Anthem Network Update: Stanford Health Care Contract to Expire September 1, 2025
Stanford Medical Center, Lucile Packard Children’s Hospital and Stanford Health Care Tri-Valley are scheduled to leave Anthem effective September 1, 2025, unless the parties reach a new agreement.
This does not impact retired members enrolled in the CompanionCare Medicare Supplement Plan.
Anthem Blue Cross (Anthem) and Stanford Health Care (Stanford) are actively engaged in mutual contract negotiations, as the current facility and professional contract agreements are set to expire on September 1, 2025. These discussions are a standard, normal and routine part of the health care industry and something we take very seriously.
We are closely monitoring the situation and will keep you informed as updates become available.
The current contract agreements between Anthem and Stanford are set to expire on September 1, 2025. Both Anthem and Stanford leadership have expressed interest in negotiating a new contract and are currently engaged in active negotiations.
If a new agreement is not reached before September 1, 2025, Stanford hospitals and doctors will be considered out-of-network for Anthem members seeking non-emergency care.
Note that emergency care would not be impacted. Anthem members could still utilize Stanford hospitals for emergency services as emergency care is always considered in-network no matter where the care is provided.
Yes! Anthem provides members with a Continuity of Care program that helps eligible members remain under the care of a current provider when a network disruption in specific situations. Members currently in a course of treatment for certain serious and complex conditions may continue to receive in-network access to Stanford Health. Members or their doctors may submit requests for Continuity of Care by contacting Anthem at 800-825-5541 for further assistance.
If a member began a course of treatment with Stanford Health Care before the contract termination date for one of the following conditions, he or she may be eligible to receive continuity of care:
- Are pregnant or just had your baby.
- Have a maternal mental health condition that has been diagnosed by your treating care provider.
- Are caring for a child up to 36 months old.
- In a hospital or other inpatient facility.
- Are getting pre-approved care.
- Scheduled for nonelective surgery by your current doctor, including your post-operative care for the surgery.
- In treatment for a serious and complex condition. This can be a sudden (acute) illness that requires specialized treatment in order to avoid death or permanent harm. It can also be an ongoing (chronic) illness that is life threatening or potentially disabling and requires specialized care over a long period of time.
- Have a terminal illness.
When a case is approved for continuity of care by Anthem, the claim is processed at in-network benefit levels. If a member has one of the conditions that qualify for continuity of care listed above, but Anthem does not approve the request, in-network benefit level coverage will not be provided. In this situation, the provider will be considered out-of-network and the member, if he or she chooses to receive care from the provider, may incur significant out-of-pocket expenses.
Members would still be able to utilize Stanford Health Care for emergency services as emergency medical services are always considered a covered benefit no matter where the care is provided. Anyone in need of emergency care should immediately go to the nearest emergency room or call 9-1-1. Coverage will be provided according to the member’s heath care policy benefits.
Members who are seeking non-emergency care should look for services at a local in-network facility. Members can locate a participating hospital in a specific area by accessing the Find Care function at www.anthem.com/ca/sisc or by calling member services at 800-825-5541.