New York City-based Mount Sinai physicians are no longer in Anthem’s network as of Jan. 1, according to both organizations.
The contract expired Dec. 31, 2025, following negotiations which began in the spring. All Mount Sinai facilities will go out of network March 1, but Medicare Advantage beneficiaries already lost access. Although some employer-sponsored plans are exempt from the changes, commercial, Con Edison, state and federal plans are affected.
In a Dec. 17, 2025, open letter, Anthem said the health system “wants to charge patients 50% more over the next three years.”
“We cannot, however, agree to extreme price increases for our members — or certainly to removing patient protections or potentially jeopardizing access to care,” the letter said.
Mount Sinai denied these claims, contending that Anthem pays Mount Sinai up to 35% less than other comparable health systems.
“This is a manufactured talking point designed to distract from the real issues in this negotiation. We requested single-digit annual increases over a three-year period,” the group said of Anthem’s claims. “We have asked only for reasonable adjustments that would begin to narrow — not eliminate — this gap.”
