Blue Shield contract termination: Frequently asked questions

What is happening? 

Blue Shield of California’s agreement with the University of California is set to expire June 30, 2025. If an agreement is not reached for a new contract, starting July 1, patients at all UC Health locations, including UC Davis Health, will be ‘out of network’. This means patients will have significantly greater costs for their care with us, or Blue Shield may refuse to pay for any costs of their care. UC Health is in active negotiations for a new agreement with Blue Shield to protect access to the exceptional care we provide to Californians covered by Blue Shield health plans.

Starting on May 1, Blue Shield of California is sending letters to its HMO members that the health plan may move patients to another care provider (not UC Davis Health). The decision to move patients is Blue Shield’s alone, and patients should call the number on the back of their insurance card with concerns.

Which Blue Shield of California health plans are affected by the negotiations? 

If a new agreement is not in place by July 1, 2025, this change would affect Blue Shield of California members across plan types, including:

• California Public Employees’ Retirement System plans
• Plans offered by employers
• Plans from the Covered California marketplace
• Medicare Advantage plans administered by Blue Shield of California

When does the current UC Davis Health agreement with Blue Shield end?

Our agreement with Blue Shield for our facilities and health care providers to be in-network will end as of June 30, 2025, unless we reach a new contract. Patients can receive care as normal until June 30. Starting July 1, patients may have to pay out of network costs or pay for the entire cost of care out-of-pocket.

Which health providers are affected by the negotiations over in-network status of UC Health providers and facilities?

All UC Health hospitals, facilities and health care professionals rely on this agreement with Blue Shield of California to remain in network for you.

I’m a Blue Shield of California HMO member. Why did I get a letter saying I’m being transferred to a new primary care provider?

Despite our continued efforts to reach a new agreement, Blue Shield of California has initiated a process to move care for its HMO members to a new provider that the health plan has chosen, starting as of July 1, 2025. It was Blue Shield of California’s decision alone to start this process and it was done even as negotiations continue. 

We are disappointed by Blue Shield of California’s decision to move care away from the physicians, nurses and other professionals you have chosen at UC Davis Health and potentially cause you treatment delays.

If you are a Blue Shield of California member who has been receiving care from a UC health care provider, you may have a right to keep your provider for a designated time period. Please contact Blue Shield of California’s member service department, and if you have further questions, you are encouraged to contact the Department of Managed Health Care, which protects consumers, by telephone at its toll-free number, 1-888-466-2219, or at a TDD number for the hearing and speech impaired at 1-877-688-9891, or online at www.dmhc.ca.gov. 

Our care teams are ready to help you complete Blue Shield of California’s form and support you through the process if you decide to ask Blue Shield of California to allow you to continue your care with us. We’ve linked to their form on our website and here to make it easy for you to access. 

I have a Blue Shield plan. What does this mean for me? 

For now, nothing changes. You can still see your physician and get care at UC Davis Health through June 30 without any changes. We cannot guarantee you will have this same access to in-network care after July 1, 2025, because our contract with Blue Shield will expire without a new agreement. We are continuing to make it clear to Blue Shield that we hope to avoid disruptions in your health care and to protect you from higher out of network charges.

I have an Anthem Blue Cross health plan. Will my coverage be affected?

No, Anthem Blue Cross is a separate organization from Blue Shield of California. Anthem Blue Cross members are not impacted.

What can I do to protect my in-network access to UC Health? 

Nothing is changing before July 1, 2025, so patients can continue to receive care as normal. 

After July 1, and until there is a new contract agreement, patients may be responsible for paying the costs of their care directly. If you have an option to switch plans mid-year, they may choose to move their health insurance to another plan that pays UC Davis Health for the care provided. 

Or, patients can reach out to Blue Shield directly with concerns about their health insurance coverage no longer covering their care at UC Davis Health.

If you have Blue Shield health insurance and an appointment with UC Davis Health after June 30, you may want to move that appointment to an earlier date, to ensure that it is covered by Blue Shield.

What if I’m in the hospital when the contract ends?

Patients that are already admitted to the hospital prior to July 1, 2024, will be covered at in-network rates through the end of their inpatient stay.

What if I am pregnant or receiving treatment for a special condition on or after June 30, 2025?

Certain patients, including those who are hospitalized, pregnant, or undergoing an active course of treatment prior to the contract end date, may qualify for ‘Continuity of Care’ through Blue Shield. Should a new agreement not be reached by June 30, 2025, UC Health providers will help their existing Blue Shield patients complete the information needed for the continuity of care request forms. Blue Shield will have more details for you on how to apply in the coming weeks.

For a Continuity of Care form, questions about Continuity of Care criteria and details on how to apply, please contact Blue Shield using the phone number on the back of your Blue Shield health insurance card. Blue Shield makes the final determinations on who qualifies for Continuity of Care.

What if I have an elective procedure scheduled at a UC Health hospital or facility on or after June 30, 2025? 

We understand that some patients may have appointments scheduled on or after June 30, 2025, and we want to be sure this care is not interrupted. If you have a scheduled appointment on or after June 30, 2025, you should call your provider’s office to request that the appointment or procedure be rescheduled prior to June 30, 2025, if possible. If you are unable to reschedule your appointment or choose to keep your appointment, you may have to pay higher out-of-pocket costs under a Blue Shield plan for your care at UC Davis Health after our contract expires, if a new agreement is not reached. Or, you may need to wait until a contract is finally reached with UC Davis Health, but we do not know how long it may take to work out a new agreement.

What if I have an emergency on or after June 30, 2025, and UC Health is out of network? 

Patients will always have in-network access to our emergency rooms, regardless of our contract status with Blue Shield. In an emergency, you should get care from the closest hospital that can help you. Patients needing emergency care can receive in-network treatment until they are stable.

How can I stay up to date on negotiations? 

As a valued patient, we want to help you understand what is happening and what you can do to make sure your care at UC Davis Health continues. The latest updates on this situation will be posted online here.