Medicare Advantage in Columbus, Ohio: What the Ohio State/Humana Network Change Means for You

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 network change that took effect on October 1, 2026 makes this Annual Enrollment Period (October 15 through December 7, for coverage starting January 1, 2027) a genuinely more important time than usual to check your plan carefully before assuming this year’s coverage still works the same way.

The Network Change Every Ohio State Patient Should Know About

Humana’s individual Medicare Advantage plans went out of network with The Ohio State University Wexner Medical Center, The James Cancer Hospital, and Ohio State-affiliated physicians on October 1, 2026, after Humana terminated that contract. The original agreement, announced in 2020, gave Humana Medicare Advantage members in-network access to all Wexner Medical Center facilities, numerous outpatient locations, and nearly 3,000 physicians in Ohio State’s physician network, which spans eight central Ohio counties. The change applies to individual Medicare Advantage plans, meaning plans you enrolled in on your own rather than through an employer or retiree program. According to Ohio State and Humana, Humana’s Medicaid and group Medicare Advantage plans stay in network. Ohio State says patients with an affected plan have a continuity-of-care period through December 31, 2026 to keep receiving care at in-network rates, and that starting January 1, 2027, anyone with a Humana individual Medicare Advantage plan who wants to keep receiving care at Ohio State must switch plans. If you have a Humana Medicare Advantage plan and see any Ohio State-affiliated provider — including specialists at The James — confirm your plan type directly with Humana and Ohio State 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 2027, and plans you choose by December 7 start on January 1, 2027. 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 change, either to a different Medicare Advantage plan or back to Original Medicare.

Three Systems, Three Different Networks

OhioHealth is one of the largest systems 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, Grove City, St. Ann’s, and New Albany — and sponsors its own Medicare Advantage plans, sold as Mount Carmel MediGold, a distinctive option in this market. Ohio State’s Wexner Medical Center anchors academic and specialty care, including The James Cancer Hospital, and opened a new 26-story inpatient tower, University Hospital, on February 22, 2026, which Ohio State describes as the largest single-facility construction project it has ever undertaken. The three systems don’t fully overlap, and it’s not unusual 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. One tradeoff to weigh: outside your Medigap Open Enrollment Period, switching from Medicare Advantage to a Supplement generally involves medical underwriting in Ohio unless you qualify for a guaranteed-issue right, and Ohio has no birthday rule that opens a yearly window.

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 may be worth a higher premium, though a PPO doesn’t guarantee that any particular hospital is in network either.

Top Carriers Serving Franklin County

Carriers that have offered Medicare Advantage plans in the Columbus market include Aetna, Anthem Blue Cross Blue Shield, AARP/UnitedHealthcare, Humana, Medical Mutual of Ohio, and Mount Carmel’s own MediGold plans. Plan availability shifts by ZIP code within the county, and which plans actually include your specific doctors depends heavily on which hospital system those doctors belong to. Ohio State publishes its own list of Medicare Advantage plans that cover care there. As of November 2026, its list for 2027 includes many Aetna plans, MedMutual Advantage plans, Mount Carmel MediGold plans, and The Health Plan plans, shows Humana only for employer-sponsored (group) Medicare plans, and does not list any AARP/UnitedHealthcare plan; its sample list of plans it does not accept includes Anthem Medicare Advantage HMO/PPO and UnitedHealthcare HMO Medicare Advantage. Ohio State notes that these lists are subject to change, and we have not checked OhioHealth’s or Mount Carmel’s plan lists for 2027, so confirm each doctor and hospital in the plan’s current provider directory before you enroll.

Understanding Medicare Star Ratings

Medicare rates Medicare Advantage plans on a 5-star scale every year, using measures such as member satisfaction, customer service, and health outcomes, and updates the ratings each fall. A star rating says nothing about whether your doctors or hospital are in a plan’s network, so network fit and drug coverage for your specific situation still come first. Between two plans that both check those boxes, the star rating can be a useful tiebreaker.

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 for 2027, given that Humana’s individual plans went out of network on October 1, 2026
• 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. In Franklin County, Ohio’s Next Generation MyCare program has offered integrated plans for people with both Medicare and full Medicaid since January 1, 2026; the state lists the eligibility requirements as full Medicaid, Medicare Parts A, B and D, and age 21 or older. Networks differ by plan, so check your doctors and hospital for the specific plan. For example, Ohio State’s own list shows some MyCare plans in network and others out of network as of January 1, 2026. Worth asking about if any of these situations apply to you or a family member.

Frequently Asked Questions

Is Ohio State’s Wexner Medical Center still in Humana’s Medicare Advantage network?

For individual Humana Medicare Advantage plans, no. Humana’s individual Medicare Advantage plans went out of network with Ohio State’s Wexner Medical Center, The James Cancer Hospital, and affiliated physicians on October 1, 2026. Humana’s Medicaid and group Medicare Advantage plans remain in network. If you have an individual Humana plan and see an Ohio State provider, Ohio State says a continuity-of-care period runs through December 31, 2026, and you would need to switch plans to keep using Ohio State on January 1, 2027 and after.

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 change to a different Medicare Advantage plan or back to Original Medicare, but not adding a stand-alone Part D plan. Right now, the Annual Enrollment Period for 2027 coverage is still open through December 7, 2026.

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.