Humana HMO Network Change
There is a Humana HMO network change for the Medicare Advantage insurance plans . Humana is now partnering with two different companies that provide durable medical equipment (DME) for Medicare Advantage beneficiaries. These changes will streamline providers and offer them all one source of DME, making it easier to connect people with the products they need. It is also to save Humana, and therefore the beneficiaries of their Medicare Advantage plans, money. The designated durable medical equipment providers will need to transition their existing rentals to providers that are now in-network with Humana. They will have 90 days to do so.
The press release from Humana stated that the two DME companies that they are now partnered with are AdaptHealth Corp. and Rotech Healthcare Inc. Their goal will be to help their Humana Medicare Advantage HMO beneficiaries achieve their best health at home with durable medical equipment. This is a more unified approach to sourcing DME and will allegedly provide a higher level of service to the beneficiaries who need these vital pieces of equipment for their quality of life.
Humana HMO Network Change – Impacted Items
The following bulleted lists are from the Humana press release and give a succinct grouping of what DME rentals must be transferred and which can remain un-transferred.
These DME groupings should be submitted to the designated DME provider (e.g. AdaptHealth Corp. for the Southeast Region) under this network change. Respiratory supplies are included. Beds and support services transferred. Mobility aids, including wheelchairs and standard power mobility also transfer.
What’s Not Changing
Additionally, DME suppliers who focus on the following areas are not imp acted by this change. Prosthetics, custom orthotics, and diabetic shoes remain unchanged. Mastectomy items and wigs, hearing aids, custom power wheelchairs also remain unchanged. And finally, there is no change to ostomy, urology and diabetic supplies.
With these changes in mind, what does an agent need to do now? Agents are free to reach out to their clients on a Humana Medicare Advantage HMO plan who use DME and notify them on the coming changes. Providers must take note of these changes and submit referrals accordingly when sourcing DME. These changes are effective on July 1st of 2023. The carrier itself, Humana, will be notifying its members of the coming changes as well.
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