Anthem Blue Cross HMO Update
Important Update Regarding Aspire Health and the Anthem Blue Cross Commercial HMO Plan
Aspire Health has been working with Anthem Blue Cross to reach an agreement that would allow us to continue participating in Anthem’s Commercial HMO network while supporting access to high-quality, affordable care in Monterey County. Despite months of discussions, we have been unable to reach mutually acceptable terms, and our current agreement is scheduled to end on December 31, 2026.
We understand that changes involving health insurance can be concerning. Our priority is to keep members informed, support continuity of care, and help individuals and families understand their options.
What this means today
- Nothing changes right now. Aspire Health providers, including providers affiliated with Montage Health and Salinas Valley Health, remain in-network for Anthem Commercial HMO members through December 31, 2026.
- Emergency care will always be available, regardless of insurance coverage changes.
- Access to hospitals within Monterey County for Anthem members is not impacted by this change.
- Who would be affected? This change only affects Monterey County residents who currently have an Anthem Blue Cross HMO insurance product and are assigned to a Primary Care Physician through Aspire Health’s plan-to-plan relationship with Anthem Blue Cross.
Do I have other options so I can continue to access providers in Monterey County in 2027?
Yes. Aspire Health maintains a similar plan-to-plan relationship with another payor through which your employer group offering may have access. This relationship includes access to a broad network of providers throughout Monterey County. Contact your employer’s human resources department to understand your employer group offerings for 2027.
Looking ahead
Aspire Health remains committed to finding solutions that support access to high-quality, affordable healthcare for the people of Monterey County. Members may wish to speak with their employer’s human resources department or benefits administrator to learn about health plan options that include local provider access.
We will continue to share updates as more information becomes available. Our focus remains on caring for our community and ensuring patients have access to the high-quality healthcare services they need and deserve.
Do you have a question? We’d love to help.
Frequently Asked Questions
This change will affect the Anthem Blue Cross HMO plan for members who live in Monterey County.
Our agreement with Anthem Blue Cross HMO will end on December 31, 2026. Members can continue receiving care as usual until that date. Starting January 1, 2027, Anthem Blue Cross HMO members may have to pay out-of-network costs or cover the full cost of care out-of-pocket.
All providers contracted with Aspire Health, such as doctors at Montage Medical Group and Salinas Valley Health’s Primecare.
No. Members of Aspire Health’s Medicare Advantage plans and Aspire’s plan-to-plan relationship with Blue Shield of California HMO plan are not affected by this termination.
The Aspire Health relationship with Anthem HMO did not include inpatient care delivered at a hospital. Please consult Anthem or your employer to verify in-network coverage.
No. Blue Shield of California is a separate organization from Anthem Blue Cross. Blue Shield of California members are not impacted by this change.
Contact your employer’s HR or benefits team if you receive insurance through work. Share that you need your plan to include in-network access to Montage Health and Salinas Valley hospitals and healthcare providers. Your employer may have other HMO options available in Monterey County.
Certain patients — including those who are hospitalized, pregnant, or undergoing active treatment — may qualify for Continuity of Care through Anthem Blue Cross. Anthem Blue Cross will make the final determination on eligibility. For more information, contact Anthem Blue Cross using the number on your insurance card or visit the California Department of Managed Health Care.
For a medical emergency, go to the nearest emergency department. All health plans are required under state and federal law to cover emergency services for active members until a patient is stabilized. Members are encouraged to contact their insurance company once stabilized to determine coverage for future care.