BANGOR, Maine (WABI) – Many Mainers are upset following Northern Light Health's decision to remove Humana from its Medicare Advantage network.
On Aug. 14, Northern Light Health notified patients with Humana Medicare Advantage that as of Sept. 30, the insurance plan will no longer be accepted at any of its locations.
In a statement, Northern Light told TV5: “Northern Light Health will terminate its Medicare Advantage Network agreement with Humana effective September 30, 2024. This was a difficult decision and was made after spending significant time and effort over the past year resolving a number of administrative issues. Northern Light Health will continue to work with patients covered under Humana Medicare Advantage plans to provide options to ensure continuity of care during this transition period. This decision only affects patients on Humana Medicare Advantage plans.”
In response, Humana said: “Northern Light Health terminated its contract with Humana effective September 30, 2024. Humana strives to provide health plan members with access to high-quality care while minimizing out-of-pocket costs. We are open to good faith discussions with Northern Light Health regarding their continued participation in our network to avoid disruption. At the same time, we must ensure that our contracted hospitals and physicians provide quality, cost-effective care to keep health care costs as affordable as possible for our members. Humana maintains a strong network and encourages members to call the Humana Customer Care phone number on the back of their membership card if they need personal assistance. Please note that the change in network participation does not affect policyholders with Humana's Medicare Supplement insurance plans.”
Bangor resident Dawn DeBoer battles a rare neuromuscular syndrome and multiple autoimmune diseases.
She is just one of many patients who have received treatment-changing news.
“I got nine letters in the mail, all saying the same thing, that none of my providers at Northern Light and Eastern Maine Medical Center would accept Humana as of September 30th,” DeBois recalled of when she was first informed of the change, “mid-year, mid-insurance cycle for Medicare.”
The notice provided clients with resources to find a new personal care provider (PCP) but came at a time when Maine is experiencing a shortage of PCPs accepting new clients.
DeBois learned this to be true from his own experience: “They gave me the name of the attending physician who would be assigned to me, and I said, 'OK,' and then I called and they said, 'Oh, that attending physician is retiring on September 4th.'
The PCP shortage isn't just affecting DeBoer, but also her neighbors in her apartment complex.
“She was very ill and neighbours knew she was having difficulty breathing but they couldn't get her to her doctor. She died at home,” DeBois recalled.
The end of the Humana Medicare Advantage plan comes at a time when many of Northern Light Health's resources are being cut, and Northern Light Mayo Hospital has ended its longtime partnership with the Corinth Fire Department that allowed it to house a hospital ambulance at the fire station.
Now DeBois is traveling to South Portland to find his doctor so he can get the medication and medical checkups he needs.
She said she can't help but think about how the elderly population living north of Bangor will struggle to make changes to their insurance coverage.
“I feel for people who don't know where to start and are just following the phone book and calling each practice and they're like, 'Sorry, we're not accepting new patients,'” DeBois explains. “Given how there is currently a shortage of primary care providers in the area and those accepting new patients, this is wrong and should be called out immediately. It honestly feels like money is being put before patients.”
For those affected by Northern Light Health's coverage cuts, DeBois advises contacting a Medicare broker who can help you find the right coverage for your individual needs and filling out the coverage extension form that was included with the Humana termination letter. The most important thing, DeBois says, is to stay positive and speak up for those affected, either for yourself or on behalf of Northern Light Health, Humana and Augusta.
Copyright 2024 WABI. Unauthorized reproduction prohibited.
