*To determine if your plan is fully insured or self-funded, please consult the back of your Anthem insurance card (see photo).
Out-of-state plans may not have this information included on their card.
Protecting Patient Access at Mount Sinai
Our Work With Anthem Blue Cross Blue Shield
For some time, Mount Sinai Health System has been talking with Anthem Blue Cross Blue Shield (formerly Empire) about renewing our contract before it expires on Wednesday, December 31. We are doing everything we can to stay in Anthem’s network and maintain your in-network access to the physicians and services you depend upon.
Patient Impact
If Mount Sinai and Anthem do not reach an agreement by December 31, 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 |
Fully Insured* |
1/1/2026 |
3/1/2026 |
Self-Funded* |
1/1/2026 |
1/1/2026 |
Note: Some employer-sponsored plans have special exceptions, which are detailed below |
||
Hotel Trades employees |
Physicians will remain in network |
1/1/2026 |
Con Edison employees |
1/1/2026 |
1/1/2026 |
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 |
1/1/2026 |
3/1/2026 |
Essential Plan 2 |
1/1/2026 |
3/1/2026 |
Essential Plan 3 |
1/1/2026 |
3/1/2026 |
Essential Plan 4 |
1/1/2026 |
3/1/2026 |
Essential Plan 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 to continue receiving health care from the Mount Sinai providers you trust.
What You Can Do Today
- If Mount Sinai and Anthem do not come to an agreement by 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 being treated for certain health conditions. Please see the section below for more information.
- 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 let them know you want to keep access to the Mount Sinai providers and services you know and trust.
- 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.
