Medicare Advantage Plans Transition to Humana

Wednesday, May 27, 2020

Medicare Advantage Plans Transition to Humana

Planning is under way for the State Health Plan’s recently announced transition to Humana for the Medicare Advantage plans. This is not effective until January 1, 2021. Medicare Advantage members will continue their current benefits with UnitedHealthcare for the remainder of this year.

All members currently covered under UnitedHealthcare will be moved to Humana for the 2021 benefit year, which begins January 1, 2021. Members will continue to have the choice of the Base or Enhanced plan under Humana as well as the option of the 70/30 Plan, which is administered by Blue Cross NC. Open Enrollment is set for October 15-31, 2020. Members will receive more information on this transition prior to Open Enrollment.

Here’s what you need to know:

  • Why was this change made?
    The award of the contract was made to Humana after a required and competitive bidding process per state contracting and procurement rules.  As a result of the procurement process, the State Health Plan Board of Trustees awarded the contract in March to Humana. The new contract is expected to generate $590 million in savings over the next three-years.
  • Who does this affect?
    This affects State Health Plan subscribers and their dependents on Medicare Advantage Base and Enhanced plans. 
  • When is this change effective? 
    This is effective January 1, 2021. Medicare Advantage members will continue their current benefits with UnitedHealthcare for the remainder of 2020.
  • Can I continue to see my provider?
    Both Medicare Advantage plans will continue to offer a passive network of providers, which allows members to continue seeing their current providers regardless of being in or out of Humana’s network. Similar to what members experience today, the provider will need to be participating with Medicare and agree to bill the Medicare Advantage plan carrier.
  • Will I receive more information? Members will receive more information on this transition prior to Open Enrollment. Watch for more information in the mail. For the latest updates, sign up to receive the Plan’s free, monthly Member Focus e-newsletter.