Written by Franklin County’s Medicare Advantage market is built around three competing hospital systems — OhioHealth, Mount Carmel Health System, and The Ohio State University Wexner Medical Center — and a major network change taking effect this fall makes 2026 a genuinely more important year than usual to check your plan carefully before assuming last year’s coverage still works the same way.
The Network Change Every Ohio State Patient Should Know About
Humana is ending its Medicare Advantage contract with The Ohio State University Wexner Medical Center, The James Cancer Hospital, and Ohio State-affiliated physicians, effective October 1, 2026. The original agreement, first signed in 2020, gave Humana Medicare Advantage members in-network access to all Wexner Medical Center facilities, numerous outpatient locations, and nearly 3,000 physicians across Ohio State’s physician network spanning eight central Ohio counties. That entire access arrangement changes on October 1 for anyone still enrolled in an affected Humana plan. If you’re a Humana Medicare Advantage member and see any Ohio State-affiliated provider — including specialists at The James — this is genuinely worth confirming directly rather than assuming your coverage carries over unchanged.
The Annual Enrollment Period, October 15 through December 7, is your main opportunity to switch plans for the following year. If you’re already enrolled in a Medicare Advantage plan and miss that window, the Medicare Advantage Open Enrollment Period, January 1 through March 31, still allows one additional switch.
Three Systems, Three Different Networks
OhioHealth is the largest system by revenue in central Ohio, operating a broad network of hospitals and outpatient locations across Franklin County and beyond. Mount Carmel Health System operates four hospitals — Mount Carmel East, West, St. Ann’s, and New Albany — along with its own Medicare Advantage plan built specifically around its own network, a genuinely distinctive option in this market. Ohio State’s Wexner Medical Center anchors academic and specialty care, including The James Cancer Hospital, and is in the process of opening a new 26-story inpatient tower in 2026, the largest construction project in Ohio State’s history. The three systems don’t fully overlap, and it’s genuinely common in Columbus for a patient to have a primary doctor at one system and a specialist at another — exactly the kind of split care a Medicare Advantage plan built tightly around a single network can leave exposed.
If You Have a Medicare Supplement, This Change Doesn’t Touch You
Worth saying plainly: if you have Original Medicare paired with a Medicare Supplement plan rather than a Medicare Advantage plan, the Ohio State network change doesn’t affect you at all. Supplement plans work alongside Original Medicare, which is accepted by OhioHealth, Mount Carmel, and Ohio State alike, along with any other provider nationwide who accepts Medicare — there’s no network to lose access to in the first place. For Franklin County residents whose care is genuinely split across multiple systems, or who’d rather not think about network contracts changing again next year, this is exactly the kind of situation that makes a Supplement plan worth a serious look.
HMO vs. PPO: The Real Difference in This Market
Medicare Advantage HMO plans generally require you to stay inside the plan’s network and usually need a referral to see a specialist. PPO plans allow you to go outside the network, typically at a higher cost, without a referral. In a three-system market like Columbus, that distinction carries real weight: an HMO built around OhioHealth’s network won’t do you much good if your specialist is at Mount Carmel or Ohio State. If your care is genuinely split across systems, a PPO’s added flexibility is usually worth its higher premium.
Top Carriers Serving Franklin County
Aetna, Anthem Blue Cross Blue Shield, AARP/UnitedHealthcare, Medical Mutual of Ohio, and Mount Carmel’s own Medicare Advantage plan all compete in the Columbus market, alongside Humana plans that, as of October 2026, no longer include Ohio State’s Wexner Medical Center in their network here. Plan availability shifts by ZIP code within the county, and which carriers actually include your specific doctors depends heavily on which hospital system those doctors belong to.
Understanding Medicare Star Ratings
Medicare rates every Medicare Advantage plan on a 5-star scale annually, based on member satisfaction, customer service, and health outcomes. Network fit and drug coverage for your specific situation still come first, but between two plans that both check those boxes, the star rating is a genuinely useful tiebreaker — plans holding a consistent 4-star rating or higher tend to see fewer member complaints and smoother claims handling, which matters more than usual this year given the reason cited for the Ohio State and Humana contract ending.
Extra Benefits Worth Comparing Closely
Dental, vision, and hearing benefits vary considerably between Medicare Advantage plans in this market — some cover only a basic annual exam, while others include a real allowance toward dentures, glasses, or hearing aids. Many Franklin County plans also include an over-the-counter allowance, a fitness benefit like SilverSneakers, or transportation assistance to medical appointments. These extras are worth comparing item by item rather than assuming “dental and vision included” means the same coverage from one plan to the next.
A Client Example
A Columbus client enrolled in a Humana Medicare Advantage plan came to us after hearing about the Ohio State network change secondhand from a neighbor, unsure whether it actually applied to her. It did — her oncologist at The James Cancer Hospital would no longer be covered as in-network starting October 1. We compared her options during the Annual Enrollment Period and helped her move to a plan that kept her full care team in-network, without disrupting treatment she’d already built a relationship around over several years.
What to Check Before You Choose
- Whether Ohio State’s Wexner Medical Center and any specific doctors you see there are actually in-network for the plan you’re considering, given the October 2026 Humana change
- Whether your regular prescriptions are covered on the plan’s drug formulary, and at what tier
- Whether an HMO’s lower cost and network restriction fits your situation, or a PPO’s added flexibility is worth the higher premium
- Whether Mount Carmel’s own Medicare Advantage plan is worth comparing directly against national carriers for your specific doctors
Special Needs Plans: A Less-Known Option
Beyond standard HMO and PPO Medicare Advantage plans, some Franklin County residents may qualify for a Special Needs Plan (SNP) — built for people with certain chronic conditions, those who qualify for both Medicare and Medicaid, or those in an institutional care setting. SNPs often include care coordination and benefits tailored to the qualifying condition, but eligibility is specific. Worth asking about if any of these situations apply to you or a family member.
Frequently Asked Questions
Is it true Ohio State’s Wexner Medical Center is dropping out of Humana’s network?
Yes. Humana is ending its Medicare Advantage contract with Ohio State’s Wexner Medical Center, The James Cancer Hospital, and affiliated physicians effective October 1, 2026. If you’re enrolled in a Humana Medicare Advantage plan and see an Ohio State provider, your in-network access changes on that date.
Can I still switch plans if I missed the Annual Enrollment Period?
Yes, if you’re already enrolled in a Medicare Advantage plan. The Medicare Advantage Open Enrollment Period, January 1 through March 31, allows one additional switch to a different Medicare Advantage plan or back to Original Medicare.
Do I need a different plan if my doctors are split between OhioHealth, Mount Carmel, and Ohio State?
Not necessarily, but it’s exactly the kind of situation worth checking carefully — a PPO plan or a broader-network option may fit better than an HMO built tightly around just one of the three systems.
Is a Medicare Advantage plan cheaper than Original Medicare plus a Supplement?
Usually lower in monthly premium, sometimes $0, but with more variable out-of-pocket costs and a network to work within. Original Medicare plus a Supplement typically costs more monthly but offers predictable costs and access to any doctor who accepts Medicare, including all three Columbus hospital systems without a network distinction.
Do Medicare Advantage plans in Franklin County include prescription drug coverage?
Most do, bundled directly into the plan. Confirming this and checking your specific medications against the plan’s formulary is one of the first things worth verifying before enrolling.
Once You’ve Chosen a Plan
Enrolling doesn’t end the relationship with your agent — network contracts, formularies, and coverage details can and do change year to year, as the Ohio State situation makes clear. A good agent checks in with you at least annually rather than only at the moment of enrollment. We track when each client’s plan is up for its yearly review and reach out proactively, rather than waiting for a network change to surprise you mid-year.
More on Serving Columbus and Franklin County
For a broader look at Medicare help across the Columbus area beyond just Medicare Advantage — including Supplement options and answers to common local questions — see our full Columbus Medicare guide.
Want to know exactly which Medicare Advantage plans still include your doctors in Franklin County? Talk with our Columbus Medicare team — there’s no cost and no obligation, and no pressure to enroll in anything on the spot.
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