Health

Anthem Individual Insurance Plans Incorrectly List WellStar As In-Network

In a release Tuesday, Georgia's insurance commissioner said Anthem incorrectly listed WellStar doctors and hospitals as in-network, when, in fact, they’re not.
In a release Tuesday, Georgia's insurance commissioner said Anthem incorrectly listed WellStar doctors and hospitals as in-network, when, in fact, they’re not.
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If you picked an Anthem plan on the individual insurance marketplace, you might want to double-check your selection.

In a release Tuesday, Georgia’s insurance commissioner said Anthem incorrectly listed WellStar doctors and hospitals as in-network, when, in fact, they’re not.

“Consumers who have enrolled in the 2020 Anthem Pathways Network individual plan on HealthCare.gov need to know that WellStar providers will not be covered at in-network rates,” said Commissioner John King in a written statement.

His office points out that none of Anthem’s plans offered on federal health exchange in Georgia cover services from WellStar providers.

But King said there should be enough time left in open enrollment for people to review their selections and switch if needed.

“Fortunately, the enrollment period for the Healthcare Marketplace remains open until Dec. 15, so consumers still have over three weeks to make any necessary changes to their plans for next year,” King said.

The release from King’s office also includes a statement from Anthem. A spokesperson for the insurance provider said it’s “committed” to helping people who want to switch plans.

It’s not the first time Anthem has posted incorrect information about where its customers can get in-network care.

The company is accused of failing to inform enrollees about a pending contract termination with WellStar during the last open enrollment period.

Several policyholders have sued the insurance provider over what their attorney, Jason Doss, has called a “bait-and-switch.” That case is pending.

In the meantime, Doss said, Anthem should extend the enrollment deadline for those who have picked its plans during the current open enrollment period.

“Consumers, when they’re purchasing complicated products like health insurance, once they make that purchase decision, it’s very difficult to reverse course,” Doss said.

WellStar, for its part, said consumers who want to use its doctors and hospitals have other options on the individual marketplace.

“To support patients affected by WellStar’s exclusion from the [Anthem insurance] product, WellStar has three additional contracts with Health Insurance Exchange (HIE) insurers: Ambetter; CareSource and Oscar,” the company said in a statement.