Anthem Managed Care Update
Anthem Blue Cross Blue Shield Contract Negotiation Update
Southwest General is committed to providing high-quality, accessible care for our community. As part of that commitment, we are currently in contract negotiations with Anthem Blue Cross Blue Shield (BCBS) for both Commercial and Medicare Advantage plans. While discussions are ongoing and progressing in good faith, Anthem members may be considered out of network at Southwest General beginning January 1, 2026, if a new agreement is not reached.
What This Means for Anthem Members
If a new contract is not finalized:
- Anthem BCBS Commercial and Medicare Advantage members will be out of network starting January 1, 2026 (hospital, provider and ancillary services)
- You may face higher co-pays or co-insurance for services received at Southwest General
- You can continue using your Southwest General providers, but your cost share may change based on your plan’s out-of-network benefits
Review Your Options During Open Enrollment
As you make health insurance decisions—whether during Medicare Open Enrollment (now through December 7, 2025) or your employer’s annual enrollment—please keep this information in mind if staying in-network with Southwest General supports your ongoing care needs.
If you are choosing employer-sponsored coverage, consider encouraging your employer to offer additional plan options beyond Anthem so you can remain in network with Southwest General.
Questions About Your Coverage?
For information about your specific benefits, contact Anthem BCBS directly using the number on the back of your insurance card.
Our Commitment to You
We understand how important it is to have reliable access to your preferred providers and services. Southwest General remains focused on keeping our community informed as negotiations continue and ensuring you receive the care you depend on.
Frequently Asked Questions
Q. Why is Southwest General negotiating with Anthem Blue Cross Blue Shield?
A. Southwest General regularly reviews its insurance contracts to ensure they accurately reflect the rising costs and administrative requirements of delivering high-quality health care. Our current agreement with Anthem needs to be updated to support the level of care we provide. As a result, we are actively working with Anthem to reach a new contract for both Commercial and Medicare Advantage plans.
Q. What is Changing?
A. If a new agreement is not reached, Anthem Commercial and Medicare Advantage members will be considered out of network at Southwest General beginning January 1, 2026. This may impact your out-of-pocket costs for care received at Southwest General.
Q. How will this affect my relationship with my Southwest General doctors?
A. You can continue seeing your Southwest General providers, even if Anthem becomes out of network. However, your co-pays, co-insurance or deductibles may increase depending on your plan’s out-of-network benefits.
Your relationship with your doctor is important—and we are here to help you explore options that keep your care affordable.
Q. How will being out of network affect my costs?
A. If Anthem becomes out of network, your care at Southwest General may result in:
- Higher co-pays or co-insurance
- A separate out-of-network deductible
- Changes in coverage for certain services
Your exact costs depend on your specific Anthem plan. Call the number on the back of your card for details.
Q. What options do I have during Medicare Open Enrollment?
A. From now through December 7, 2025, Medicare-eligible patients can adjust their coverage. If you want to maintain in-network access to Southwest General, you may:
- Switch to Traditional Medicare, which will continue to cover Southwest General services
- Enroll in a Medicare Advantage plan that remains in network with Southwest General
We can help you understand your choices.
Q. What if I get my Anthem Medicare Advantage plan through a retiree or pension program?
A. Some retiree and union plans offer
the same benefits for both in- and out-of-network services. If this applies to your plan, your out-of-pocket costs at Southwest General
may not change, even if Anthem becomes out of network.
Since each plan is different, we encourage you to:
- Check with your plan administrator, or
- Email us your plan details at InsuranceQuestions@swgeneral.com so we can help you review your benefits.
Q. What should I do if I’m worried about increased costs?
A. You have several options:
- Contact Anthem Customer Service (number on the back of your card)
- Review Medicare Open Enrollment options
- Call Southwest General at 440-816-5142 or email InsuranceQuestions@swgeneral.com for help understanding plans that allow you to stay in network
We’re here to help guide you through your choices.
Q. Can Southwest General help me choose a new plan?
A. Yes. Our team can:
- Explain your coverage
- Review potential plan options
- Help you identify plans that keep Southwest General in network
- Connect with a licensed insurance broker if needed
Contact us at 440-816-5142 or InsuranceQuestions@swgeneral.com.
Q. Can you recommend an insurance broker?
A. Many local brokers are licensed to help patients enroll in Medicare options. Patients have successfully worked with:
Larry Riddell Insurance
490 Cleveland St., Elyria, OH 44035
440-309-8498
https://riddellinsurance.com/contact/
KAZ Company
4807 Rockside Rd., Suite 660, Independence, OH 44131
216-901-9300
https://medicareplansneo.com/
Q. When would this change take effect?
A. If no agreement is reached, Anthem members will become out of network on January 1, 2026. Until that date, Southwest General will remain in network for Anthem Commercial and Medicare Advantage plans.
Q. I still have questions. Who can I contact?
A. We’re here to help.
Call:
440-816-5142
Email:
InsuranceQuestions@swgeneral.com