Get answers to your questions

To be clear: nothing changes today. Sentara remains in-network for Anthem members through at least December 31, 2026. Sentara is now formally preparing for a transition to out-of-network status beginning January 1, 2027 for Medicare Advantage and ACA Exchange, and January 28, 2027 for Medicaid. We are supporting affected patients as they navigate the transition and Anthem’s continuity-of-care process and will share more details as that planning takes shape.

As open enrollment season approaches, we encourage affected members to find a health plan that allows them to keep seeing their Sentara doctors and care teams in-network. Upcoming enrollment dates are:

• Medicare Advantage: October 15 - December 7, 2026 
• Exchange: November 1, 2026 - January 15, 2027 
• Medicaid (Charlottesville/Western Halifax): August 19 – October 31, 2026 
• Medicaid (SW Virginia): December 19, 2026 - February 28, 2027 

Sentara has also partnered with Chapter, a licensed Medicare advisory service, to offer free, personalized guidance to patients eligible for Medicare Advantage. Patients can visit askchapter.org/sentara or call 1-855-531-2355 for more information. 

Sentara remains in-network for Anthem members through at least December 31, 2026, and nothing changes about your coverage at this time. We encourage you to review your plan options when your enrollment window opens and consider which plan allows you to continue seeing your Sentara doctors and care teams in-network. 

Upcoming enrollment dates are: 

• Medicare Advantage: October 15 - December 7, 2026 
• Exchange: November 1, 2026 - January 15, 2027 
• Medicaid (Charlottesville/Western Halifax): August 19 – October 31, 2026 
• Medicaid (SW Virginia): December 19, 2026 - February 28, 2027 

For those with employer-sponsored insurance: Your enrollment window and plan options are determined by your employer. We encourage you to speak with your HR or benefits team during your company's open enrollment period. 

For now, keep appointments as scheduled. 

Anthem members in Virginia are statutorily allowed to continue care post-termination for up to 90 days for commercial and Medicaid plans, and up to 60 days for Medicare Advantage plans. Patients who qualify for additional continuity-of-care protections, including those in active cancer treatment or obstetrics care, will retain in-network access further into 2027. Sentara is committed to supporting affected patients and helping them navigate Anthem’s continuity-of-care process as much as possible. 

Our proposal is straightforward: with the costs of providing health care skyrocketing year after year, we requested a modest 6.2% single-year blended rate increase across all our plans. Anthem has not agreed to our more-than-fair proposal for Medicare Advantage, Medicaid, and ACA Exchange plans. Separately, Anthem continues to delay payment on the $105 million in care that Sentara has already provided its members. 

Negotiations on commercial plans continue, and we are working toward a fair agreement that reflects the true cost of delivering high-quality care to the thousands of Anthem members who rely on Sentara across Virginia.

The 30% that Anthem has called out is just one business line (commercial) and compounds rate changes over multiple years. Sentara’s proposal is a modest single-year 6.2% blended rate adjustment that spans our entire business relationship with Anthem, which includes all plans. In fact, Anthem repeatedly requested a decrease for the majority of Medicare Advantage, Medicaid, and ACA Exchange plans.

Sentara Health Plans and Sentara's care delivery system (i.e., hospitals and physician practices) are separate, independently operated parts of the organization, and have no role in these negotiations or bearing on the rates we have proposed. For nearly one year, Sentara has been working diligently to stay in Anthem's network — for Anthem's own 380,000 Virginia members. Sentara has been working to protect access, not limit patient choice. In fact, we contract with several other payors including Aetna, Cigna, Humana, and UnitedHealthcare and we are actively negotiating with others to increase options for our patients.

Congress recently passed a federal law (known as H.R. 1) that is expected to cut healthcare funding nationwide and cause many people to lose insurance coverage in the coming years. When a patient loses coverage, we still care for them – that does not change. At the same time, tariffs on medical devices, equipment, and pharmaceuticals are driving up what it costs for us to deliver that same care. Any agreement meant to hold for the next several years has to take these factors into consideration. Both Sentara and Anthem have a shared interest in maintaining a sustainable health care system that ensures patients can continue to access the care they need. 

The Health Action Network is an initiative created and supported by Elevance Health, the parent company of Anthem. Instead of using their increasing profits to fairly pay healthcare providers like Sentara the cost of delivering high-quality care, they have instead invested that money in marketing campaigns targeting Virginians who only want to be able to access the care they deserve.  

The 22.7% figure is an average increase and will vary by member location, since Sentara Health Plans offers coverage statewide. Sentara's 2026 premiums started from the lowest base in the state. The increase reflects several factors affecting the entire individual insurance market that are not unique to Sentara, including rising medical costs, higher utilization of services, and the reinstatement of the state-permitted tobacco use surcharge after a temporary one-year prohibition expired. For 2027, Sentara expects to remain the lowest- or second-lowest-cost option in most regions of the state.

It's also important to note that Sentara Health Plans and Sentara's care delivery system (i.e., hospitals and physician practices) are separate, independently operated parts of the organization. Sentara Health Plans' premium filings are unrelated to and have no bearing on Sentara’s contract negotiations with Anthem.

Any increase in premiums would be Anthem’s choice, not an automatic consequence of Sentara’s proposal. Anthem has made clear that it intends to pass along any increases to its members, especially employer groups, rather than absorb them or reduce its shareholder payouts. Anthem is a highly profitable, for-profit company and how it chooses to allocate those costs is a decision Anthem is making, not one Sentara is making for it.