Scripps Health patients with Anthem

Alert for Scripps Health patients with Anthem! 

As of January 1, 2025, Scripps Health is no longer an enrolled provider for those patients with Anthem Blue Cross. 

What happened? 

Scripps Health and Anthem Blue Cross could not come to terms on a contract renewal.  Effective January 1, 2025, Anthem Blue Cross no longer contracts with Scripps Health to provide primary care and specialty care services.  Anthem Blue Cross will continue to pay for emergency services provided by Scripps Health. Patients may also be eligible to receive continuing care through Scripps Health primary care and specialty care providers if they meet criteria for continuity of care. See below for more details.  

Who is impacted? 

The termination of this contract will impact patients with Anthem Blue Cross through Covered California and all Anthem Blue Cross employer-sponsored commercial insurance plans.   

Note that those with Original Medicare (fee for service) with a Supplemental Medicare Plan through Anthem will NOT be impacted and can continue to obtain care from Scripps Health providers. 

Options for impacted patients of Scripps Health: 

1. Contact Anthem Blue Cross member services to identify a new provider(s).  
2. Some Scripps Health patients may be able to select a new health plan that contracts with Scripps Health as a network provider.   
   • If you are in a Covered California Anthem Blue Cross plan you may use the shop and compare tool on the Covered California website to look for a new plan that contracts with Scripps as a provider.  The website for Scripps Health also lists the plans that they are an enrolled provider.  A special enrollment period is created for those who lose access to treating providers as the result of the termination of a contract between their plan and provider.  The special enrollment period only lasts 60 days from the termination of the contract or from the date you learn of the termination of the contract.  
   • If you are covered by Anthem Blue Cross through your employer, you must first contact your employer’s human resources department or benefits manager for information about whether you have the option to choose a new plan.  The law only requires certain employer-based coverage types to offer a special enrollment period when a provider’s contract with the employer-based health plan terminates. 
3. Elect to continue treatment with Scripps Health providers if you qualify for continuity of care.  The law requires health plans to permit patients to continue treatment with non-network providers in certain circumstances.  For Scripps Health patients with Anthem Blue Cross, you may qualify to continue receiving covered services continuity of care or ongoing care if you - 
4. 1. • Are receiving acute care (e.g. from a hospital).  Coverage of services will continue through the duration of the acute condition. 
      • Have a serious chronic condition.  This includes disease, illness, or other medical problem(s) or medical disorder(s) that is serious, ongoing, and lacks a cure or will worsen over time, or requires ongoing treatment to maintain remission or prevent deterioration. Coverage will continue until care can be safely transitioned to a network provider for up to a period of 12 months. 
      • Are pregnant, including the three trimesters of the pregnancy and the immediate post-partum period.  Coverage shall not exceed 12 months from the diagnosis or the end of the pregnancy, whichever is later.  
      • Have a terminal illness. Coverage of services may continue through the duration of the terminal illness and may exceed 12 months.  
      • A newborn child through age 36 months. Coverage of services shall not exceed a 12-month period from the termination of the contract or the new enrollment effective date for the patient.  
      • Need a surgery or other procedure that is authorized by the plan as part of a documented course of treatment.  The surgery or procedure must be performed within 180 days of the contract’s termination date or within 180 days of the effective date of coverage for a newly covered enrollee. 

How do I elect to continue treatment under continuity of care protections? 

If you are in employee-sponsored coverage, contact your employer’s human resources or benefits manager to request a copy of your evidence of coverage to learn of your continuity of care options. You may also contact the member services of Anthem Blue Cross specific to your line of coverage for more information.  

If you are in Anthem Blue Cross through Covered California, you may request continuity of care by calling members services of Anthem Blue Cross and requesting continuity of care with Scripps Health.   

You may also request continuity of care by completing Anthem Blue Cross’ continuity of care request form, and faxing it to Anthem Blue Cross at the following number:  

• Medical Requests 1-877-214-1781 
• Behavioral health requests 1-877-521-4787 
• Applied behavior analysis services 1-866-582-2287 

Where can I get additional information or help? 

You can contact the Consumer Center for Health Education and Advocacy for information or assistance to navigate the continuity of care approval process. You may reach the Consumer Center at 1-877-734-3258 or online at www.lassd.org.  

Scripps Health website has a detailed frequently asked questions page related to the Anthem contract termination.   

You can also contact Anthem Blue Cross for additional information on your options to either find new a new network provider(s) or to request continuity of care to continue seeing your Scripps Health provider(s).  

What can I do if Anthem Blue Cross says no or denies my request? 

You may file a plan grievance or appeal against Anthem Blue Cross if you disagree with their determination of your continuity of care request (or any adverse decision regarding your care) or are dissatisfied with any aspect of their handling of your care.  To file a plan grievance or appeal, you may contact the appeal and grievance line at Anthem Blue Cross:  

To file a plan grievance or appeal, you may contact the appeal and grievance line at Anthem Blue 

Cross by calling Member Services at 1-855-817-5785 (TTY: 711) Monday through Friday from 8 a.m. to 8 p.m.