IMPORTANT NOTICE
VCU Health will be out-of-network with some Anthem Medicare Advantage plans effective January 1, 2027
What is happening and who is impacted
VCU Health and Anthem made a mutual decision for VCU Health to be out of network with some Anthem Medicare Advantage plans, effective January 1, 2027.
This impacts all VCU Health hospitals, providers, therapy services, doctors’ offices, clinics and labs.
VCU Health remains in the Anthem network for all Anthem commercial, Medicaid, Dual Special Needs, and Medicare Supplemental plans.
| Remaining in network | Out of network |
|---|---|
|
|
What this means for you
Patients with an impacted Anthem Medicare Advantage plan (listed above) will be “out of network” effective January 1, 2027.
Being out of network means access to our health care services will be impacted because Anthem may not pay for medical care at VCU Health, which could result in higher out-of-pocket costs for patients.
To avoid higher out-of-pocket costs, patients with an impacted Anthem Medicare Advantage plan need to take action during the Annual Enrollment Period to avoid potentially paying more for their health care services at VCU Health.
Options include:
- Switching to another Medicare Advantage plan during the Annual Enrollment Period, which takes place between October 15 and December 7, 2026. Please note that new plans do not take effect until January 1, 2027.
- Transferring care to a non-VCU Health provider. Patients should contact Anthem for a list of in-network providers.
Additional questions and answers
Q: I have an Anthem commercial plan, Virginia’s Insurance Marketplace exchange plan or Medicaid plan. Does this impact my access to VCU Health?
A: No, VCU Health remains fully participating with Anthem commercial plans, Virginia’s Insurance Marketplace exchange plans and Medicaid plans.
Q: If I have an impacted Anthem Medicare Advantage plan, what do I do if I have an appointment scheduled after January 1, 2027?
A: Patients should contact our Patient Appointment Center at 800-762-6161 regarding visits scheduled after January 1, 2027 to discuss alternative options.
Q: Can I still schedule an appointment/procedure with VCU Health if I am out of network?
A: If your Anthem Medicare Advantage plan is out of network, we recommend scheduling appointments with a provider who is in your plan’s network to avoid unexpected costs. Contact Anthem for a list of in-network providers.
If your current coverage is out of network and you choose to keep your appointment/ procedure, it’s important to know that VCU Health’s financial policy requires a minimum prepayment for services being scheduled.
The prepayment amount is 50% of the estimated total amount due for services being scheduled, with the remaining balance expected to be paid at the time of service.
Your appointment could be cancelled if prepayment is not provided. If you have coverage through a new plan that is in network for VCU Health at the time you receive care, you will be refunded.
Q: Which VCU Health locations and providers are affected by VCU Health going out of network with the impacted Anthem Medicare Advantage plans?
A: All VCU Health locations and providers are affected by this change in network status. This includes all VCU Health hospitals, providers, therapy services, doctors’ offices, clinics, labs, clinicians, physicians, nurse practitioners, physical and occupational therapists, and behavioral health providers.
Q: Can I switch to a different Medicare Advantage plan that is in network with VCU Health?
A: Yes. You can enroll in a new Medicare Advantage plan during the Annual Enrollment Period which runs from October 15, 2026, through December 7, 2026. It is important to note that new plans do not take effect until January 1, 2027.
VCU Health participates in other Medicare Advantage networks, including:
- Humana
- Aetna
Q: What do I need to do if I obtain a new Medicare Advantage plan that is in network with VCU Health?
A: If you switch to a new plan, you should contact the VCU Health Patient Appointment Center as soon as possible to provide your new insurance information.
- VCU Health Patient Appointment Center: 800-762-6161
Q: If I want to keep my current Anthem Medicare Advantage coverage, what do I do?
A: Patients should contact Anthem to identify a list of in-network providers and begin transferring care to a new provider.
Q: I have an Anthem Medicare Supplemental Plan, what does that mean for me?
A: VCU Health continues to accept all Medicare Supplemental Plans, so the change in VCU Health’s participation with Anthem Medicare Advantage will have no impact on your coverage or benefits through your Anthem Medicare Supplement plan.
Q: What if I have an impacted Anthem Medicare Advantage plan and I’m a current patient in the middle of receiving ongoing complex care like chemotherapy treatments when VCU Health becomes out of network with Anthem? Can I continue to receive care at VCU Health?
A: Anthem Medicare Advantage members currently receiving treatment might qualify for a “Continuity of Care” exception that will allow you to temporarily maintain in-network benefits (after January 1, 2027) through the completion of your treatment course but no longer than 90 days.
Patients are responsible for submitting the Continuity of Care request to Anthem, and Anthem must approve any requests. Patients need to contact Anthem to find out how to qualify for a Continuity of Care exception by calling the member services phone number listed on their insurance card.
Q: I am an Anthem Medicare Advantage transplant patient at VCU Health. Does this mean I can no longer receive care from my transplant provider?
A: There may be options for impacted out of network patients to receive transplant services at VCU. VCU and Anthem would have to come to an agreement on a patient-by-patient basis.
Please contact your VCU Health transplant financial coordinator for additional details or if you have any questions.
Q: If my appointment was scheduled before VCU Health and Anthem mutually agreed to go out of network and the appointment takes place after January 1, 2027, will I be responsible for paying the bill?
A: Yes, all patients are responsible for making sure their healthcare bills are paid. VCU Health’s financial policy requires a minimum prepayment for services being scheduled and all out of network patients are billed directly. We do not bill insurance directly for out of network patients.
Q: What do I need to do if I obtain a new Medicare Advantage plan that is in network with VCU Health?
A: If you switch to a new plan, you should contact the VCU Health Patient Appointment Center as soon as possible to provide your new insurance information.
- VCU Health Patient Appointment Center: 800-762-6161
Q: Who can I call with other questions?
A: HELP IS AVAILABLE:
- If you have questions about an upcoming appointment, please call VCU Health Patient Appointment Center: 800-762-6161
- If you have general billing questions, please call VCU Health Customer Service: 888-803-0082
For questions about your insurance plan and coverage, please call the Anthem member services phone number listed on your insurance card.
You have options
Continuity of Care
- Call the member services number on your Anthem health plan ID card to determine if you qualify for “Continuity of Care.”
If you are an impacted Anthem Medicare Advantage patient:
- You can switch to another Medicare Advantage plan during the Annual Enrollment Period, which takes place between October 15 and December 7, 2026. Please note new plans do not take effect until January 1, 2027.
- To discuss your options, call 1-800-MEDICARE (1-800-633-4227) (TTY: 1-877-486-2048).
- You can also contact the Virginia Insurance Counseling and Assistance Program (VICAP) at 1-800-552-3402. Trained volunteers can assist you with questions.