St. Luke’s leaving Humana Medicare Advantage network raises local concerns

St. Luke’s Health System announced it would be out-of-network for Humana Medicare Advantage plans beginning Jan. 1, 2026. The move does not bar Humana members from receiving care at St. Luke’s facilities, but it can increase their out-of-pocket costs when those hospitals are no longer in the insurer’s network.

For Baker County, the change matters because many local Medicare Advantage enrollees use providers outside the county for specialty care. Centers for Medicare and Medicaid Services data show about 679 Baker County residents were enrolled in Medicare Advantage plans as of September 2025. Those residents who routinely travel to Boise for cardiology, oncology, or other specialty services at St. Luke’s may see higher copays, coinsurance or unexpected bills if services are billed as out-of-network.

Local context provides some mitigation. Saint Alphonsus, which owns the Baker City hospital, returned Humana to its network, leaving a primary local hospital available to Humana members with in-network coverage. That continuity will help many residents who receive their care close to home, but it does not replace specialty services available only in larger regional centers.

The St. Luke’s change reflects a broader trend of hospitals and health systems renegotiating relationships with Medicare Advantage plans, a dynamic driven by disputes over contract rates, payment models and care management. For rural communities this negotiating churn can magnify longstanding barriers: limited local specialty providers, longer travel times, and greater financial vulnerability among older adults who often live on fixed incomes.

Practical implications for Baker County residents include verifying provider network status before scheduling appointments, asking providers and insurers for cost estimates in writing, and exploring whether planned services can be provided locally at Saint Alphonsus or other in-network facilities. Beneficiaries who face unexpected bills should contact their Medicare Advantage plan to contest charges or request prior authorization information.

Policy questions underlie the immediate financial concerns. As private Medicare Advantage plans expand their role in Medicare, contracting disputes between insurers and health systems can shift costs onto patients and strain rural health access. That pattern raises equity concerns for older adults in Baker County and other rural areas who already disproportionately contend with transportation, mobility and income limitations.

Health officials and elected leaders in Baker County may need to monitor how these network changes affect appointment patterns, emergency transfers and uncompensated care at local facilities. For now, residents with Humana Medicare Advantage coverage should confirm network status for any out-of-area care and prioritize in-network options where possible to limit unexpected costs.