Under the consent order, which lasts through the end of 2019, Anthem agreed to cover visits to WellStar primary care physicians and specialists for members who purchased their individual policies off the ACA exchange. However, Anthem won’t cover hospital inpatient admissions or outpatient services like X-rays.
The changes come after Anthem stopped covering WellStar services earlier in 2019 for individual plan members who were already locked in to their health insurance policies for the year. The members argue they didn’t learn about the change until they bought their policies, despite the fact Anthem notified WellStar in August 2018 about the change.
Read more here.
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