Important Information About Scripps Health and Anthem Blue Cross Negotiations

At Scripps, our highest priority is caring for you and your family, and we are committed to keeping you informed and supported throughout this process. We understand the stress that this may be causing you and your family.

For Scripps and the doctors who care for patients at Scripps Health, our focus is always on patient care. To continue providing high-quality care, we need to be paid fairly. These payments support the doctors, nurses, and care teams who provide care, as well as the facilities, equipment, medications, and supplies needed to care for you and your family. 

Scripps Health is committed to reaching a fair agreement with Anthem that protects patients’ access to high-quality care across our hospitals, clinics, physicians, and services. 

Our goal is to keep Scripps doctors, hospitals and care teams accessible and in-network to Anthem members.  

Although a new agreement has not yet been reached, our goal is to keep Scripps in Anthem’s network and we remain committed to negotiating in good faith to reach an agreement that keeps our physicians, hospitals, and services in-network with Anthem, ensuring patients and families can continue to access the trusted care they rely on.  

We believe that recent discussions between the parties have been productive, and that there has been measurable progress in narrowing unresolved gaps. While we cannot guarantee an outcome, we believe an agreement remains within reach if both organizations approach the negotiations with a shared commitment to patients’ interests and mutual sustainability. A durable resolution should ensure a relationship that supports the delivery of high-quality care, reduces avoidable administrative burdens, facilitates full and timely payments, and improves the experience for patients and providers. 

At this time, negotiations are ongoing. The current contract will expire on September 30, 2026. 

Scripps Health has cared for this community for more than 100 years. 

Scripps employs more than 17,000 people in San Diego. 

As a nonprofit organization, our mission is to serve the health care needs of our community. We reinvest our revenue into Scripps’ mission and purpose to ensure you receive the quality of care that you deserve and to ensure that Scripps is here to care for you both now and in the future. We are a San Diego-based nonprofit organization. We do not have shareholders, issue stock or pay dividends. 

These negotiations are about more than ensuring that Scripps is paid fairly by Anthem for the services that we provide to you and your family. We believe that Anthem and Scripps can agree on the rate increase. 

The agreement between Scripps and Anthem goes beyond rates. The agreement also influences how quickly care is approved, how claims are processed, and how easily patients can access recommended treatments. 

As we negotiate, our priority is to make health care simpler and more accessible for patients by reducing insurance-related requirements that can delay care, create frustration, and add unnecessary costs. 

We believe patients should be able to receive the care their doctors recommend without unnecessary obstacles. We also believe Anthem should promptly and fairly pay for the care provided to you and your family. 

Scripps is committed to addressing the administrative burdens and payment delays that have affected patients, providers, and health systems. Our goal is a more efficient experience that helps patients get the care they need when they need it. 

Reducing administrative burden: Scripps believes that patients should be able to access care and that physicians and other care providers should focus on patient care. They should not be burdened with administrative challenges that interrupt patients’ access to care. Administrative challenges mean doctors, nurses, patients and other resources become focused on getting approvals and divert critical resources away from clinical care. The money you pay for your health insurance should be focused on paying for healthcare services, not red tape and delays. 

In 2026 alone, Anthem introduced more than 30 new reimbursement and site-of-care policies that expanded prior authorization requirements, restricted where some patients can receive care, and increased administrative requirements for physicians and hospitals. When accessing care has more obstacles, patients often feel the impact through delays, additional paperwork, and uncertainty. Patients should expect their insurance to allow them to receive the care that their doctors recommend in a timely fashion and without undue friction. 

When Scripps provides high-quality, medically necessary care to Anthem members, that care should be paid fully and promptly by Anthem. That should be your expectation as a patient and Scripps’ expectation as your care provider. Unfortunately, that is not what happens. 

The payments that Scripps receives from Anthem helps pay for doctors and nurses that provide your care. It also goes toward paying for services and supplies, including medications, that are provided during your care. It also supports many other things including maintaining buildings and purchasing the clinical equipment that ensures you receive the high quality of care that you deserve. 

In May 2025, Scripps and Anthem agreed to extend the current contract while continuing discussions toward a new, sustainable agreement. That extension is set to expire on September 30, 2026.  

While negotiations are ongoing, nothing has changed for Anthem members today. You can continue to receive care from your Scripps physicians and hospitals just as you do now. 

If you are covered by Anthem, we encourage you to contact Anthem and let them know that continued access to Scripps doctors, hospitals, and services is important to you and your family. Ask Anthem to reach a fair agreement that keeps Scripps in-network and removes unnecessary barriers to care. 

If your organization offers Anthem health coverage, we encourage you to contact your Anthem representative and express your support for a fair agreement that keeps Scripps in-network. Employers play an important role in advocating for affordable, accessible, high-quality care for employees and their families. 

Anthem has informed us that, in accordance with regulatory requirements, it has or will notify you before September 30 that you have been assigned to a new provider who is not part of the Scripps network. As a result, you will no longer have in-network coverage for non-emergency services provided by your current Scripps physicians beginning October 1, 2026.  

Exceptions may exist for some patients with certain medical conditions to continue their care with their Scripps providers for a limited time through continuity of care rules. You should contact Anthem for information on how to apply for continuity of care.  

If you need emergency care on or after October 1, 2026, Anthem is required to cover those services, even if they are provided at a Scripps hospital that is no longer in Anthem’s network. For any other services, you should contact Anthem to determine what benefits are provided under your health plan. 

If Scripps and Anthem do not reach an agreement prior to October 1, 2026, Scripps and Anthem have agreed to a temporary transition period from October 1, 2026 through December 31, 2026. This benefit will be available to most Scripps patients who have Anthem insurance. During this period, Scripps and Anthem have agreed that those patients can continue accessing Scripps hospitals and doctors as in-network and still use their in-network benefits. This arrangement is subject to the terms of your Anthem benefit plan. There may be some services or sites of care that are not subject to this transition period. If that occurs, Scripps and your care teams will work with you to reschedule impacted services to locations that are subject to the transition plan. Updated information will be provided if Scripps and Anthem do not reach an agreement in advance of the end of the existing agreements.

Anthem is legally required to offer extended, in-network benefits coverage for certain patients to continue receiving care at Scripps. This is referred to as “Continuity of Care.” The types of conditions for which patients are entitled to seek Continuity of Care include the following:  

• Patients who are hospitalized at the time that the hospital goes out-of-network 
• A serious chronic condition 
• Pregnancy 
• Care of a newborn child between birth and age 36 months 
• Terminal illness 
• A surgery or other procedure that is authorized by the health plan and scheduled to occur within 180 days of the provider going out-of-network 

If you think you may qualify for Continuity of Care benefits, we encourage you to apply for Continuity of Care as soon as possible. The application can be downloaded here. Anthem is responsible for determining which patients qualify and will make those determinations on a case-by-case basis. If you have any further questions regarding Continuity of Care through Anthem Blue Cross or the application process, please contact Anthem by calling the number on the back of your insurance card.  

You always have access to emergency care, regardless of network status. If you or a loved one are experiencing a medical emergency, please go to the nearest emergency room immediately. Health plans like Anthem are required to cover emergency services provided at any hospital’s emergency department, including those that are not in the health plan’s network. Call Anthem at the number on the back of your insurance card to learn more.  

Scripps accepts several other health insurance plans. You can view our list of in-network health insurance plans here.  

Patients who receive their prescriptions at a Scripps pharmacy are not impacted by the termination and can continue to receive their prescriptions from a Scripps pharmacy as you normally would. 

Patients with Traditional Medicare or a Medicare Supplement plan are not impacted by this negotiation. If you have coverage through Traditional Medicare or a Medicare Supplement plan, you can continue to visit your Scripps hospitals and physicians as you normally would. 

Anthem has used several names over the years, including “Anthem, Inc.”, “Anthem Blue Cross” and “Elevance.” Blue Shield of California is a separate company from Anthem. Scripps participates in Blue Shield’s networks and will continue to be in-network for those networks after October 1, 2026. Please call the number on the back of your insurance card or reach out to your employer’s Human Resources department if you receive insurance through your employer to learn how your coverage is impacted, based on your specific plan and circumstances. 

If you have a Blue Cross/Blue Shield plan from outside California, please contact 1-800-SCRIPPS or the number on the back of your insurance card to help determine if you may be impacted.  

For more information on the progress of the negotiation, please continue to visit this page, and be sure to read emails and any other communications from Scripps Health for important updates. You can also call 1-800-SCRIPPS Monday through Friday 7 a.m.-7 p.m. PT with any questions.