Patients who use VCU Medical Center in Richmond and have an Anthem Medicare Advantage HMO-POS, PPO or chronic-condition plan will find the hospital out of network on Jan. 1, 2027. VCU Health’s Anthem page calls it a mutual decision between the health system and the insurer, and the annual enrollment period that lets members pick a different plan closes Dec. 7.
The split does not touch every Anthem member. The change applies only to Anthem Medicare Advantage plans that are not dual-eligible special needs plans, Anthem and VCU Health said in the Business Wire release announcing their new multi-year agreement. VCU Health stays in Anthem’s Medicare Advantage network through Dec. 31, 2026.
For a member, the question comes down to the doctor. All VCU Health locations and providers are affected by the change in network status, the health system’s page says, so a cardiologist, a cancer team or a primary care office on the VCU Health roster all fall under it. A member who wants to keep them has to be in a plan that VCU Health still accepts by the time the new year starts, and the plan must get the request to join by Dec. 7, Medicare.gov says.
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Which Anthem plans lose VCU Health and which keep it?
VCU Health lists three Anthem plan types as out of network: Medicare Advantage HMO-POS, Medicare Advantage PPO and the Medicare Chronic Conditions Special Needs Plan, known as a C-SNP. The Business Wire release describes the same group as Medicare PPO, Medicare HMO and chronic special needs plans.
Several products stay in. Anthem’s Medicare dual special needs plan in Virginia, whose members get integrated benefits through Anthem HealthKeepers Plus, keeps access to VCU Health providers and facilities under the renewed agreement. So do Anthem commercial, Individual and Family, and Medicaid plans, and traditional Medicare paired with an Anthem Medicare Supplement policy, according to the release and VCU Health’s page.
What did the two companies say about the agreement?
Marlon Levy, M.D., the chief executive of VCU Health, said in the release: “We value our long-standing relationship with Anthem and are pleased to have reached an agreement.” Monica Schmude, president of Anthem Blue Cross and Blue Shield in Virginia, said the partnership reflects a shared commitment to quality and affordability.
Neither executive gave a reason for taking some Medicare Advantage plans out of the network, and the release does not disclose financial terms or how long the agreement lasts. VCU Health’s page describes the Medicare Advantage change as mutual, which is the only explanation either side has put in writing.
What happens to a patient in the middle of treatment?
Anthem Medicare Advantage members who are currently being treated might qualify for continuity of care, VCU Health says. Eligible patients can temporarily keep in-network benefits after Jan. 1, 2027, but for no longer than 90 days, and Anthem must approve the request. The page does not say how a member applies, so the first call goes to Anthem at the member services number on the insurance card.
Patients who keep scheduled care out of network face a prepayment rule. VCU Health’s page says out-of-network patients must prepay 50% of the estimated total, and appointments may be cancelled if the prepayment is not made. A plan that is in network on the day of service avoids that step, which is the practical reason to settle the plan question before January.
How does a member switch before Jan. 1?
Open enrollment, which VCU Health’s page dates Oct. 15 through Dec. 7, 2026, lets members join, drop or switch Medicare Advantage plans, and new coverage takes effect Jan. 1. Medicare.gov says people already in a Medicare Advantage plan also get a second window from Jan. 1 to March 31, with coverage starting the first of the month after the plan gets the request.
VCU Health’s page points members to three numbers: its Patient Appointment Center at 800-762-6161, 1-800-MEDICARE at 1-800-633-4227, and the Virginia Insurance Counseling and Assistance Program, known as VICAP, at 1-800-552-3402. Billing questions go to VCU Health Customer Service at 888-803-0082.
Will your VCU Health doctors still be in network after Jan. 1?
A member who stays in an affected Anthem plan past Dec. 7 can wake up on Jan. 1 with VCU Health out of network, a 90-day continuity request that Anthem has to approve and a 50% prepayment for scheduled visits. The new plan has to keep the doctors a member actually sees.
The 2027 Medicare Open Enrollment Decision Kit is a 55-page guide built for that comparison. It includes a provider call script for confirming a doctor’s network status and a cost calculator spreadsheet that compares plans on cost, drugs and doctors.
Get the provider call script and plan-comparison calculator for choosing past VCU Health’s exit →
This article was produced with AI assistance and edited for accuracy against the sources linked above.
David M. Keller is a finance writer based in Columbus, Ohio, covering personal finance and consumer-focused economic topics. He earned his degree in journalism from Ohio University and began his career reporting on local business and economic trends for a regional media outlet. Since then, he has contributed to a variety of online publications, focusing on clear, practical coverage of topics such as cost of living, debt, and everyday financial decision-making.
