Which UCSF Health care professionals and facilities are impacted?

UCSF Health hospitals at Mission Bay, Mt. Zion, Parnassus, and Oakland, along with our health care professionals, depend on this agreement with Blue Shield of California to stay in-network for you. UCSF Health Community Hospitals at Saint Francis and St. Mary’s are not affected by these negotiations and will remain in-network.

Why is this happening?

UCSF, along with University of California (UC) hospitals and physician groups, has been in negotiations with Aetna for several months. Unfortunately, we have been unable to reach a fair agreement and the current contract is expected to expire. We are a non-profit organization and we use reimbursements from Aetna to provide critical health care services for its members. Aetna’s negotiating position is difficult to understand, especially when health insurance companies are making billions in revenue while hospital systems across the country continue to struggle with major financial challenges.

Which Blue Shield of California health plans are affected by the negotiations?

If a new agreement is not in place by July 1, 2025, this change would affect Blue Shield California members across plan types, including: California Public Employees' Retirement System plans Plans offered by employers Plans from the Covered California marketplace All Medicare plans offered or administered by Blue Shield of California, including but not limited to Medicare Advantage plans

I have an Anthem Blue Cross health plan. Will my coverage be affected?

No, Anthem Blue Cross is a separate organization from Blue Shield of California. Anthem Blue Cross members are not impacted.

What does this mean for Blue Shield HMO Plan Participants with a Hill Physician Medical Group Primary Care Physician or Specialist?

Visits to UCSF Medical Group and UCSF Bay Children's Physicians/UCSF Benioff Children’s Physicians (both PCPs and specialists) will remain in-network but most services at UCSF Medical Center and UCSF Benioff Children's Hospitals in Oakland and San Francisco will be deemed out-of-network by Blue Shield.

I have a Blue Shield of California PPO plan. What does this mean for me?

For now, nothing has changed. You can still see your doctor and get care at UCSF Health until July 1, 2025. We continue to do our part to negotiate in good faith in hopes of avoiding a disruption in your health care and potentially higher out-of-network financial responsibility. If your PPO plan includes out-of-network benefits, you can still receive care at UCSF; however, your out-of-pocket costs will likely be higher. Not all PPO plans offer out-of-network benefits—if your plan does not, any care you receive at UCSF after June 30, 2025, will not be covered. In that case, you would be considered a self-pay patient and may qualify for our self-pay program, which offers various discount and payment plan options. We recommend contacting Blue Shield to review the details specific to your plan and determine if you are eligible for Continuity of Care .

Blue Shield of California Insurance and UCSF Health

Published May 2025

Important Information for Patients with Blue Shield of California Insurance Plans

UC Health is continuing negotiations for a new agreement to keep our health care facilities and professionals "in network" with Blue Shield of California health plans and preserve access to care for millions of Californians.

If a new agreement isn't reached, UCSF Health — including UCSF Medical Center, UCSF Benioff Children's Hospitals in San Francisco and Oakland, UCSF Medical Group, and UCSF Benioff Children's Physicians — will be out of network for Blue Shield of California members starting July 1, 2025. This change would affect Blue Shield of California members across plan types, including:

California Public Employees' Retirement System plans
Plans offered by employers
Plans from the Covered California marketplace
All Medicare plans offered or administered by Blue Shield of California, including but not limited to Medicare Advantage plans

Please note: UCSF Health Community Hospitals at Saint Francis and St. Mary's are not affected by these negotiations and will remain in-network.

What happens next?

Nothing is changing just yet. You can still see your doctor and receive care at all UCSF Health physicians and hospitals through June 30, 2025, without any changes. You are important to us, and we look forward to remaining your health care provider.

If UCSF Medical Center, UCSF Benioff Children's Hospitals in San Francisco and Oakland, UCSF Medical Group and UCSF Benioff Children's Physicians are excluded from Blue Shield of California's network, patients with Blue Shield coverage may face much higher out-of-pocket costs—or may even lose coverage for care at certain UCSF hospitals and clinicians altogether.

If you are a Blue Shield of California HMO member with Hill Physicians Medical Group, your Primary Care Physician (PCP) will remain the same, and you will continue to retain access to most common lab and imaging services. However, referrals to UCSF specialists and hospitals may be impacted and could be considered out-of-network. We recommend speaking with your Hill Physicians PCP to obtain referrals to in-network specialists and hospitals within Blue Shield of California. Please also be aware that UCSF Medical Center and UCSF Benioff Children's Hospitals in San Francisco and Oakland will be out-of-network for most hospital services, including admissions, surgeries, infusions, dialysis, and more.

What are we doing?

We are actively engaged in negotiations with Blue Shield of California in hopes of reaching a new agreement that preserves your in-network access to UCSF Health without interruption.

What can you do?

If you have questions or concerns about this potential change, we encourage you to contact Blue Shield of California's member services using the phone number on your insurance card. We also invite you to join us in urging Blue Shield to work toward a solution that supports fair operational measures and reimbursement at levels that help ensure we can continue providing high-quality care, access to lifesaving medications and clinical programs, and support for our dedicated physicians, nurses, and care teams — while maintaining the facilities our patients rely on and support our plans to achieve the State mandated Earthquake safety seismic standards.

Frequently Asked Questions

What is happening?
UC Health is continuing negotiations for a new agreement to keep our health care facilities and professionals "in network" with Blue Shield of California health plans and preserve access to care for millions of Californians.

If a new agreement is not reached by June 30, 2025, UCSF Health's care facilities and providers; UCSF Medical Center, UCSF Benioff Children's Hospitals San Francisco and Oakland, UCSF Medical Group, and UCSF Benioff Children's Physicians, will no longer be "in network" with Blue Shield of California starting on July 1, 2025. For now, nothing is changing as we continue to try to reach a fair agreement to preserve Blue Shield of California members' access to UCSF Health care.
Which Blue Shield of California health plans are affected by the negotiations?
If a new agreement is not in place by July 1, 2025, this change would affect Blue Shield California members across plan types, including:
- California Public Employees' Retirement System plans
- Plans offered by employers
- Plans from the Covered California marketplace
- All Medicare plans offered or administered by Blue Shield of California, including but not limited to Medicare Advantage plans
Which UCSF Health care professionals and facilities are impacted?
UCSF Health hospitals at Mission Bay, Mt. Zion, Parnassus, and Oakland, along with our health care professionals, depend on this agreement with Blue Shield of California to stay in-network for you. UCSF Health Community Hospitals at Saint Francis and St. Mary’s are not affected by these negotiations and will remain in-network.
I have an Anthem Blue Cross health plan. Will my coverage be affected?
No, Anthem Blue Cross is a separate organization from Blue Shield of California. Anthem Blue Cross members are not impacted.
What does this mean for Blue Shield HMO Plan Participants with a Hill Physician Medical Group Primary Care Physician or Specialist?
Visits to UCSF Medical Group and UCSF Bay Children's Physicians/UCSF Benioff Children’s Physicians (both PCPs and specialists) will remain in-network but most services at UCSF Medical Center and UCSF Benioff Children's Hospitals in Oakland and San Francisco will be deemed out-of-network by Blue Shield.
I have a Blue Shield of California PPO plan. What does this mean for me?
For now, nothing has changed. You can still see your doctor and get care at UCSF Health until July 1, 2025. We continue to do our part to negotiate in good faith in hopes of avoiding a disruption in your health care and potentially higher out-of-network financial responsibility.

If your PPO plan includes out-of-network benefits, you can still receive care at UCSF; however, your out-of-pocket costs will likely be higher. Not all PPO plans offer out-of-network benefits—if your plan does not, any care you receive at UCSF after June 30, 2025, will not be covered. In that case, you would be considered a self-pay patient and may qualify for our self-pay program, which offers various discount and payment plan options. We recommend contacting Blue Shield to review the details specific to your plan and determine if you are eligible for Continuity of Care.

Who do I contact if I have questions that cannot be answered by these FAQs?

Contact UCSF Health at (888) 689-8273 or [email protected].

For questions about your insurance coverage, plan membership or eligibility for continuing care, we encourage you to call the toll-free telephone number on your Blue Shield membership card for assistance.