Update Regarding First Physicians Group and Humana Health Insurance Plans
Effective Jan. 1, 2025, First Physicians Group will no longer participate with Humana insurance, and FPG will be removed from Humana’s network of healthcare providers. We understand Humana network members may have questions and concerns. Below, you will find information and additional contacts to help answer questions and guide you through this change.
Frequently Asked Questions
Which Humana plans are affected by the pending change?
The pending change applies to all Humana health plans, which includes Humana Medicare Advantage, Humana Medicaid and Humana commercial/employer group plans.
The pending change does NOT affect patients with traditional Medicare and Medicare Supplemental plans.
What happens in an emergency?
In emergency situations, out-of-network charges do not apply. Anyone requiring emergency care has the right to seek care at Sarasota Memorial’s three Emergency Care Centers (Sarasota, Venice and North Port). In addition, our freestanding ER in Lakewood Ranch is slated to open later this year.
What if I’m pregnant or undergoing treatment for serious illness or injury?
We will do everything we can to support and ensure continuity of care for patients currently under care with an FPG provider. Members undergoing care from an FPG provider that should not be interrupted or delayed, such as obstetrical care or cancer care, have the right to request that Humana continue to cover their services at FPG as an “in-network” provider. In such cases, we can help them request a “continuity of care” authorization from Humana.
How serious is this situation?
It is important to note this change is not due to a contract negotiation or termination. The change is part of Sarasota Memorial Health Care System’s ongoing efforts to make sure insurances accepted by SMH and its subsidiary, First Physicians Group, are aligned, so that patients seeking care from an FPG provider can receive care ordered by their FPG provider at SMH facilities if they need to be admitted or undergo further testing or procedures. As you may recall, Sarasota Memorial’s contract with Humana expired in 2019, and at that time, SMH and its outpatient/urgent care centers became out-of-network providers for members of Humana’s health insurance network, including commercial/employer group, Medicare Advantage and Medicaid health plans.
Is there anything I can do to keep my FPG physician/care providers?
Our highest priority is ensuring our community has access to high quality, reliable health care, and we are now focused on providing Humana members with information that will help them plan for their future medical needs.
Humana members who have been patients of FPG in the last two years were mailed a letter on Sept. 27, 2024 notifying them of the pending change and providing a list of health insurers that First Physicians Group has participating provider agreements as of Jan. 1, 2025.
For Medicare-eligible patients and those with Humana’s Medicare Advantage plans, open enrollment begins soon. Below you will find a link to a list of insurances with which FPG will have contracts effective Jan. 1, 2025.
Health Insurances Accepted as of January 1, 2025
For information about insurance plans accepted by First Physicians Group as of Jan. 1, 2025, please go to www.firstphysiciansgroup.com/insurance.
This is not a solicitation. This information is intended to help patients make informed decisions about their health and well-being and to update previous communications from First Physicians Group.
Contact Information
If you have questions about whether you qualify for in-network coverage for continued care and services, please contact Humana (their number should be on your health insurance card).
If you have questions about how this impacts care provided by your FPG physician, please contact our central office at (941) 917-2600, weekdays 8:30 a.m.-5 p.m. Our team will provide any assistance we can to ensure you have uninterrupted access to high-quality care.