Important Update for Patients with Humana Insurance

Effective May 1, 2025

Despite extensive efforts, Commonwealth Pain & Spine was unable to reach a new agreement with Humana. As a result, beginning May 1, 2025, we will no longer be in-network with Humana Medicare Advantage and Humana Healthy Horizons Medicaid plans in Kentucky and Indiana. 

We understand this change may affect your care, and we are here to help you understand your options.

Note: This change does not affect patients in North Carolina, South Carolina, or Illinois

Please read the following to find information regarding your specific plan:

Humana Medicare Advantage PPO Plans

Commonwealth Pain & Spine will continue accepting patients with Humana Medicare Advantage PPO plans after May 1, 2025.

As a result:

• New patient referrals with Humana Medicare PPO coverage will still be accepted.
• Patients may continue care under out-of-network benefits.
• Patients who wish to continue using in-network benefits, Commonwealth will    submit a Continuity of Care (COC) form for approval. 

If the COC is approved, in-network coverage can continue through July 31, 2025. After that date, patients may continue care using out-of-network benefits, but out-of-pocket costs may increase slightly depending on your plan.

For assistance or questions about your coverage, please contact Humana Customer Care at 800-457-4708.

Humana Healthy Horizons Kentucky Medicaid

Commonwealth Pain & Spine is no longer contracted with Humana Kentucky Medicaid as of May 1, 2025. While we have made efforts to support our patients through this transition, please be advised that effective July 31, 2025, we will no longer be able to see patients who continue to have active coverage with Humana Healthy Horizons Medicaid.

If you currently have an upcoming appointment scheduled on or after August 1, 2025, or plan to schedule one in the future, you will first need to switch to a different Medicaid Managed Care Organization (MCO) with which we are in-network. We will be unable to schedule or provide care to any patients who remain with Humana Healthy Horizons Medicaid after this date.

To continue your care with Commonwealth Pain & Spine, please contact Kentucky Medicaid Member Services at 1-800-635-2570 to explore your options for switching plans. Medicaid has specific rules that may apply depending on your situation, so it is important to discuss your eligibility to change MCOs with a representative.

We are currently in-network with the following Kentucky Medicaid plans:

• Passport by Molina
• Aetna Better Health
• WellCare
• UnitedHealthcare Community Plan

If you are unable to switch your Medicaid plan, you will need to seek pain management services at another clinic that is contracted with Humana Healthy Horizons Medicaid.  If you are having trouble with your plan or accessing care, you may also file a formal complaint with Kentucky Medicaid.

For further assistance, you may also contact:

• KY Medicaid Member Services (Cabinet for Health and Family Services): 1-800-635-2570
• Commonwealth Pain & Spine Humana hotline – (502) 409-7502
• Humana KY Medicaid Member Services: 1-800-444-9137

We want to emphasize that we deeply regret this change. We value you as our patient and this decision does not reflect our commitment to your health and well-being. We are still hopeful that we will reach an agreement with Humana but unfortunately at this time we are unable to do so. We are here to support you during this transition and will do our best to help guide you through the next steps.

Humana Medicare Advantage HMO Plans

Effective May 1, 2025, Commonwealth Pain & Spine will no longer accept new patient referrals for individuals covered by Humana Medicare Advantage HMO plans.

As a result:

• All new patient appointments scheduled on or after May 1, 2025, for Humana Medicare HMO members will be canceled.
• Established patients may continue care only if a Continuity of Care (COC) form is submitted and approved.

An approved COC allows patients to continue receiving in-network coverage through July 31, 2025. Without a COC form on file, HMO members will be responsible for 100% of care costs, as these plans do not offer out-of-network benefits.

Some patients may be eligible to extend their COC approval beyond July 31, 2025. For questions or assistance, please contact Humana Customer Care at 800-457-4708.

How We Can Support You

We understand these changes may be difficult, and we are committed to helping you through this transition.

• If you are unsure of your plan type or benefits, please contact our office.
• If you need assistance completing or submitting a Continuity of Care form, we can help.
• If you are considering switching plans, we can provide information to support your decision.

Please call us at (502) 409-7502 or send a message through our Patient Portal if you have questions. Additional updates will be posted on our website.

Thank you for trusting Commonwealth Pain & Spine. We remain committed to your care and well-being.