Anthem has terminated its agreement with UC Health, including UCR Health, jeopardizing in-network access to care for millions of Californians. If a new agreement is not in place by December 31, 2023, UCR Health will be considered 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
- Patients who selected an Anthem plan through their employer
- Patients who purchased an Anthem plan in the Covered California marketplace
- Patients with Medicare Advantage plans administered by Anthem
- Patients with Medi-Cal plans administered by Anthem
- UC medical residents and fellows who are enrolled in the Anthem HMO plan
This termination does not affect the in-network availability of UC Health facilities and providers for UC employees UC students with UC SHIP coverage, UC medical residents and fellows in the PPO plan or UC retirees. Their health plans are governed by separate UC-Anthem agreements.
What Does This Mean?
If UCR 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 even find that Anthem will no longer cover their health care costs through UCR Health at all.
You can still see your doctor and get treatments at UCR Health until December 31, 2023 without any changes. You are important to us, and we look forward to continuing to serve you with exceptional care.
What Are We Doing?
In the months ahead, we will negotiate with Anthem in an effort 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. 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. UCR Health needs a fair agreement with Anthem to maintain the standard of care you rely on. We are urging Anthem to protect the care you deserve.
What Can You Do?
Although nothing is changing before January 1, 2024, you can look for an alternate plan during your open enrollment period to ensure you can continue to access care from UCR Health and avoid potentially increased co-pays and disruptions in 2024:
- The CalPERS open enrollment period runs from September 18 through October 13, 2023. You can use this time to evaluate other plan options.
- If you are a patient with a Medicare Advantage, you may choose to consider your options during your open enrollment period beginning October 15.
- People with Medi-Cal coverage can change plans at any time if there are other plans available in your country.
- People who purchase their health plan through Covered California can review plan choices during open enrollment from November 1 through January 31.
- Anthem patients who get their insurance from their employer typically have open enrollment periods in the Fall during which they can review health plan options.
UCR Health is in network with the following health insurance plans for the 2024 benefit year:
- Aetna
- Blue Shield
- Cigna
- Cigna Behavioral Health
- Coventry Healthcare
- Health Net
- Magellan Health Services
- Managed Health Service
- MultiPlan/PHCS
- US Behavioral Health Plan/Optum
- United Healthcare
- Medicare
- Medi-Cal
- IEHP
- TriCare
- TriWest
- (OptumCare) PrimeCare Medical Network, Inc.
- Aligned Community Physicians Medical Group
- All United Medical Group IPA, Inc.
- Alpha Care Medical Group
- HealthCare Partners Affiliates Medical Group
- LaSalle Medical Associates
- Desert Oasis Healthcare (pediatric services only)
- Regal Medical Group and Lakeside Medical Org, a Medical Group, Inc.
- Riverside Medical Clinic, Inc.
COMMON QUESTIONS
If you have a question that’s not answered below, please contact us at [email protected].
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 UCR Health and all UC Health locations across the state. UCR Health is in negotiations for a new agreement with Anthem that covers the exceptional care we provide to Californians covered by Anthem.
Our agreement expires after December 31, 2023.
The following patients are impacted by the negotiations:
- Patients who selected an Anthem plan through the California Public Employees’ Retirement System
- Patients who selected an Anthem plan through their employer
- Patients who purchased an Anthem plan in the Covered California marketplace
- Patients with Medicare Advantage plans administered by Anthem
- Patients with Medi-Cal plans administered by Anthem
- UC medical residents and fellows who are enrolled in the Anthem HMO plan
All UC Health hospitals, facilities and health care professionals rely on this agreement with Anthem to remain in network for you.
For now, nothing changes. You can still see your doctor and get care at UCR 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.
Anthem is using its strength and size to demand unfair contractual arrangements for our services, even as it consistently raises member premiums and reports record profits for shareholders. UCR Health consistently ranks among the nation’s best across a variety of specialties. We bring the power of internationally renowned academic medicine to patients in the communities we serve, delivering the absolute best of what’s possible in health care. As one of the region’s most vital health care resources, UCR Health needs a fair agreement with Anthem to maintain the standard of care that our patients rely on for their health.
Have Questions?
As a valued patient, we want to help you understand what is happening and what you can do to make sure your care at UCR Health continues. Should you have any questions or concerns, please reach out to [email protected].