SAN DIEGO (KGTV) – Regina Key has been going to Scripps Health for 20 years and has insurance with Anthem Blue Cross.
“It's now the 31st and we still don't have a concrete answer as to what to do tomorrow,” Key said.
She's one of Anthem's 125,000 insured people who are receiving medical care at Scripps while wondering what the new year will bring.
“This has been a very frustrating and worrying process,” Mr Key said.
The deadline for contract negotiations between Scripps and Anthem is January 1st.
Both sides raise many issues.
Scripps calls for Anthem's policy to eliminate delays and burdens on patients accessing care.
Anthem says Scripps' demands could lead to price hikes and significantly increase deductibles and out-of-pocket costs.
“I only have one prescription and it’s not cheap,” Key said.
If no deal is reached, Regina and many others could lose Anthem Insurance members from the Scripps network.
So Regina rushed to the pharmacy to get her prescription filled, as the deadline was fast approaching.
“And I knew that if I didn't go to the pharmacy today, when my insurance would cover it, I would end up paying $100 that I didn't want to spend on a prescription that would normally cost $10,” Key said.
But as a mother of two, she also has other people's health to worry about.
“My two children are generally healthy, but as you know, there are some specialized health care providers that they need to see and are currently making appointments,” Key said.
“That's all going to be turned upside down. The last thing you want as a parent is to feel like you can't give your kids what they need to make sure they're healthy.”
both scripps and national anthemWe post on our website to advise our members and patients about what's to come.
Each notice takes a similar position on the current state of negotiations, adding that they continue to advocate for members and patients.
A Scripps Health spokesperson told ABC 10News: “Discussions with Anthem Blue Cross continue. It is important that patients understand that emergency care will not be affected regardless of the outcome of the negotiations. We welcome patients at Scripps Health regardless of their insurance plan, and Scripps will continue to share updates as they become available.
A spokesperson for Anthem sent ABC 10News the following statement: “Despite our good faith efforts to reach a new agreement, it appears that Scripps has chosen to withdraw from Anthem's regional provider network effective January 1, 2025. Crips has requested a significant increase in fees for Anthem's eligible patients. That increase will result in higher profits, especially for local employers, who will pocket the costs of membership. It would have been a blow. More than 80% of Anthem Blue Cross members have employer insurance that pays directly for employee medical expenses.
“Members currently receiving treatment for serious and complex conditions may be able to continue treatment with their current healthcare provider for a limited time. To do so, members or their physicians may contact our Service Center. Anthem members also work with several other high-quality partners in San Diego County, including UC San Diego Health, Sharp Healthcare, and Palomar Medical Center. ) will continue to be accessible in-network. These partners are ready to provide care to members currently under Scripps.
“We are in active discussions to reach an agreement that will bring Scripps physicians and facilities back into our network and provide affordability to the employers and consumers we serve. For the latest information, please visit: anthem.com/ca/scrippshealth/ [anthem.com].”
This is an anxious time of year as we prepare for a new season.
“This is completely unprecedented for us, so we just have to deal with it. I don't think there's going to be panic, just a state of high alert,” Key said.
