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 August 10, 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?

You can still see your doctor and get care at UCSF Health. 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, which could occur if a new agreement is not reached by August 10, 2025. 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 August 9, 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 July 2025

Important Information for Patients with Blue Shield of California Insurance Plans

UCSF Health and Blue Shield of California are continuing to work toward a new agreement that would allow UCSF providers and hospitals to remain in Blue Shield’s network.

To support these ongoing discussions, both parties have agreed to extend the current contract through August 9. This means there will be no changes to your coverage or access to UCSF Health at this time. You may continue to make appointments and receive care with your UCSF providers as usual.

We remain hopeful that we will reach an agreement that protects our ability to provide high-quality care and preserves in-network access for Blue Shield members.

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. 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 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 August 9, 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 August 10, 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 August 10, 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?
You can still see your doctor and get care at UCSF Health. 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, which could occur if a new agreement is not reached by August 10, 2025.

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 August 9, 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.