Anthem Health Insurance and UCSF Health
Important information for patients with Anthem Blue Cross Health Insurance Plans
Anthem has terminated its agreement with UC Health, including UCSF Health and UCSF Benioff Children's Hospitals, effective December 31, 2023. If a new agreement is not in place by December 31, 2023, Anthem will consider UCSF Health out of network beginning January 1, 2024, for the following Anthem-covered patients:
- Patients who selected an Anthem plan through the California Public Employees' Retirement System
- Commercially insured patients, including those with employer-sponsored health plans and those who purchased an Anthem plan on the ACA Health Insurance Marketplace
- Patients with Medicare Advantage plans administered by Anthem
- Patients with Medi-Cal (managed Medicaid) plans administered by Anthem
What does this mean for UCSF Health Patients?
If UCSF Health is excluded from Anthem's network beginning on January 1, 2024, patients with Anthem health plans could face significantly higher out-of-pocket expenses – or Anthem may no longer cover their health care costs through UCSF Health at all.
You can still see your doctor and get treatments at UCSF Health and UCSF Benioff Children's Hospitals without any changes until December 31, 2023.
What are we doing?
We are in active negotiations with Anthem to secure a new agreement before the end of the year. A new agreement would allow you to continue to receive health care from us without interruptions or added costs. UCSF Health needs a fair agreement with Anthem to maintain the standard of care you rely on. As a trusted local care provider, we have a responsibility to ensure we are in the best position to provide high-quality care to our patients and community members. We are urging Anthem to protect the care you deserve.
What can you do?
Although nothing is changing before January 1, 2024, you may have the option to select an alternate benefit plan during your open enrollment period to ensure you can continue to access care from UCSF Health and avoid potentially increased co-pays and disruptions in 2024.
For a list of the health insurance plans UCSF Health will be in network with for the 2024 benefit year, please visit our Billing and Insurance page.
Frequently Asked Questions (FAQs) for patients with Anthem
- What is happening?
Anthem Blue Cross has terminated its agreement with UC Health, effective December 31, 2023, jeopardizing in-network access to care for millions of Californians at UCSF Health and all UC Health locations across the state. UCSF Health is working toward a new agreement with Anthem that covers the exceptional care we provide to Californians covered by Anthem.
- When does the current in-network agreement with Anthem end?
Our agreement expires after December 31, 2023.
- Which Anthem health plans are affected by the negotiations?
The following patients are impacted by the negotiations:
- People who selected an Anthem plan through the California Public Employees' Retirement System
- Commercially insured patients, including those with employer-sponsored health plans and those who purchased an Anthem plan in the Covered California marketplace
- Individuals with Medicare Advantage plans administered by Anthem
- Individuals with Medi-Cal (managed Medicaid) plans administered by Anthem
- Which UC health care professionals and facilities are impacted?
All UC Health hospitals, including UCSF Health and UCSF Benioff Children's Hospitals, facilities and health care professionals rely on this agreement with Anthem to remain in network for you.
- I have an Anthem plan. What does this mean for me?
For now, nothing changes. You can still see your doctor and get care at a UCSF Health facility until December 31, 2023, without any changes. Due to Anthem's decision to terminate our contract, we cannot guarantee you will have this same access to in-network care after December 31, 2023. Despite their decision to terminate before our negotiations had even begun, we continue to make it clear that we are prepared to negotiate in good faith in hopes of avoiding a disruption in your healthcare and potentially higher out of network charges.
- What if I have an appointment with a UCSF Health provider or facility before January 1, 2024?
Care you receive at UCSF Health before January 1, 2024 will still be considered in-network by Anthem.
- What should I do if I am an Anthem member and have an appointment scheduled on or after January 1, 2024? Can I still see my doctor?
At the time, we recommend that you keep your appointment. We're hopeful that we will be able to reach a fair agreement with Anthem before the end of the year. UCSF Health is committed to ensuring you have access to care, and we encourage you to keep your appointment. However, it's important to understand that Anthem's decision to terminate our contract means you may be responsible for higher out of pocket costs by being out of network or Anthem may not cover any part of your care at all for care that is provided once UCSF Health is out of network.
We know that many Anthem members are in critical stages of health care with UCSF Health. UCSF Health is committed to working with all our patients to ensure you are provided all available options to continue your care with us.
- Can UCSF Health recommend a specific insurance plan that will be in network for 2024?
We have reached agreements with several insurance plans to be in network for 2024. To view the complete list, visit here.
- What can Anthem members do?
Many employers hold their Open Enrollment periods in the fall when you may be able to make changes to your health insurance plan. You can consider your options during Open Enrollment and look for another plan that ensures you can continue to receive care from UCSF Health in 2024.
- Does this apply to current UCSF and UCSF Health faculty, students, retirees or employees?
No. UCSF and UCSF Health faculty, employees (including Benioff Children's Hospital Oakland), retirees and UCSF students have a separate agreement with Anthem. This contract is not impacted by Anthem's decision to cancel its contract with UC Health.
- What if I'm an Anthem member but I didn't receive a letter from UCSF Health?
We're in the process of notifying our patients about Anthem's termination now so they can make an informed decision during their open enrollment periods. You may still receive a message from UCSF Health. Even if you did not receive a message and are an Anthem member in one of the categories above, this termination will apply to you, and you should plan accordingly.
- What is UCSF doing to resolve this issue and negotiate with Anthem?
We are in active negotiations with Anthem in hopes of reaching a new agreement before the end of the year. This would allow you to continue to receive health care from us without interruptions or added costs.
- Why is it important for UCSF Health to have an agreement with Anthem?
Contracts with insurance companies like Anthem ensure that UCSF Health receives fair payment for the services we provide to patients with Anthem insurance. Anthem is using its strength and size to demand unfair terms for our services, even as it consistently raises the cost of premiums for its members and reports record profits for shareholders. As one of the region’s most vital health care resources, UCSF Health needs a fair agreement with Anthem to maintain the standard of care that our patients rely on for their health. The exclusive mission of UCSF Health is to serve the health of Californians, and we continue to make investments in our facilities, our physicians and our staff to expand vital clinical services, improve patient access, and make care more convenient for our community.
We want to help you understand what is happening and what you can do to make sure your care at UCSF Health continues. Should you have any questions or concerns, please reach out to us at (888) 689-8273 or [email protected].