The current contract between Stanford Health Care and Stanford Medicine Children’s Health and Anthem Blue Cross ended on Thursday, September 1, 2022. Stanford Health Care, Stanford Medicine Children’s Health and Anthem Blue Cross are negotiating a new contract to continue patient access to our network of care.
Yes. However, the Anthem Managed MediCal contract is not part of this negotiation so Anthem Managed MediCal patients are not impacted.
No.
Yes.
Yes. However, the Anthem Managed MediCal contract is not part of this negotiation so Anthem Managed MediCal patients are not impacted.
The Stanford Health Care and Stanford Medicine Children’s Health contracts (including UHA and PCHA) with Anthem Blue Cross ended on September 1, 2022. Affinity Medical Group’s agreement ended on September 1, 2022.
Stanford Health Care and Stanford Medicine Children’s Health will continue to welcome Anthem Blue Cross PPO patients and honor Anthem Blue Cross’s in-network rates for all services and care at our facilities. This means that your out-of-pocket costs should not be more than Anthem Blue Cross’s in-network amounts for services and care. We have adopted this policy to ensure patients and families will not have any major changes to the cost nor disruption to their care.
Stanford Health Care and Stanford Medicine Children’s Health will still be out-of-network for the Covered California plans.
No. If the contract expires before an agreement is reached, Stanford Health Care and Stanford Medicine Children’s Health will continue to welcome Anthem Blue Cross PPO patients and honor Anthem Blue Cross’s in-network rates for all Covered Services and care at our facilities. In other words, out-of-pocket costs should be no greater than Anthem Blue Cross’s in-network amounts for Covered Services and care. We have adopted this policy to ensure patients and families will not experience any significant disruption to their care or change in the quality or cost of care.
Yes. PPO patients can continue to schedule appointments and receive care as usual.
Yes, Anthem Blue Cross PPO patients can continue to see their same doctors.
Patients should plan to go to their appointment as scheduled. Stanford Health Care and Stanford Medicine Children’s Health will see all Anthem PPO patients regardless of their authorization status for Covered Services.
No. Stanford Health Care and Stanford Medicine Children’s Health are not contracted with Anthem Blue Cross for Covered California. Patients covered by Covered California should be advised to seek services at an Anthem Blue Cross Contracted provider hospital or physician.

If you are an Anthem Blue Cross HMO member and are assigned to Affinity Medical Group IPA, you can continue to see the same Affinity Medical Group doctors until September 1, 2022. If Stanford and Affinity do not reach an agreement with Anthem Blue Cross before Anthem Blue Cross sends you a new membership card, you will automatically be reassigned by Anthem Blue Cross to a new PCP and a new Member Group or IPA.

If you are reassigned to a new PCP, you will likely be required to coordinate your ongoing health care needs with your newly assigned primary care provider as well as any referral and authorization requests. In certain circumstances, your health care needs may mean that you will be able to continue care with your current Affinity Medical Group provider for a certain length of time. You are encouraged to contact either Affinity Medical Group at 888-309-2221 or the telephone number on your Anthem Blue Cross membership card to determine how you might qualify for continued services. If Stanford Health Care and Stanford Medicine Children’s Health and Affinity reach an agreement with Anthem Blue Cross before you are reassigned, you may be able to remain with your current Affinity physician.

We are required by law to provide you with the following information: “If you have been receiving care from a health care provider, you have a right to keep your provider for a designated time period. Please contact your HMO’s customer service department, and if you have further questions, you are encouraged to contact the Department of Managed Health Care, which protects HMO consumers, by telephone at its toll-free number, 1-888-HMO-2219, or at a TDD number for the hearing impaired at 1-877-688-9891, or online at www.hmohelp.ca.gov.”

If you are an Anthem Blue Cross HMO member and are assigned to Affinity Medical Group IPA, you can continue to see the same Affinity Medical Group doctors until September 1, 2022. Your Affinity Medical Group doctor’s office can schedule appointments up to September 1, 2022.

If Stanford and Affinity do not reach an agreement with Anthem Blue Cross before Anthem Blue Cross sends you a new membership card that gives you to a new PCP and Medical Group or IPA, you may need to schedule a new appointment with your newly assigned primary care provider and arrange for any referral or authorizations to be made.

In some cases, you may be able to keep your September appointment even if Anthem Blue Cross gives you to a new doctor. You will need to contact either Affinity Medical Group at (888) 309-2221 or Anthem Blue Cross at the time to see if you determine whether you qualify for continued services. If Stanford Health Care and Stanford Medicine Children’s Health do reach an agreement with Anthem Blue Cross before you are reassigned, you may be able to stay with your current doctor and go to your scheduled appointment.

We are required by law to provide you with the following information: “If you have been receiving care from a health care provider, you have a right to keep your provider for a designated period of time. Please contact your HMO’s customer service department, and if you have further questions, you are encouraged to contact the Department of Managed Health Care, which protects HMO consumers, by telephone at its toll-free number, 1-888-HMO-2219, or at a TDD number for the hearing impaired at 1-877-688-9891, or online at www.hmohelp.ca.gov.”

Anthem Blue Cross HMO members who are currently receiving treatment may be eligible to complete their care with their current Affinity Medical Group provider if they meet one of the qualifications listed below. Anthem Blue Cross must first approve the continued care with your provider, otherwise care after September 1, 2022, will be considered out of network and will not be a covered benefit. You are encouraged to contact either Affinity Medical Group at (888) 309-2221 or the toll-free telephone number on your Anthem Blue Cross membership card to determine how you might qualify for continued services.

Conditions that may qualify for continued care with your Affinity Medical Group provider:

● Are pregnant
● Currently receiving ongoing medical care
● Have a newborn child up to 36 months old who is receiving care
● Have a current authorization for health care services
● Otherwise concerned that this change will disrupt your care

We are required by law to provide you the following information: “If you have been receiving care from a health care provider, you may have a right to keep your provider for a designated time period. Please contact your HMO’s customer service department, and if you have further questions, you are encouraged to contact the Department of Managed Health Care, which protects HMO consumers, by telephone at its toll-free number, 1-888-HMO-2219, or at a TDD number for the hearing impaired at 1-877-688-9891, or online at www.hmohelp.ca.gov.”

If you are an Anthem Blue Cross HMO patient affiliated with a community IPAs such as Palo Alto Medical Foundation (PAMF), Hill Physicians, SCCIPA, Brown & Toland, PMG of San Jose:

No. These IPAs/Medical Groups are not currently affected by these negotiations. There are no changes to your coverage or care.

If you are an Anthem Blue Cross HMO member assigned to Affinity Medical Group:

Yes. These negotiations do apply to you and your care. If you are an Anthem Blue Cross HMO member and are assigned to Affinity Medical Group IPA, you can continue to see the same Affinity Medical Group physicians until August 31, 2022. If Stanford and Affinity do not reach an agreement with Anthem Blue Cross before Anthem Blue Cross sends you a new membership card assigning you to a new primary care provider and Medical Group/IPA, you will automatically be reassigned by Anthem Blue Cross to a new primary care provider and a new Member Group/IPA. If you are reassigned to a new PCP, you will likely be required to coordinate your ongoing health care needs with your newly assigned primary care provider as well as any referral and authorization requests. In certain circumstances, your health care needs may qualify you to be able to continue care with your current Affinity Medical Group provider for a specific period. You are encouraged to contact either Affinity Medical Group at (888) 309-2221 or the toll-free telephone number on your Anthem Blue Cross membership card to determine how you might qualify for continued services. If Stanford and Affinity do reach an agreement with Anthem Blue Cross before you are reassigned, you will be able to remain with your current Affinity physician.

We are required by law to provide you with the following information: “If you have been receiving care from a health care provider, you have a right to keep your provider for a designated time period. Please contact your HMO’s customer service department, and if you have further questions, you are encouraged to contact the Department of Managed Health Care, which protects HMO consumers, by telephone at its toll-free number, 1-888-HMO-2219, or at a TDD number for the hearing impaired at 1-877-688-9891, or online at www.hmohelp.ca.gov.”

Members enrolled in the Connected Care plan through Intel are not impacted by the Anthem PPO / Stanford Health Care contract negotiations and termination. Connected Care members will continue to be able to access all contracted Stanford Health Care providers and facilities. Intel Connected Care members or patients can contact the Connected Care Concierge Center at (800) 971-4153 for any additional questions about their plan.
Patients can call (650) 736-5580 or toll-free at (844) 877-6692. You may also email info@stanfordanthemfacts.com for more information. HMO members assigned to Affinity Medical Group IPA may visit AffinityMD.com or call (888) 309-2221.