If you have Ohio Medicare Advantage coverage through Humana and use Ohio State University Wexner Medical Center, or you’re covered through UnitedHealthcare and use Virginia’s Valley Health System, here’s what you need to know: both networks have changes landing on October 1 — earlier than the usual January 1 start of a new plan year.
What’s Actually Changing
Ohio State University Wexner Medical Center (Columbus, Ohio): Individual Humana Medicare Advantage members will be out-of-network starting October 1, 2026. This includes Ohio State’s hospitals, the James Cancer Center, and Ohio State-affiliated physicians. Humana Medicaid members and group Medicare retiree plans through an employer are not affected.
Valley Health System (Winchester, Virginia, serving the northern Shenandoah Valley and parts of West Virginia): UnitedHealthcare Medicare Advantage members will lose in-network benefits starting October 1, 2026.
Why This Is Happening
Both changes follow contract negotiations between the hospital systems and insurers over reimbursement rates and claims handling. Ohio State and Humana did reach a partial agreement that preserved group and Medicaid coverage, though individual Medicare Advantage plans were not included in that resolution.
Why This Matters for You
Because these changes take effect before Medicare’s Annual Enrollment Period opens on October 15, there’s a short window where the network change is in place but AEP hasn’t started yet. A few things are worth knowing:
- Emergency care is generally still covered at in-network rates regardless of contract status.
- Many plans offer some continuity-of-care protection for members already in an active course of treatment.
- AEP, starting October 15, is your normal opportunity to review and change your plan for 2027 if this network change affects you.
What You Can Do
- Check whether you’re affected. If you’re a Humana Medicare Advantage member who uses Ohio State, or a UnitedHealthcare Medicare Advantage member who uses Valley Health, your plan can confirm your network status.
- Ask about continuity-of-care options if you’re in active treatment. Insurers typically have a process for this — it’s worth asking directly what applies to your situation.
- Use AEP (October 15 – December 7) to review your options. This is the normal window to switch plans or explore Original Medicare with a Medigap policy if you’d like your coverage to work differently.
- If you need care in the meantime, it’s fine to ask your plan about costs beforehand so there are no surprises.
- Your doctors can be a good resource. They can tell you which plans they currently participate in.
Let’s Talk Through Your Options
If either of these hospital systems is part of your care, we’re glad to help you understand what it means for your specific plan — at no cost and no pressure. Reach out anytime.
Ohio Medicare Advantage: The Bottom Line
For Ohio Medicare Advantage members specifically, the timing matters. Losing access to Ohio State Wexner mid-year is different from a change that happens every January, and it’s easy to miss if you’re not watching your mail. If you’re enrolled in an Ohio Medicare Advantage plan through Humana and regularly see providers at Ohio State’s hospitals, the James Cancer Center, or an Ohio State-affiliated physician, confirm your network status now rather than waiting for AEP to open on October 15. Ohio Medicare Advantage members who are mid-treatment should also ask their plan directly about continuity-of-care protections, since many plans allow a transition period even after a provider leaves the network. And if this change means your current Ohio Medicare Advantage plan no longer fits how you get care, AEP is your window to make a switch for 2027 — we’re happy to walk through what’s available in your area.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
