Anthem Blue Cross HMO Update
Welcome to our resource page for members impacted by the changes to Aspire Health's partnership with Anthem Blue Cross HMO.
Montage Health is deeply committed to the well-being of all Monterey County residents. We know that transitions like these can be unsettling, and we want you to know that we're here for you every step of the way.
Since 2018, Aspire has partnered with Anthem Blue Cross to administer a commercial HMO product, including providing claims processing, utilization review, and network administration. While Aspire has continuously worked to support the plan’s operations, ongoing challenges and steady decline in memberships have led Anthem Blue Cross to decide to discontinue this specific community partnership, effective March 1, 2025. This change ONLY impacts people with an Anthem Blue Cross HMO plan.
We are concerned about Anthem Blue Cross' unilateral decision which limits convenient access to healthcare for 2,500 Monterey County residents and disrupts long-standing physician relationships. Montage Health is actively working to secure an alternative agreement, so please check back routinely for updates.
In the meantime, we encourage you to reach out directly to Anthem Blue Cross to check your coverage, file a grievance, and file a complaint against Anthem at the Department of Managed Health Care (DMHC).
Frequently asked questions
Who does this change impact?
This change ONLY impacts people with an Anthem Blue Cross HMO plan. View accepted insurance plans.
Will I still have access and coverage for Emergency Department services at Community Hospital of the Monterey Peninsula?
For a medical emergency, go to the nearest emergency department. All health plans are required to cover emergency services until a patient is stabilized under state and federal law. Members are encouraged to contact their insurance once stabilized to determine coverage for future care.
Will my care be covered at MoGo Urgent Care locations?
No. Members with an Anthem Blue Cross HMO plan can still go to MoGo Urgent Care, but they will have to pay the full self-pay amount of $250. For a $25 charge, Montage Health also offers 24/7 eVisits for minor illness or injury that do not require an in-person physical examination.
If I have a Montage Medical Group provider, will my care still be covered?
It depends.
In some cases, you may be able to keep your doctor, medical group, or hospital for a limited time under "continuity of care." For more information, please visit the California Department of Managed Health Care.
You can still see a Montage Medical Group provider that is no longer covered under your plan, but you will be responsible for paying the bill.
Will coverage continue for Community Hospital/Montage Health outpatient services such as lab and radiology services?
While many services may be covered, all members are encouraged to check with their insurance prior to any elective services for coverage information.
If I’m having a baby, will my birth be covered at Community Hospital of the Monterey Peninsula?
While many services at Community Hospital for delivery may be covered under the continuation of care rules for pregnancy, all members are encouraged to check with their insurance company to understand their specific insurance coverage.
How can members obtain their medical records for any crucial care transition to their new provider?
To obtain a copy of your medical record, contact your provider or visit our medical records page.
Who should I contact if I have questions about my coverage?
Please contact Anthem HMO for any questions about coverage.
