SACRAMENTO — Sutter Health will remain in the provider network for Anthem Blue Cross insurance plans sold on the open market.
The Sacramento-based health system and Anthem said Monday that they had reached an agreement on a new multiyear contract. It means that local patients covered by traditional Anthem health plans may continue to see doctors with Sutter Gould Medical Foundation and have access to Sutter hospitals.
In the Northern San Joaquin Valley, Sutter hospitals include Memorial Medical Center of Modesto, Sutter Tracy Community Hospital and Memorial Hospital Los Banos.
Representatives for Sutter and Anthem said the agreement does not apply to the Anthem Blue Cross health plans sold through Covered California, the exchange established through the Affordable Care Act. Sutter participates only in the Blue Shield plans available through Covered California.
In November, some Sutter Gould patients covered by traditional Anthem insurance were notified in letters from the insurer that they would be assigned to other doctors Jan. 1 because a previous contract was set to expire. Sutter Gould patients who did not act on the letters can keep their doctors without further action.
Sutter said any Anthem members who signed up with other doctors and wish to re-enroll with Sutter Gould should call Anthem by using the toll-free number on their insurance cards.
We are pleased that our hospitals and doctors will continue providing high-quality services as part of the Anthem network, Sutter Health Chief Operating Officer Sarah Krevans said in a news release. We regret any inconvenience our patients may have experienced during these past few weeks as the parties worked to negotiate a new agreement.
Amid the widespread confusion this fall in the health insurance market, thousands of other individuals and families with Anthem coverage were notified their plans were canceled because they didnt meet the standards of the Affordable Care Act. Some insurance agents are advising those policyholders to enroll in health plans offered directly by insurers if they want to keep their doctors.
The provider lists for health plans offered by Covered California are not the same as the networks for plans purchased directly from insurers.
The provider networks are going to be limited on Covered California, said Nick Bavaro of Bavaro Benefit Plans. The only people we are putting in Covered California are people who had no insurance before this and are eligible for a premium subsidy.
Bavaro said one of his customers, who faced a more than 100 percent increase in cost for a comparable Anthem plan, would have lost his Sutter Gould doctors if he had purchased a plan from Covered California.
Sutter spokeswoman Kami Lloyd said in an email that our networks primary partner in Covered California products is Blue Shield. We are open to participating in new health plan products where it works for both parties.
Bee staff writer Ken Carlson can be reached at firstname.lastname@example.org or (209) 578-2321.