As of June 9th, Anthem is currently in contract negotiations with Northern Light Health (NLH). Anthem members will have access to NLH as in-network under the current contract until at least December 30, 2025. However, they haven't yet reached agreement and if they do not, then Anthem clients will no longer be accepted by Northern Light as of 2026.
Why is this happening? It depends on who you ask. Anthem states that NLH is proposing a 30% increase over the next 3 years. However, NLH claims Anthem is paying them 15% less than other Maine healthcare providers whom Anthem works with. The people who ultimately get hurt are the clients, unfortunately.
Click Here for Anthem's Statement
Click Here for Northern Light's Statement.
Who does this effect? Individuals on group Anthem plans, marketplace Anthem plans and Anthem Medicare Advantage plans. This does not effect individuals with an Anthem Medicare Supplement.
What should you do if you have Anthem and see Northern Light doctors? Recognize that contract negotiations are normal and this will likely be resolved due to the volume of Mainers that use both Anthem and NLH. However, if Anthem does leave the network, we will have plenty of time to change your coverage to a plan that covers Northern Lights.
For Anthem Medicare Advantage clients, we can meet during Open Enrollment from October 15th to December 7th. United Healthcare, Martin's Point, Aetna, WellCare and Original Medicare with any Medigap will still be in-network.
For Anthem Marketplace clients, that open enrollment is from November 1st to January 15th and Community Health Options, Harvard Pilgrim & Taro are all still in-network,
Long Story Short: Anthem and Northern Lights are in negotiations and I will keep you all updated if changes need to be made to your healthcare plan. If you need to chat about it, call me anytime at 207-248-8411
