Scripps Health, Anthem Contract Expired in San Diego
Local business owners and employees on specific HMO plans must navigate new in-network coverage gaps at Scripps.
Updated on Oct. 1, 2026 in Healthcare
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Scripps Health and Anthem Blue Cross failed to reach a new agreement, ending their contract on September 30, 2026. This shift impacts local users of Anthem Priority HMO and CalPERS Select HMO plans, moving services at Scripps out-of-network for non-emergency care.
Why it matters
The expiration creates immediate disruption for local employers and staff reliant on Scripps facilities for primary or specialty care. As health networks narrow, companies must account for potential coverage gaps when selecting annual insurance benefits for their workforce.
Patients with surgeries scheduled within a 180-day window may qualify for continuity of care. Newborns and those with chronic conditions are also eligible for continued coverage during a temporary grace period lasting through December 31, 2026.
The players
Scripps Health
A prominent non-profit integrated health system operating multiple hospitals and clinics in San Diego County.
Anthem Blue Cross
A major health insurance provider offering a wide range of managed care plans across California.
UC San Diego Health
An academic health system serving as a major provider of tertiary and quaternary care in Southern California.
The details
The termination of the contract means that non-emergency services at Scripps Health are no longer covered as in-network for affected Anthem HMO members. While a temporary transition period is active through the end of the year, patients must verify continuity of care requirements for ongoing treatments like surgery or pregnancy. Separately, the healthcare landscape in the region continues to tighten, as UC San Diego Health plans to remove United Healthcare HMO from its network beginning January 1, 2027.
Timeline
September 30, 2026: The contract extension between Scripps and Anthem expired.
October 1, 2026: In-network coverage for non-emergency Scripps services ended.
October 1, 2026 – December 31, 2026: A temporary grace period is available for affected patients.
October 15, 2026 – December 7, 2026: Medicare annual enrollment takes place.
January 1, 2027: United Healthcare HMO departs the UC San Diego Health network.
Market Landscape
This split follows a documented industry trend of narrowing provider networks across California. It sits alongside recent network adjustments at UC San Diego Health, illustrating increased friction between regional health systems and major insurance payers.
Small business owners should immediately audit their current health insurance offerings to determine if staff are covered by the affected Anthem plans. Advise employees with ongoing procedures to check their eligibility for the 180-day continuity of care protection.
The takeaway
Healthcare network stability has become a primary operational risk for employers managing employee benefits. Owners should verify network status with their insurance broker before major enrollment cycles to avoid unexpected disruptions in employee access to local care providers.
What happens next
The Medicare annual enrollment period runs from October 15, 2026, to December 7, 2026, providing a critical window for individuals to adjust coverage plans.
Further reading
For more on evolving coverage trends, visit our Healthcare section.
More information
To review available options and plan details, visit the Medicare coverage plans portal.
Source note: This article includes information reported by KSWB 5/69.
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