Anthem: Reid Health is Leaving Your Clients’ Health Plan Network

Anthem has negotiated for several months with Reid Health to keep them in your clients’ health plan network but did not reach an agreement. Therefore, Reid Health will be leaving the plan’s network on March 18, 2024.

Because they are leaving, your clients’ employees may pay more for care they receive from Reid Health doctors and facilities.

Anthem sent a letter to your clients and their employees to let them know about this change and how it impacts their care and costs. The information below summarizes those details.

Seeing a doctor and choosing a care facility in the plan’s network keeps costs down

It’s up to the employee to choose which doctor to see and which care facility to use, but selecting one in their plan will cost less. They can find a doctor or care facility in their plan by logging in to anthem.com. They also can call Member Services at the number on their member ID card.

Employees may pay more if they decide to keep seeing a Reid Health doctor or receiving care at a Reid Health facility

If the employee decides to keep seeing a Reid Health doctor or receive care at a Reid Health facility after March 17, 2024, they may pay more or all of the costs for the care. Some plans only cover care from doctors and care facilities in the plan’s network, except in emergencies. Employees can check their plan documents to learn more.

There may be exceptions

An employee may be able to stay with this doctor or care facility for a limited time if they are receiving certain types of care. Under federal law, this includes:

• Treatment for a serious and complex condition. This can be a sudden (acute) illness that requires specialized treatment to avoid death or permanent harm. It also can be an ongoing (chronic) illness that is life threatening or potentially disabling and requires specialized care over a long period of time.
• Care if they are already in a hospital or other inpatient facility.
• Scheduled, nonelective surgery by their current doctor, including postoperative care for the surgery.
• Care before, during, and after pregnancy.
• Care if they are terminally ill.

Additionally, their plan may allow them to stay with this facility for a limited time if they’re receiving certain types of care not specified by federal law. Their plan documents include more information about continuity of care.

If you have questions, please visit anthem.com/reidhealth or contact your ExpressLink representative.