When Humana first announced it was heading toward a network split with Ohio State, most of the attention went to Medicare Advantage retirees who could lose access to the Wexner Medical Center. That framing left out a second, larger group facing the same October 1 deadline: Ohioans covered by Humana Healthy Horizons, the company’s Medicaid managed care plan. Humana’s own statement on the dispute names both groups side by side, and for Medicaid members, there is typically less financial cushion to absorb a sudden switch in doctors.
Humana Healthy Horizons Medicaid Members Are Losing Access Too
Humana’s newsroom statement is direct about who is affected: “Affected Humana Medicare Advantage and Humana Healthy Horizons Medicaid members have been notified of this network change.” Humana Healthy Horizons is the company’s Medicaid managed care plan in Ohio, contracted with the state to cover residents who qualify for Medicaid based on income, along with pregnant individuals, infants, children, adults over 65, and people with disabilities. Those members now face the same October 1 network change as Humana’s Medicare Advantage enrollees, even though Medicaid coverage works under different rules and typically leaves members with fewer out-of-network options to fall back on.
That distinction matters for how much this disruption actually costs a household. A Medicare Advantage member who goes out-of-network often faces a higher copay or coinsurance bill rather than losing coverage outright. A Medicaid managed care plan, by contrast, is frequently built around a defined network with little or no out-of-network benefit at all, since the whole point of the managed care contract between Humana and the state is to steer members to providers the plan has already agreed to pay. For a Medicaid household with little financial cushion, an out-of-network Wexner visit after October 1 could mean the full cost of care falls on the patient rather than being partly covered.
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What Ends at Ohio State’s Wexner Medical Center on October 1
According to Humana’s statement, The Ohio State University Wexner Medical Center, The James Cancer Center, and OSU-affiliated physicians will become out-of-network for Humana members starting October 1, 2026. That covers a broad slice of central Ohio care: Wexner’s hospital campuses, its cancer treatment center, and the physicians who practice under the OSU Physicians network. Once the date passes without a new agreement, routine visits, specialist care, and non-emergency procedures at those locations would generally be billed at Humana’s out-of-network rate, which for a Medicaid managed care plan can mean the visit isn’t covered at all rather than simply costing more.
Why the Contract Talks Between Humana and Ohio State Stalled
Humana’s own FAQ addresses why no deal has been reached, stating that the company “remains open to good-faith discussions with The Ohio State University” and is “open to renewing the contract, permitting both parties to continue focusing on keeping healthcare costs affordable for our members.” That is a common framing in provider-payer disputes: each side blames the other’s terms for the impasse, while the actual sticking points, typically reimbursement rates, are rarely spelled out publicly. What’s notable here is that the same contract covers both the Medicare Advantage and Medicaid lines of business, so a resolution on one plan type would likely resolve the network status for both at once.
What Continuity-of-Care Protections Look Like
Humana says it will offer continuity-of-care support to help members transition to in-network providers, and that members with certain medical conditions may qualify to keep seeing their current Wexner-affiliated provider at the in-network benefit level for a limited period even after October 1. Humana also says any true medical emergency is covered at the in-network rate regardless of which hospital a member goes to. Those protections exist, but they are not automatic for every appointment; Humana’s FAQ frames continuity of care as something members qualify for based on their specific treatment, not a blanket extension for anyone with a Wexner doctor.
What Medicaid Members Should Do Before October 1
Unlike Medicare Advantage, which has a defined annual enrollment window, Ohio Medicaid managed care members can request a plan change outside of a strict once-a-year period when a network disruption like this affects their care. The Ohio Medicaid Consumer Hotline, the state’s official enrollment resource, lists Humana Healthy Horizons among several Medicaid managed care plans operating in Ohio, alongside other insurers members can transfer to, and it helps members compare and switch between them. Members can call to ask whether their situation qualifies for a plan change tied to this specific network loss, and to check whether a different Medicaid managed care plan already includes Wexner and OSU Physicians in its network before deciding whether to switch. Members who want to stay with Humana but need continuity-of-care consideration should also call the number on the back of their Humana Healthy Horizons ID card well before October 1, since Humana has said that determination is handled case by case rather than automatically. More detail on what the plan covers and how to reach its member support line is available on Humana’s own Ohio Medicaid program page.
This article was produced with AI assistance and reviewed by a human editor. Figures are linked to their primary sources; where a claim could not be verified from the public record, we say so.
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