Skip to main content

Anthem Blue Cross CA 2014 Provider Directories Finally Available

The Pathway Network provider directories are now online for searching.  Anthem will be using the Pathway/Pathway-X networks for all 2014 Individual & Small Group health plans in California.

Use the link below to access the PDF directories (it's not searchable online yet) for your area to find out which providers are in-network for ObamaCare coverage plans from Anthem Blue Cross.

Anthem Provider Directories



Dave
www.davefluker.com

Comments

  1. Thanks for keeping on top of this. It has been a struggle to get the proper information.

    Unfortunately, I feel like I am getting lost in the vocabulary.

    Pathway X vs. Pathway Tiered
    ON vs. OFF Individual Exchange
    EPO Tiered Network vs. HMO


    Although I can find my doctor in the PDF, I cannot say with any degree of certainty of which plans I can choose from and keep my doctor.

    It would be so helpful to map the terms on the CoveredCA website to Anthem's proprietary terms.

    ReplyDelete
  2. One of my wife's doctors, Roger Winkle in San Mateo County, is listed as in the Anthem Pathway X, and Pathway PPO, network. However, I called the doctor's office on October 21 and they told me he will not be in network. The Anthem network list is not accurate, and has not changed since October 24.
    What is very distressing is it appears ALL the Anthem plans I can buy, either through the Covered CA website, or directly from Anthem, have the same network. Pathway X for the exchange plans, and Pathway PPO for the policies sold on the Anthem website. Apparently these are all the same plans, with different names. If Dr Winkle is not in the Pathway X Exchange plans, he will also not be in the other "normal" plans on the Anthem website. In other words, there are no available PPO plans that can be purchased with Dr Winkle in network. Stanford Hospital, and the Menlo Medical Clinic with all it's doctors, are where the rest of our doctors are located. If they are not included in the Pathway X, or Pathway PPO plans, then there is no possible way to buy a policy with any of our doctors/hospitals. Since we live in Alameda county, our only option is Kaiser. Healthnet and Blue Shield decided we Alamedians are a bunch of money losing sickies and will not be offering policies in our county.

    ReplyDelete
  3. Good to hear your experience. Sorry that your choices are limited. We have not gotten any answers. We are in LA County. Our Plan B is to move to a HealthNet PPO not on CoveredCA if the Anthem EPO does not cover our doctors. The HealthNet PPO network seems to be fairly broad and they publish their premiums right on the website. Hopefully, we are not overlooking any of the fine print.

    ReplyDelete
    Replies
    1. Has anyone been able to get a definitive answer about whether or not Cedars and UCLA will be providers for Anthem EPOs. Also, I've read that even if my doctor and hospital are EPO providers, the amount I will have to pay will be based on what Tier, either 1 or 2, they are providers for.

      Delete
    2. I go to Cedars regularly, as one of my primary doctors is works with the hospital. If you are, or have been a patient, they should have sent you a notice earlier this year, notifying you about the change with the insurance policies. I called and, spoke to woman who told me that unless I was still covered by the same insurance ( I was with blue shield ppo network) plan that I had since 2010, they would still accept it. If not, she told me I would have to choose from a select list of providers and plans, to get continued coverage. Healthnet was one of the only standout providers I could remember her saying, but they were all definitely PPOs.

      To get more info, you should definitely speak to someone. I would suggest calling cedars general number, and direct the call towards the insurance department, thats where the woman explained everything to me.

      Delete
    3. If these are the Gold and Silver EPO Anthem plans, then UCLA appear to be in the network:

      Anthem Blue Cross Gold Direct Access, a Multi-State Plan-CA
      Anthem Blue Cross Silver Direct Access, a Multi-State Plan-CA

      The trouble is that I cannot definitively get Anthem to identify these plans.

      Delete
    4. Also when I spoke to the woman in the Cedars insurance department she specifically said that they will only accept PPO. Every time that I've spoken with an Anthem broker about their different plans (while trying to research this whole obamacare jumble of new plans and loopholes), this past couple of months, each one has said that they no longer offer PPO plans in California or Los Angeles county at least which is what some said. It looks like Blue shield and Health net are the only more well known providers offering PPOs within the state/ county ( which cedars accepts, UCLA probably as well)

      Delete
    5. An update...

      We have bit the bullet and signed up for the Anthem Gold EPO in LA county using the CoveredCA website. There seems to be no new answers forthcoming to our basic questions about the provider network and we are reluctant to invest any more time on this. The CoveredCA website said that it was forwarding our application to Anthem. The next step is for us to receive a invoice. Perhaps at that time, we can place another call to Anthem to inquire about the provider network. We are hopping that the invoice will have the full Anthem friendly name of the plan that we signed up for.

      Delete
    6. FYI: All of UCLA will participate in Covered California. Buy they will only accept Anthem EPO and Health Net PPO. And as always they accept Medicare, for those that qualify.

      Delete
  4. I cant find the hospitals for Pathway X - Tiered and Pathway Tiered. If you click on the above link of "Anthem Provider Directories", Hospitals are not listed. It is as ifthey forgot to put the first page on the site. They are listed on the others. Does anyone know if Orange Coast Memorial or St. Joesphs Hospitals in Orange County are on the Pathway Tiered List?

    ReplyDelete
  5. Do any of you know if Cedars Sinai accepts and provides full coverage care for Anthem Blue Cross Silver 94 EPO, an MSP, through the Covered CA Exchange? I called the insurance department at Cedars Sinai about a week ago and they said NO. Then I called yesterday and they said YES but they can't support it with a written document. Help!

    ReplyDelete
  6. cedars and blue cross have a tier 2 deal, ask cedars for their tax id then call blue cross, this is the only way to get the correct info which i spent three days uncovering. cedars doesnt want people to know this because they get more money through the health net plan.

    ReplyDelete
  7. The following was added to Cedars-Sinai web site on Tuesday:

    Anthem Blue Cross’ new individual and family plans for 2014 will exclude the majority of Cedars-Sinai physicians from its new narrow network of providers.

    Cedars-Sinai Medical Center is offered as an in-network hospital in PPO plans and as a Tier 2 facility in Exclusive Provider Organization (EPO) plans.

    If you curently have an individual or family plan from Anthem Blue Cross that includes Cedars-Sinai, you may be able to keep that plan through a process called grandfathering.

    Please call the member services phone number on the back of your insurance card to find out if you are eligible. If so, all you need to do is continue to pay your premiums and you automatically will keep your current plan.
    Anthem Blue Cross will not allow grandfathering if your coverage started after March 23, 2010. If your plan began after that date, you will need to change plans before Jan. 1, 2014.
    *Information updated Jan. 7, 2014

    ReplyDelete
  8. I had to get new insurance as my cobra was about to expire. I was told my sutter doctors took anthem Bluecoss/shields. So I called anthem directly (so I thought) when I got my card and it said covered california pathways x the plan I did not want because I do not want covered california the whole reseaon I called anthem directly in first place. I have been waiting for a Neuro. Apt for five months, the day of my apt. I was told they do not except this plan and I missed my long awaited apt. I feel scammed I am angry and no can't find anyone who takes this insurance in placer/sacramento county.

    ReplyDelete

Post a Comment

Popular posts from this blog

Anthem Blue Cross (CA) Adding SilverSneakers® Fitness Program

Anthem Blue Cross (CA) announced this morning that they will be adding the SilverSneakers Fitness Program to California Medicare Supplement Plans A, F, and N.  The added benefit will begin on January 1st, 2017. 

Once approved for release into the market, more states have been added to the list as existing and new members in our marketed plans will enjoy the value-added benefits of the SilverSneakers Fitness program at no additional cost! Effective January 1, 2017, California members in our marketed plans will enjoy SilverSneakers, too.  The program offers members their choice of paths to better health. For those who enjoy a traditional workout setting, SilverSneakers offers access to more than 13,000 fitness locations across the country, including use of classes and guidance from a Program AdvisorTM. In addition, for those who can’t get to a fitness center, SilverSneakers Steps® kits focus on at-home or on-the-go general fitness, walking, strength training or yoga. And if that is not …

How Will Donald TRUMP ObamaCare?

With the election of Donald Trump as the next US President, healthcare reform and ObamaCare are on the chopping block.  There is media speculation that a transformation away from the current ObamaCare system will be rather immediate once Donald Trump is sworn into office in January.  


While changes are certainly coming, I would not expect a wholesale changeover immediately, but rather over the course of 2017.  My hope is to see an open market available at any time during the year (like it used to be) instead of an abbreviated Open Enrollment Period.  

Below are some key points to a Donald Trump-Care system and a link to his Healthcare Reform Paper which goes into more detail...



 1. Completely repeal Obamacare. 2. Modify existing law that inhibits the sale of health insurance across state lines. 3. Allow individuals to fully deduct health insurance premium payments 4. Allow individuals to use Health Savings Accounts (HSAs). 5. Require price transparency from all healthcare providers.6. Bl…

2016 Open Enrollment Has Begun

Here to kickoff the 2016 open enrollment period which will run from November 1, 2015 to January 31, 2016.  

It is important to remember that during the open enrollment period all rules regarding SEP (special election period) enrollment dates for loss of employer coverage are off of the tablle. Than means no retroactive start dates on the Covered California health exchange.

Remember during open enrollment you may sign up for any available health insurance plan either off- or on-exchange with no medical underwriting.

My site features live free instant quotes and online applications for off-exchange subscribers.

For Covered California exchange subscribers, I can take your information over the phone and set up your account on Covered CA for you.  You would need to log in with a special code I would provide upon submission of the application and select your plan/pay the initial premium via Covered CA.  

Carrier for 2016 include:

*Anthem Blue Cross PPO, Tiered PPO and HMO
*Blue Shield of Californi…