kept at the in-network rate through December 29.
The notice carves out exceptions that change the math for some retirees. AARP Medigap and Supplemental policies, along with Group Retiree PPO plans, are not affected by the dispute at all, while people on individual HMO or POS Medicare Advantage plans face the full loss of in-network status. NewYork-Presbyterian says doctors at ColumbiaDoctors and Weill Cornell Medicine will keep seeing UnitedHealthcare patients regardless, but the hospital services those doctors order (lab work, imaging, inpatient admission) would stop being covered as in-network once the deadline passes.
The Federal 90-Day Window for “Continuing Care Patients”
Both disputes sit on top of a federal safeguard that exists no matter which insurer’s transition policy is stricter. CMS’s own guide for patients whose doctor is leaving their network describes a “continuing care patient” protection available under most types of health insurance: someone undergoing treatment for a serious and complex illness, receiving institutional or inpatient care, scheduled for non-elective surgery, pregnant and in treatment, or terminally ill can keep seeing the outgoing provider at the in-network rate for up to 90 days after the network relationship ends…