Graves Gilbert Clinic and Humana

November 10, 2025

What You Need to Know About Graves Gilbert Clinic and Humana Insurance Plans

What Graves Gilbert Clinic is Saying

According to a letter to patients dated October 17, 2025:

Unless Graves Gilbert Clinic and Humana resolve a contractual dispute before February 1, 2026, “GGC will no longer participate as an in-network provider for Humana Medicare Advantage and Humana Medicare plans.”

Who is NOT Affected

You are not affected if you have any of the following:

• Original Medicare (Part A & B) only
• Humana Medicare Supplement (Medigap) plans
• Humana Prescription Drug Plans
• Medicare Advantage plans from companies other than Humana
• Commercial or employer-based Humana plans (including KTRS and KPPA)
• No current or future Graves Gilbert providers

Who IS Affected

You are affected if you have Graves Gilbert providers you see or want to see and have:

• A Humana Individual Medicare Advantage plan (HMO or PPO), or
• A Humana Medicaid plan

If You Have a Humana Individual Medicare Advantage HMO

1. Humana HMO plans only pay for in-network services.
2. Keeping your Humana HMO and your GGC providers will increase your out-of-pocket costs after February 1, 2026.
3. To switch plans for a January 1, 2026 effective date, changes must be made by December 7, 2025.

If You Have a Humana Individual Medicare Advantage PPO

1. Your GGC providers will no longer be in-network.
2. PPO plans provide the best cost savings for in-network care.
3. You may continue seeing GGC providers but will pay out-of-network costs.
4. Using out-of-network providers will increase your maximum out-of-pocket costs and financial risk.
5. Keeping your Humana PPO and GGC providers will increase your out-of-pocket costs after February 1, 2026.
6. To change your PPO plan for a January 1, 2026 effective date, you must do so by December 7, 2025.

If You Have a Humana Medicaid Plan

• Other Managed Care Organizations (MCOs) administer Medicaid benefits and participate with Graves Gilbert Clinic.
• You may be able to switch to another MCO that includes GGC providers.

How McCay & Associates Insurance Can Help

• Our agents can review all Medicare Advantage and Medicaid plans available in your ZIP code.
• We can help you compare your current plan and available options so you can determine the best choice for you.

Questions?
Call McCay & Associates Insurance at 270-842-4236. Our team is here to help you understand your options and avoid unexpected costs.