10/30/2024 | Press release | Distributed by Public on 10/30/2024 15:39
As Medicare open enrollment started this October, healthcare facilities like Tanner Health have evaluated their partnerships with payers offering specific Medicare Advantage (MA) insurance plans. After extensive negotiations spanning back to last fall, Tanner Health will no longer be a Participating Provider with Humana Medicare Advantage PPO as of Jan. 1, 2025.
"We're always going to do what's best for our patients first," said George Royal, the director of managed care at Tanner. "This decision to terminate is not one we take lightly. Fortunately, we are in open enrollment through Dec. 7, and those concerned about Tanner no longer being in-network can change their plan to remain in-network with another MA provider."
This change affects Humana Medicare Advantage plans only. This change has raised concerns throughout the community about what Medicare Advantage plans Tanner participates in and what options are available if someone needs to adjust their coverage. Tanner continues to participate in traditional Medicare and Medicare Advantage plans with Aetna, Cigna, Clover Health and Pruitt Health, in addition to all Medicare supplement plans offered by all insurance companies.
"We continue to have patient care impacted by Humana denials and their extensive authorization process. Humana denies some inpatient authorization requests by applying their criteria instead of the Medicare standard. Additionally, some patient hospital discharges are delayed, waiting for Humana to respond and authorize approval for post-acute care like inpatient rehabilitation, skilled nursing, and home health services. In some cases, these services are even denied," said Loy Howard, president and chief executive officer for Tanner Health.
The Humana termination does not impact Tanner hospitals' participation with Anthem (Blue Cross of Georgia) nor United Healthcare. Tanner hospitals continue to participate with these insurance company's commercial products.
Tanner Medical Group providers will continue to be a participating provider in both commercial and Medicare Advantage plans with Anthem and United.
"We want to help answer any questions our patients have," says Howard. "We're committed to helping patients navigate these changes, providing information and assistance to ensure they can make informed decisions about their healthcare coverage."
For a complete list of insurance payers accepted at Tanner Health hospitals and Tanner Medical Group practices,
visit tanner.org/2025-insurance-update.
For questions or concerns
If you have any questions and want to speak with a Tanner representative about Tanner's participation in your health plan or Medicare options, call 770-812-8752 or email [email protected] for assistance. Tanner's managed care experts are here to answer your questions.
Please contact your insurance coverage provider if you have any specific questions about your coverage or plan.