Anthem Consumers in California Discover Health Plans No Longer Provide Out-of-Network Coverage After End of 2017 Enrollment Period

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Santa Monica, CA – Consumers are just beginning to discover that Anthem eliminated coverage for out-of-network doctors ​now that the Affordable Care Act “Open Enrollment Period” to secure health coverage for 2017 ended on January 31.

“Anthem broke the law and its promises to consumers by illegally eliminating coverage for doctors not participating in Anthem’s limited network,” said Ben Powell, staff attorney for Consumer Watchdog. “This change leaves customers potentially facing thousands of dollars or more in unexpected medical bills.” 

Attorneys for Shernoff Bidart Echeverria, LLP and Consumer Watchdog filed a class action lawsuit on October 31, 2016 against Anthem Blue Cross for illegally converting Preferred Provider Organization” or “PPO” plans, which offer out-of-network benefits, into “Exclusive Provider Organization” or “EPO” plans, which provide no out-of-network benefits. 

Click here to download the lawsuit: 

Many specialists treating chronic diseases and other physicians do not participate in or have been excluded from Anthem’s network.  Under the new change implemented by Anthem, Anthem will not pay for services provided by so-called “out-of-network” physicians. As paying full cost of out-of-network care is untenable for all but the wealthiest, consumers likely face loss of access to these physicians altogether, a prospect particularly harmful for those in the midst of treatment.

Consumer Watchdog noted that under the so-called “guaranteed issue” provision of the Affordable Care Act (aka Obamacare), consumers with pre-existing medical conditions can no longer be barred from accessing health insurance.  However, by eliminating PPO plans and cutting-off access to out-of-network doctors, a benefit especially important to patients with medical problems, Anthem is illegally discriminating against sicker patients, among other violations of law.


Consumer Watchdog is a nonpartisan consumer advocacy organization with offices in Washington, D.C. and Santa Monica, CA. Find us on the web at:

Shernoff Bidart Echeverria LLP leads the nation in protecting policyholders from insurance company abuse. The firm has been protecting the rights of insurance consumers, both individuals and businesses, for over 35 years after having set the legal precedent requiring insurance companies to act in good faith. For more information, go to


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