Please Note:
– Stanford Health Care encompasses Stanford Hospital, its facilities, clinics and professional services.
– Stanford Children’s Health encompasses Lucile Packard Children’s Hospital Stanford, its facilities, clinics and professional services.
– University HealthCare Alliance (UHA): All communications as they relate to Stanford Health Care contract negotiations include UHA unless separately called out.
– Packard Children’s Health Alliance (PCHA): All communications as they relate to Stanford Children’s Health contract negotiations include PCHA unless separately called out.
Stanford Health Care – ValleyCare and its facilities and Affinity Medical Group IPA are not affected by this termination.

Why are Stanford Health Care and Stanford Children’s Health in negotiations with Anthem Blue Cross?
Stanford Health Care and Stanford Children’s Health have been negotiating with Anthem Blue Cross for the last few months to renew the contract which expired on September 1, 2019. We continue our negotiations for a new contract to maintain patient access to our network of care.

As negotiations progress, everyone at Stanford Health Care and Stanford Children’s Health remain focused on our primary responsibility of providing our patients and their families with the best possible care and we are actively working to reach an agreement with Anthem.

Note: Stanford Health Care – ValleyCare and its facilities and Affinity Medical Group IPA are not affected by this termination

Has the contract expired?
The contract with Anthem expired on Sunday, September 1, 2019. The contract includes Stanford Health Care, Stanford Children’s Health, University HealthCare Alliance (UHA) and PCHA. We continue our negotiations for a new contract to maintain patient access to our network of care.

Although our contract with Anthem has expired, Stanford Health Care and Stanford Children’s Health will continue to welcome Anthem patients and honor Anthem’s in-network rates for all services and care at our facilities. Therefore, out-of-pocket costs for patients should be no greater than Anthem’s in-network amounts for 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.

We are required by law to provide you with 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 frame. Please contact your HMO’s customer service department, and if you have further questions, you may 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.”

Note: Stanford Health Care – ValleyCare and its facilities and Affinity Medical Group IPA are not affected by this termination

How will patients be affected now that the contract expires?
Although our contract with Anthem has expired, Stanford Health Care and Stanford Children’s Health will continue to welcome Anthem patients and honor Anthem’s in-network rates for all services and care at our facilities. Therefore, out-of-pocket costs for patients should be no greater than Anthem’s in-network amounts for 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.

We understand this process can be confusing and are here to support our patients and their families during this time and ensure they continue to receive the same level of care they have grown to expect from Stanford Health Care and Stanford Children’s Health.

Patients can obtain more information by calling us at (650) 736-5580 or toll-free at (844) 877-6692, or they can also email info@stanfordanthemfacts.com or visit www.stanfordanthemfacts.com for the latest information on the negotiations.

We are required by law to provide you with 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 frame. Please contact your HMO’s customer service department, and if you have further questions, you may 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.”

What should I do about choosing my health plan for next year as I have to make my selection with my employer in the next 30-90 days?
Stanford Health Care (which encompasses Stanford Hospital, facilities, clinics, and professional services), University HealthCare Alliance (UHA) and Stanford Children’s Health (which encompasses Lucile Packard Children’s Hospital, facilities, clinics, professional services and Packard Children’s Health Alliance (PCHA)) accept all of the major insurance companies.

We suggest you verify with your employer the specific options available to you and then view our accepted health plans at:

• Stanford Health Care: https://stanfordhealthcare.org/for-patients-visitors/health-insurance-plans/employer-sponsored-group-plans.html

• Stanford Children’s Health: https://www.stanfordchildrens.org/en/patient-family-resources/insurance-information/employer-group-plans

I am an Anthem Covered California member, does this contract expiration apply to me?
No. Stanford’s contract with Anthem did not include Stanford Hospital or Lucile Packard Children’s Hospital Stanford as providers in the Covered California network. Stanford Health Care – ValleyCare is contracted as an in-network hospital and will remain contracted in the Anthem Covered California provider network. The physicians’ services for Stanford Health Care, Stanford Children’s Health, University HealthCare Alliance and PCHA are not considered in-network for Anthem’s Covered California network.
Will the cost of Anthem patients’ treatments or out-of-pocket expenses change now that the contract has expired?
No. Stanford Health Care and Stanford Children’s Health will continue to welcome Anthem patients and honor Anthem’s in-network rates for all services and care at our facilities. In other words, out-of-pocket costs for patients should be no greater than Anthem’s in-network amounts for 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.
Can patients still schedule appointments at Stanford Health Care and Stanford Children’s Health facilities?
Yes, patients can continue to schedule appointments as usual at Stanford Health Care and Stanford Children’s Health facilities.

We are required by law to provide you with 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 frame. Please contact your HMO’s customer service department, and if you have further questions, you may 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.”

What should patients do if they have a procedure/appointment scheduled, but do not yet have authorization by Anthem?
Patients should plan to attend their appointment as scheduled. Stanford Health Care and Stanford Children’s Health will continue to see all patients regardless of their authorization status.

We are required by law to provide you with 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 frame. Please contact your HMO’s customer service department, and if you have further questions, you may 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.”

Do negotiations apply to members of various Medical Groups and Independent Practice Associations (IPAs)?
If you are an HMO patient affiliated with a community medical group or IPA such as Palo Alto Medical Foundation (PAMF), Hill Physicians, SCCIPA, Brown & Toland, PMG of San Jose, John Muir or Affinity Medical Group:

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

We are required by law to provide you with 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 frame. Please contact your HMO’s customer service department, and if you have further questions, you may 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.”

Can patients enrolled with one of these Medical Groups or IPAs continue to see the same physicians?
Yes, Anthem patients can continue to see their same physicians.

We are required by law to provide you with 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 frame. Please contact your HMO’s customer service department, and if you have further questions, you may 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.”

I am an employee of Stanford University/Stanford Health Care/Stanford Children’s Health. Do the negotiations apply to my health care benefits?
No. Stanford employee plans are contracted with Aetna, Blue Shield, Kaiser and SHC Alliance, and are not affected by this negotiation.
Who can patients contact for more information about the negotiations?
Patients can call (650) 736-5580 or toll-free at (844) 877-6692. They may also email info@stanfordanthemfacts.com or visit StanfordAnthemFacts.com for more information.