Thousands of people are at risk of losing Scripps Health doctors as Anthem’s contract negotiations close

SAN DIEGO – Thousands of Scripps Health patients with health insurance through Anthem Blue Cross may be forced to find a new doctor starting Wednesday, as time runs out for the two sides to agreement to keep Scripps doctors in the Anthem network.

Scripps hospitals and doctors can leave Anthem’s health care network if they don’t agree to the terms of the new contract before Jan. 1.

This means that thousands of patients may pay out-of-network fees, while others may be stuck looking for another health care provider.

Scripps has been sending letters to patients since October warning them of the potential change.

Scripps Health sent the following statement to CBS 8:

Scripps Health is committed to making a positive difference in the lives of the communities we serve, which is why we continue to negotiate, in good faith, to try to reach an agreement with Anthem Blue Cross.

If a new contract isn’t in place by Jan. 1, Anthem is still required by law to provide extended in-network benefit coverage for certain patients, such as those who are pregnant or receiving cancer treatment. Song is responsible for determining which patients are eligible based on the criteria. Patients should contact Anthem to learn more and apply for Continuity of Care coverage.

It’s also important to know that everyone in our community is always welcome at Scripps Health, regardless of whether or not they have an insurance plan. Emergency care is always considered online and is not affected by this change.

We understand that contract negotiations between health care providers and health plans can cause uncertainty for patients who may be affected. It is important to know that Scripps communicates with Anthem as an advocate for our patients’ interests. As a health care provider, we are here to take care of people, but we can only do that if Anthem changes their current policies that create unnecessary burdens and barriers to care. Hopefully Anthem will share our sense of urgency.

Patients are encouraged to reach out to their department of labor or benefits, or directly to Anthem, to understand how a change in their health care network may affect their access to care, to learn how how it might affect their out-of-pocket costs, and share their concerns about maintaining access to Scripps Health’s high-quality care.

Patients can visit www.scripps.org/anthem.

Anthem responded in a statement posted on its website:

Scripps Health has notified Anthem Blue Cross that it will leave our network on January 1, 2025, unless we agree to allow them to significantly increase the price they charge patients covered by Anthem’s health plans.

Anthem has been working hard for months to negotiate to keep Scripps on our network and we remain hopeful that an agreement will be reached – but we will not agree to an excessive increase in The price Scripps is currently seeking could lead to a much higher exit. – out-of-pocket costs, deductibles, and copayments for our health plan members.

At Anthem, we are always working to ensure access to high-quality, affordable health care while improving and improving the patient and provider experience as much as possible. We believe our members deserve better, and we will never stop advocating for them.

Patients are encouraged to be prepared if an agreement is not reached in time. National Senior Benefit Advisors is a San Diego agency that can help seniors get such a change free of charge.

“Basically, our process is that we discuss their different options and see what their health needs are, and hopefully choose the best plan for their situation. ,” NSBA co-founder Shaun Hunsaker told CBS 8.