If you’re on an Anthem Medicare Advantage plan and get your care through Sentara, you may have seen headlines about their ongoing contract negotiations. Here’s a plain-English look at what’s happening and what it could mean for your coverage.
What’s Actually Changing
Sentara Health, one of the largest hospital systems in Virginia, and Anthem Blue Cross Blue Shield are negotiating new contract terms for 2027. Sentara has sent Anthem a notice to end its contracts effective January 1, 2027, for Medicare Advantage and commercial plans, and January 28, 2027, for Medicaid, if new terms aren’t reached. Nearly 380,000 Anthem members statewide could be affected, with the heaviest concentration in the Hampton Roads region.
Sentara has proposed a 6.2% rate increase for 2027. Anthem has countered with a 1% decrease. Sentara also cites disputed claims payments; Anthem says members can currently continue seeing Sentara providers with no coverage changes.
Why This Is Happening
This kind of negotiation is common in healthcare: hospital systems and insurers periodically renegotiate reimbursement rates, and public back-and-forth like this often resolves before any deadline takes effect. It’s also possible it won’t. Either way, it’s a good opportunity to understand your options.
Why This Matters for You
If your Anthem Medicare Advantage plan relies on Sentara hospitals or physicians, it’s worth understanding what would change if the contract does lapse, and what your options would be. Medicare’s Annual Enrollment Period (October 15 – December 7) gives you a normal, built-in opportunity to review your plan each year regardless of how this particular negotiation turns out.
What You Can Do
- Keep an eye on updates from Sentara and Anthem. Both have posted public pages with the latest status of negotiations.
- Review your plan’s network. It’s helpful to know whether Sentara facilities are central to your care, and how your plan generally handles network changes.
- Use AEP as your normal review window. Every fall is a good time to compare your Medicare Advantage plan against your other options, whether or not this particular situation affects you.
- Ask your doctors what they’re seeing. Sentara-affiliated physicians can share their own read on how negotiations are progressing.
- Know that protections sometimes apply. In some past hospital-network situations, CMS has extended additional enrollment flexibility to affected members. If a change here does happen, it’s worth checking whether that applies to your situation.
Let’s Talk Through Your Options
Whatever happens with Sentara and Anthem, we’re happy to walk through your plan and your options with you – at no cost and no pressure. Reach out anytime for a free Virginia Medicare consultation.
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
