SAN DIEGO (KGTV) – Regina Key's been going to Scripps Health for 20 years and is insured by Anthem Blue Cross.
"Now it's the 31st and we still don't have no concrete answer as to what we are supposed to do tomorrow,” Key said.
She's one of 125,000 people insured by Anthem and get health care at Scripps wondering what the new year holds.
"It's been an extremely frustrating and worrisome process,” Key said.
That's because the contract negotiation deadline for Scripps and Anthem is January 1st.
Both sides are raising a number of issues.
Scripps asking for the removal of delays and burdens for patients accessing care in Anthem's policies.
Anthem says what Scripps is asking for will lead to price hikes that could result in much higher deductibles and co-pays.
"My one prescription that I have is not cheap,” Key said.
If no deal's made, Regina and plenty of others could be out-of-network at Scripps as anthem insurance members.
So, Regina raced to the pharmacy to get any prescriptions filled with the deadline getting closer by the minute.
"And I knew that if I didn't get from the pharmacy today when it was covered, I would be on the hook for $100s that I'd prefer not to spend on a prescription that I normally get for $10s,” Key said.
But the mom of two has other people's health to be worried about as well.
"My two kids, who are generally healthy, do have some, you know, specialty providers that we need to see, that we have current appointments with,” Key said.
“That is all going to be upended which you never want as a parent feel like you're not able to provide your kids with what they need to make them sure that they're healthy."
Both Scripps and Anthemposted to their websites advising members and patients on what's next for them.
Each of the notices takes similar stances on where negotiations stand, adding they continue to advocate for members and/or patients.
A spokesperson for Scripps Health told ABC 10News, “Discussions with Anthem Blue Cross continue. It is important patients understand that emergency care will not be impacted, regardless of the outcome of the negotiation. Patients are always welcome at Scripps Health, no matter what insurance plan they have. Scripps will continue to share updates as new information becomes available.”
An Anthem spokesperson sent ABC 10News the following statement: “Despite our good faith efforts to reach a new agreement, it appears Scripps has chosen to leave Anthem’s local care provider network effective January 1, 2025. Scripps demanded drastically increased prices for patients covered by Anthem—increases that would have led to higher out of pocket costs for our members and would have hit area employers particularly hard. More than 80% of Anthem Blue Cross members are insured by employers that pay their employees’ healthcare costs directly.
“Members currently receiving treatment for serious and complex conditions may be able to continue care with their current provider for a limited time. To do so, members or their doctors may contact our service center to request Continuity of Care accommodations. Anthem members also continue to have in-network access to several other high-quality partners throughout San Diego County who are prepared to provide care for members currently under Scripps, including UC San Diego Health, Sharp HealthCare, Palomar Medical Center and others.
“We want Scripps doctors and facilities to return to our network and remain in active discussions to reach an agreement that offers affordable prices for the employers and consumers we serve. To stay updated, please visit anthem.com/ca/scrippshealth/ [anthem.com].”
It’s an unsettling time of the year just as we get ready to ring in a new one.
"This is totally unprecedented for us so, I'm just going to have to wing it,” Key said. "I think it's just going to be a constant state of not panic but just high alert."
