- If you receive your Anthem insurance through your employer, tell your Human Resources or Benefits Department that you want to keep access to Mount Sinai Health System’s high-quality providers and services.
- Call Anthem at the number on the back of your insurance card and demand they keep your access to the Mount Sinai providers and services you know and trust.
- Check your out-of-network benefits. Review your insurance plan’s out-of-network benefits or contact Anthem to determine your out-of-network expenses if you prefer to continue to receive care from Mount Sinai.
- For Medicaid Plans: You have the option to change your Medicaid plan at any time during your first 90 days with a new plan. You can also change your plan after your first 12 months with your plan.
- For Essential Plans: Consider changing your Essential Plan to one that Mount Sinai participates with. You have the option to change your plan any time during the year.
- When Mount Sinai and Anthem’s contract expires on December 31, Anthem may continue to cover your care at in-network rates for a limited period of time through continuity-of-care benefits if you are receiving certain specialty care. Please see the section below for more information.
Protecting Patient Access at Mount Sinai
Our Work With Anthem Blue Cross Blue Shield
For some time, Mount Sinai Health System has been attempting to renew our contract with Anthem Blue Cross Blue Shield (formerly Empire) before it expires on Wednesday, December 31.
Unfortunately, based on communications we’ve received from Anthem, it appears that we will not come to terms before our contract expires. We are deeply disappointed that Anthem has not addressed the issues we’ve been discussing, and we want to ensure you are prepared and have the resources you need at this time.
What You Can Do Today
To view a list of insurance plans Mount Sinai will participate with in 2026, please click here.
Patient Impact
As a reminder, when our contract expires on December 31:
- More than 9,000 Mount Sinai physicians will no longer be in Anthem’s network beginning Thursday, January 1.
- Mount Sinai’s hospitals and facilities will no longer be in Anthem’s network beginning Sunday, March 1.
When Mount Sinai and Anthem’s contract expires, the date your physician or hospital would become out of network with Anthem may vary depending on your specific health plan. View the list below for more information about out-of-network dates for your specific plan. This change could impact all Blue Cross Blue Shield plans, including out-of-state plans.
Employer-Sponsored Plans |
||
Anthem Plan |
Physician Out-of-Network Date |
Hospital and Facility Out-of-Network Date |
Commercial |
1/1/2026 |
3/1/2026 |
Note: Some employer-sponsored plans have special exceptions, which are detailed below |
||
Hotel Trades employees |
Physicians will remain in network |
3/1/2026 |
Con Edison employees |
1/1/2026 |
3/1/2026 |
State and Federal Plans |
||
Anthem Plan |
Physician Out-of-Network Date |
Hospital and Facility Out-of-Network Date |
Child Health Plus |
1/1/2026 |
3/1/2026 |
Medicaid |
1/1/2026 |
3/1/2026 |
HARP |
1/1/2026 |
3/1/2026 |
MLTC/MAP |
1/1/2026 |
3/1/2026 |
Essential Plan 1-5 |
1/1/2026 |
3/1/2026 |
What You Need to Know
- Nothing changes today. Please keep all the appointments and procedures you have scheduled with Mount Sinai hospitals, physicians, and outpatient services. Do not delay routine health screenings, procedures, or tests that are vital to your health.
- Emergency care is always covered, no matter our contract status with Anthem. Your insurance company is required by law to cover emergencies at in-network rates.
- A network change in the future could cause you to pay more out of pocket because the provider being promoted by Anthem as alternatives are almost all more expensive than Mount Sinai.
Continuity of Care
If you are currently receiving care from certain Mount Sinai–affiliated specialty providers or using specific specialty services, your health plan may be required to continue covering your care at in-network rates for a limited period of time under continuity-of-care protections.
Mount Sinai is committed to helping our patients maintain access to medically necessary care and has made repeated efforts to work directly with Anthem to support continuity-of-care requests. To date, we have been unable to confirm that Anthem has approved continuity-of-care coverage for any of our patients.
Anthem’s approach to continuity of care has created confusion, delays, and additional administrative hurdles for patients seeking to continue their care. In response, Mount Sinai has begun reaching out directly to patients we believe may be eligible for continuity-of-care protections and is doing everything possible to support patients and coordinate their care.
Anthem controls the continuity-of-care review and approval process and has not enabled a direct or effective pathway for resolution. Determinations regarding eligibility and approval for continuity-of-care benefits are made solely by Anthem, and Mount Sinai physician practices do not have access to Anthem’s internal systems or decision-making processes.
If you believe you qualify for continuity-of-care coverage and have been unable to get clear information or a response from Anthem, we encourage you to seek additional assistance by contacting the New York State government agencies below:
- If your health coverage is employer-sponsored: Call the New York State Department of Financial Services at 1-800-342-3736, or 1-212-480-6400 if you live in New York City. You can also file a complaint online at dfs.ny.gov/complaint.
- If your coverage is through a government-sponsored plan: Call the New York State Department of Health at 1-800-206-8125 or email them at managedcarecomplaint@health.ny.gov.
Mount Sinai’s Position
Mount Sinai has negotiated in good faith with Anthem Blue Cross Blue Shield since the spring to reach a fair, responsible agreement before our contracts expire. Anthem—not Mount Sinai—has chosen to walk away from the negotiating table and allow these contracts to lapse.
Anthem’s public claims that Mount Sinai is demanding “50 percent higher rates” are flatly false. This is a manufactured talking point designed to distract from the real issues in this negotiation. We requested single-digit annual increases over a three-year period.
The facts are straightforward
Anthem pays Mount Sinai up to 35 percent less than other major New York health systems, despite Mount Sinai delivering some of the highest-quality, most complex care in the region. We have asked only for reasonable adjustments that would begin to narrow—not eliminate—this gap. Even with those adjustments, Mount Sinai would remain less expensive than the alternative systems Anthem is now steering patients toward.
Equally concerning is Anthem’s persistent failure to pay what it already owes. Anthem currently owes Mount Sinai more than $450 million for care that has already been provided to its members. That is not a billing dispute—it is care delivered, claims submitted, and payments withheld. Anthem is effectively using Mount Sinai as an interest-free bank while reporting record profits.
These negotiations are about more than rates. They are about Anthem’s chronic denials of medically necessary care, delayed payments, and administrative practices that create barriers for patients and physicians alike. Anthem’s business model may be profitable for shareholders, but it undermines access to timely, high-quality care for New Yorkers.
Elevance Health, Anthem’s parent company, is the second largest for-profit insurer in the country with more than $175 billion in revenue and more than $6 billion in profit in 2024. These profits are fed by Anthem’s repeatedly raising premiums for employers and members while underpaying providers who deliver care on the front lines.
Mount Sinai is a not-for-profit health system. Every dollar we receive is reinvested into patient care, medical education, research, and caring for all who need us, regardless of their ability to pay. We cannot—and will not—subsidize a for-profit insurer’s margins at the expense of patient access and financial sustainability.
For any other questions, call one of Mount Sinai’s dedicated community information lines:
- Anthem Commercial patients: 833-912-3558
- Anthem Medicaid and Essential Plan patients: 833-912-5604
