UPDATE

Insurance Changes –
Humana Coverage Update
at Graves Gilbert Clinic

UPDATE

Insurance Changes –
Humana Coverage Update
at Graves Gilbert Clinic

Important Information About Humana Insurance & Your Care at Graves Gilbert Clinic

Graves Gilbert Clinic (GGC) is committed to keeping our patients informed about changes that may affect their care.

What is happening between Graves Gilbert and Humana

Graves Gilbert Clinic is still working with Humana in good-faith negotiations to reach an agreement that protects access to high-quality, affordable care for the individuals and families we serve. If an agreement is not reached, GGC would no longer be in-network for some Humana plans starting February 1, 2026.

Please read below to see if this affects you.

Who Is Not Affected

You are not affected if you have any of the following:

Original Medicare (Part A and Part B only)
Humana Medicare Supplement (Medigap) plans
Humana Prescription Drug Plans (Part D only)
Tricare Humana
Medicare Advantage plans from insurance companies other than Humana
Humana Group Medicare Advantage PPO plans for KTRS and KPPA

Who May Be Affected

You may be affected if you currently see, or plan to see, a Graves Gilbert Clinic provider and have:

A Humana Individual Medicare Advantage plan (HMO or PPO), or
A Humana Medicaid plan

If You Have a Humana Individual Medicare Advantage HMO

HMO plans generally only cover in-network care.
If GGC is no longer in-network, your costs could be much higher after February 1, 2026

If You Have a Humana Individual Medicare Advantage PPO

GGC providers would no longer be in-network.
You may continue seeing GGC providers, but you would be responsible for out-of-network costs.
Out-of-network care usually means higher bills.

If You Have a Humana Medicaid Plan

Medicaid is managed by different health plans.
Some Medicaid plans do include Graves Gilbert Clinic.
You may be able to switch to another plan that includes GGC providers.

Enrollment Period Guidance

Medicare Advantage Open Enrollment runs Jan. 1 – March 31.
During this time, you can:
- Switch to a different Medicare Advantage plan.
- Return to Original Medicare.

Review your coverage and contact your insurance provider to make any changes to your insurance coverage.

Frequently Asked Questions

Why was the deadline extended?

To allow more time for negotiations that work towards an agreement that keeps your care affordable and accessible.

Will my care stop during negotiations?

No. Your care continues without interruption.

What if I’m a KY State Retiree or KY Retired Teacher?

You will not be affected event if Humana becomes out of network at GGC. Your Humana Group Medicare Advantage PPO plan covers you at the same cost for in- network and out-of-network care. You can keep seeing your GGC providers without extra costs.

Why did GGC issue a notice to cancel participation with Humana to start negotiations in the first place?

GGC and Humana have been in discussions for many months. Unfortunately, we were unable to reach an agreement that supports: Timely payments Patient access without administrative barriers Sustainable, high-quality care in our region.

Our mission is — and always has been — to protect the health of this community.

What if I want to stay with my GGC doctor even if they are out-of-network?

You can still receive care at Graves Gilbert Clinic. However, visits and procedures may be billed as out-of-network under your Humana plan, which could increase your costs.

Who can help understand how this change may affect me?

We recommend patients check their plan. Review your out of network coverage. Then:

Talk with an insurance agent to explore options such as switching to a plan that includes Graves Gilbert Clinic.
Or talk to our Patient Services team 270.780.2491. They can help verify cost and coverage.

Licensed Local Insurance Support: These trusted partners can review your benefits and help find a plan that fits your needs:

Humana Medicare Advantage:

Houchens Insurance Group – Chappell Watt | (800) 960-3560 | [email protected]

McCay & Associates Insurance | (270) 842-4236 | [email protected]

Jobe Loyd | (812) 470-0285 | [email protected]

Humana Medicaid | 855-459-6328 | kynect.ky.gov to learn about other in network options