Keeping Healthcare Affordable for All Missourians

 

Despite good faith efforts including offers of reasonable payment increases that are in line with other Missouri health systems, Anthem Blue Cross and Blue Shield was unable to reach a new contract with MU Health Care. As a result, MU Health Care is no longer in Anthem’s network as of April 1, 2025. This means that until they return to our network, our members may pay considerably more for care at MU Health Care’s doctors and hospitals than they would at an in-network care provider. Please see below for assistance in transferring to an in-network care provider or, for members previously in treatment at MU Health Care for serious or complex health conditions, options to continue care with your current provider.

 

MU Health Care has demanded drastic price increases over the next three years for its patients covered by Anthem. We cannot agree to price hikes of this magnitude for our members. Standing up for affordable care for all Missourians is part of our mission.

 

MU Health Care has chosen to end its contract to serve Anthem Medicare Advantage health plan members effective April 1, 2025. This means Anthem Medicare Advantage members may pay more for care after that date at MU Health Care. Please see below for information about alternative care providers in our network and additional steps we’ve taken to assist members currently receiving treatment at MU Health Care.

 

For members covered by Anthem employer-sponsored, Taft-Hartley programs, small business, and individual plans
We continue to negotiate with MU Health Care in hopes they return to our network soon. Until then our members may pay much more for care at MU Health Care than at an in-network provider. We know MU Health Care is an important provider for many families. But we know that affordability is also important and their proposed price hikes over three years would have created a massive financial burden for our members and their employers.

 

These higher costs would mean Anthem members would pay higher co-pays and other out-of-pocket expenses. In addition, 80% of Anthem members are covered by employers who directly pay their employees’ healthcare bills. That means that Central Missouri employers would have to shoulder the burden, instead of using that money to invest in employee wage increases, hiring, and business growth.

 

Our Offer: Fair Payment Increases That Keep Healthcare Affordable
We continue to offer MU Health Care payment increases that are fair, in line with other Missouri health systems, and ensure affordability while supporting the care MU Health Care provides. We also continue to offer performance-based incentives that reward MU Health Care for delivering high-quality, value-based care— improving health outcomes and helping to control costs without putting an extra burden on employers, employees, and families.

 

Affordable healthcare is essential. MU Health Care's proposed increases would create financial challenges for families, businesses, and the state as a whole.

  

We have coordinated with our other Central Missouri care provider network partners to ensure our members will have access to high quality care. These include:

It is important that our members’ care is not disrupted while they look for a new doctor or facility that is in their plan’s network. Members may be eligible to keep receiving care for certain conditions or scheduled services at MU Health Care for a limited time.

 

Members previously receiving care at MU Health Care for serious and complex conditions -- including urgent surgeries that are already scheduled, treatments for terminal illness, ongoing treatments for a serious and complex condition, care for pregnancy, and more -- may qualify for in-network benefits with MU Health Care for a limited time or until their treatment is complete.

 

Members should contact our member service center at the number on their ID card to find out whether they are eligible for continuity of care, or if they have already been pre-approved for continuity of care.

 

Please note that coverage for emergency care will be provided according to the member’s policy benefits at in-network cost shares.

 

Members can also complete and submit a Continuity of Care Request Form if certain circumstances apply. If approved, Members will be eligible to continue care with a MU Health Care provider at the network benefit level until it is medically appropriate to transfer care to an alternate in-network provider. Members should not complete and submit the form if they are not currently receiving ongoing care or if they do not have upcoming services scheduled. Members may submit a continuity of care request form if any of the following circumstances apply:

Members receiving certain types of treatment/care at MU Health Care were proactively notified and preapproved to continue their current treatment with MU Health Care at their plan’s in-network benefit level. Anthem automatically extended these in-network benefits for the care they’re receiving from MU Health Care through June 29, 2025, for their current diagnosis. Those members don’t need to do anything to receive this extension. This preapproval does not apply to any other diagnosis or to other members of their family covered on their insurance with Anthem. If members need care at MU Health Care beyond June 29, 2025, our member service center can tell them how to apply for a network exception request based on need for specialized services in their area.

What should I do if I need emergency medical care from MU Health Care?
Members should always call 9-1-1 or go to the nearest emergency room in a life-threatening situation. Coverage for emergency care will be provided according to the member’s policy benefits at in-network cost shares.

 

Yes. Most Anthem health plans include coverage for services at out-of-network care providers.  Anthem members may receive care at MU Health Care as they did previously, and Anthem will reimburse the member directly per the terms of their health plan. However, it’s important to note that with no contract in place, MU Health Care may bill you above and beyond Anthem’s payment for services rendered.

Using in-network care providers is always the least expensive option.  For help moving to an in-network care provider, please login to the Sydney Health app or Anthem.com, or call our customer service center at the number on your ID card.

 

Anthem members enrolled in employer-sponsored, Taft-Hartley, small business, Medicare Advantage, and individual plans will be impacted.