Sansum and Anthem Blue Cross Solidify Health Insurance Agreement for 2025

 Blue Shield of California’s Medicare Advantage HMO Still Not Covered by Sansum Clinic

In a significant development for health insurance policyholders, Sansum Clinic, owned by Sutter Health, and Anthem Blue Cross have successfully finalized an agreement regarding health insurance contracts for the year 2025.

This arrangement ensures that patients can continue to receive medical care from their in-network doctors and care centers through Sansum.

The agreement encompasses several insurance policy types, including Anthem Blue Cross HMO (Health Maintenance Organization), PPO (Preferred Provider Organization), and EPO (Exclusive Provider Organization), along with Medi-Cal and Medicare Advantage plan enrollees.

This resolution comes as a considerable relief to patients who, in the absence of an agreement, would have been compelled to bear higher medical costs for out-of-network services or face the challenge of seeking new healthcare providers.

However, Sansum Clinic’s negotiations with Blue Shield of California regarding their Medicare Advantage HMO plan have unfortunately not resulted in an agreement. Consequently, policyholders were faced with the need to select alternate insurance plans prior to December 7 for this year. Despite the setback with the Medicare Advantage HMO plan, Sansum continues to serve members who are enrolled in Blue Shield’s other health plans, including its commercial HMO, EPO, and PPO offerings.

For those whose insurance plans will be affected, it’s recommended to contact other nearby clinics such as UCLA Health, CenCal Health, Neighborhood Clinics, or your insurance company for verified in-network providers.

Related Articles

https://www.edhat.com/news/sansum-clinic-to-drop-some-hmo-plans-in-2025-still-negotiating-with-anthem-plans/

https://www.edhat.com/news/insurance-dispute-with-sansum-clinic/