Anthem Medicaid Plans

What to Know for Anthem Medicaid Plans

For several months, Reid Health has been working with Anthem insurance to reach a new agreement on contracts for hospital, clinic and physician and provider services that reflects the exceptional care our caregivers deliver every day.

Unless we achieve a new contract soon, all Anthem plans will be out of network with Reid Health hospital and medical providers beginning on March 18, 2024. This includes Anthem Managed Medicaid.

For Indiana residents, Anthem’s Managed Medicaid plans include:

Anthem Healthy Indiana Plan (HIP)
Anthem Hoosier Healthwise
Anthem Hoosier Care Connect

For Ohio residents, Anthem’s Managed Medicaid plans include:

Anthem Blue Cross and Blue Shield

If you receive information that your Anthem Managed Medicaid plan is not in network before March 18, 2024, we encourage you to call the Reid Health Community Helpline at 765-965-4250.

What if I Want to Change From My Anthem Managed Medicaid Plan?

In Indiana:

Visit: The Indiana Medicaid for Members webpage.

Or Call: 877-438-4479

Find your plan listed (i.e., Healthy Indiana Plan, Hoosier Healthwise, etc.)
Call the Helpline number listed with the information for your plan.

In Ohio:

Visit: The Ohio Medicaid Managed Care webpage

Or Call: 800-324-8680

Important Tips:

If you have been enrolled in your Anthem Managed Medicaid plan for less than 90 days, you can change your plan now.
- If you anticipate a gap between March 18 and when your new plan would take effect, apply now for Continuity of Care.

If you have been enrolled in your Anthem Managed Medicaid plan for longer than 90 days, you can request to change plans *beginning March 18 if Reid Health goes out of network with Anthem.
- If you anticipate a gap between March 18 and when your new plan would take effect, apply now for Continuity of Care.

If you have been enrolled in your Anthem Managed Medicaid plan for more than 90 days and have concerns about your access to healthcare under your Anthem Managed Medicaid plan, you can request to change or disenroll from your plan at any time for “Just Cause”.

What is “Just Cause”?

A “Just Cause” is a request to change or disenroll from a plan outside the annual open enrollment period or initial 90-day period after enrollment.
There are many reasons an Anthem Managed Medicaid member may choose to file a “Just Cause” grievance. If Anthem Managed Medicaid is out of network with Reid Health, and you may need to travel for care, you can explore how to file a “Just Cause” grievance. Some of the reasons for a grievance include:
- Limited access to a primary care clinic or other health services within reasonable proximity to a member’s residence.
- Lack of access to providers experienced in dealing with the member’s healthcare needs.
- HIP patients should state that they are requesting a change due to their “Member’s primary healthcare provider disenrolls from the member’s current health plan.”
- The Hoosier Healthwise and Hoosier Care Connect patients should state that they are requesting a change due to “Limited access to a primary care clinic or other health services within reasonable proximity to a member’s residence”

Anthem Managed Medicaid FAQ

These are FAQs related to Medicaid Anthem plans. For general FAQ, visit the homepage.

Will I still be able to see my Reid Health physician or provider?

If we do not reach an agreement, Reid Health will be considered out-of-network with Anthem beginning on March 18, 2024. It’s important to know that patients can always visit Reid Health’s Emergency Department for emergency care, regardless of their insurance plan status.

What is “Continuity of Care”, and how do I know if I qualify?

Anthem is required by law to provide Continuity of Care coverage to those patients who qualify. This provides ongoing coverage for patients who are being treated for a long-term medical condition, such as cancer care or behavioral healthcare. It also provides continued coverage for those who have established a plan of care with their provider – such as an expectant mother.

If you believe you qualify for Continuity of Care, go back to the home page and scroll down to the Continuity of Care section, or click here.

Generally, it takes about 30 days for Continuity of Care forms to be reviewed and/or approved by Anthem.

I have an appointment scheduled for after March 17 – should I cancel my appointment?

We encourage all our patients with Anthem insurance to keep any pre-scheduled appointments. We’ve received tremendous support from our patients who wish to continue receiving care from their trusted Reid physician and care team. Many patients have already taken steps to change their plans or contact Anthem to express their concerns. We appreciate our community’s support and trust. Because of this response and our desire to care for our community, we will resume scheduling all patients with Anthem insurance for appointments beyond March 17. We remain hopeful Anthem will return to the table for good faith discussions.

Reid Health will continue communicating directly with patients who may experience any changes so that they understand these changes and their options moving forward. Those patients who may be impacted can call the Community Helpline at 765-965-4250.

Patients can always visit Reid Health’s Emergency Department for emergency care, regardless of their insurance plan status.

What should I do if I already have an appointment scheduled after March 17, 2024?

Patients with Anthem insurance should keep any pre-scheduled appointments, even those that occur after March 17. We’ve received tremendous support from our patients who wish to continue receiving care from their trusted Reid physician and care team. Many patients have already taken steps to change their plans or contact Anthem to express their concerns. We appreciate our community’s support and trust. Because of this response and our desire to care for our community, we will resume scheduling all patients with Anthem insurance for appointments beyond March 17. We remain hopeful Anthem will return to the table for good faith discussions.

Patients can always visit Reid Health’s Emergency Department for emergency care, regardless of their insurance plan status.