Patients who are covered by a Humana Medicare Advantage health insurance plan might have to pay more than in the past for care at Saint Alphonsus Health System, including its hospitals in Baker City, Ontario, Nampa and Boise.

Officials from Humana and Saint Alphonsus said they are willing to continue trying to negotiate an agreement that returns Saint Alphonsus to Humana’s network of providers.

As of Jan. 1, though, Saint Alphonsus is no longer part of Humana’s network, said Shelly Cutler, a spokesperson for Saint Alphonsus.

“This outcome is deeply disappointing,” Cutler wrote in an email to the Baker City Herald on Monday morning, Jan. 6. “Over the last several months, Saint Alphonsus worked hard to reach a fair agreement that appropriately covers the true cost of care we provide. Our patients place incredible trust in us when choosing Saint Alphonsus for their care. Please know we did everything within our power to protect their access and remain in network for care and services.”

Lisa Dimond, corporate communications lead for Humana, wrote in an email to the Baker City Herald on Monday afternoon: “We continue to have good-faith discussions with Saint Alphonsus Health System and remain open to renewing the contract if it’s fair to both sides. We understand that changing healthcare providers can be difficult, and we will work with our Medicare Advantage members to help them select new in-network providers to ensure their care is not interrupted. We encourage our members to call the Humana Customer Care phone number on the back of their membership card if they need personal assistance.” 

A section on Humana’s website mentions Humana’s negotiations with Trinity Health, the Michigan company that owns Saint Alphonsus.

The Humana website states that “While Humana strives to keep quality healthcare accessible and affordable, Trinity Health is making significant financial demands that will drive up patient costs.”

Cutler said Saint Alphonsus patients who have a Humana Medicare Advantage plan could pay more for care than in the past.

She urged patients to call the number on the back of their Humana card to learn about “continuity of care,” which could potentially help patients “continue in-network care at Saint Alphonsus.”

Under continuity of care, Humana members can potentially keep their previous level of coverage at Saint Alphonsus for up to 90 days after Jan. 1.

Saint Alphonsus also has a website with information about the situation — saintalphonsus.org/Humana.

According to the website, “Saint Alphonsus has been working diligently to secure a new agreement with Humana that more appropriately covers the true cost of the care we provide to patients with a Humana Medicare Advantage plan.”

Cutler said Saint Alphonsus notified patients who had Humana plans in advance that the plans would cease to be part of the network on Jan. 1.

But she said people who newly enrolled in a Humana plan during the open enrollment period in late 2024 apparently did not learn about the situation with Saint Alphonsus through Humana.

Cutler said Saint Alphonsus is part of the network for other private companies that offer Medicare Advantage plans.

According to the Kaiser Family Foundation, Medicare Advantage plans are alternatives, from private firms, to traditional Medicare, the federal health insurance program for older Americans.

In 2024 almost 33 million Medicare beneficiaries were enrolled in a Medicare Advantage plan, according to the Kaiser Family Foundation. Humana is one of the bigger providers of Medicare Advantage plans.