Sentara Health says its contract talks with Anthem Blue Cross Blue Shield of Virginia are over for Medicare Advantage, Medicaid and ACA Exchange plans, which leaves about 25,000 Anthem Medicare members on course to lose in-network access to Sentara hospitals on Jan. 1, 2027. The health system announced the break on Oct. 5, after Anthem let an Oct. 1 deadline pass without accepting Sentara’s proposal. Sentara’s notice to patients says talks on commercial, employer-sponsored plans have not ended, and Anthem says it is still willing to negotiate.
For a member of an Anthem Medicare Advantage plan in Hampton Roads, the practical question is narrow and dated: Medicare’s annual enrollment period runs Oct. 15 to Dec. 7, and the network change lands three and a half weeks after it closes. Anyone who sees a Sentara hospital or a Sentara-affiliated specialist has to decide inside that window whether to ride out the dispute on the current plan or move to one that keeps those doctors in network.
Anthem members who use Sentara have until Dec. 7 to pick a plan that still covers their hospital on Jan. 1. The 2027 Medicare Open Enrollment Decision Kit compares plans on cost, drugs and doctors with a cost calculator spreadsheet and a prescription-by-plan comparison.
Run your Sentara doctors and drugs through the Open Enrollment Decision Kit calculator →
Why Sentara walked away
Aubrey L. Layne Jr., Sentara Health’s executive vice president and chief administrative officer, put the system’s position in one line: “we can no longer absorb their underpayments.” Sentara says Anthem repeatedly proposed lower reimbursement for most of the plan types in question and did not accept the proposal laid out in a Sept. 23 letter by the Oct. 1 deadline.
The notice also lists grievances that have nothing to do with future rates. Sentara says Anthem continues to delay payment on more than $105 million owed for care already provided, refused to pay $27 million following a 2025 billing settlement, and withheld $9.7 million by downgrading the severity of emergency department visits. It adds that Anthem canceled claim-resolution meetings for the rest of the year on the same day it issued a Sept. 28 press release, and that it terminated Blue Distinction certifications for all Sentara hospitals, a program Sentara says does not affect reimbursement or referrals. On its newsroom index, Sentara headlines the episode as “Anthem fails to accept fair and reasonable agreement.”
Anthem’s answer
Anthem tells the story the other way around. Spokesperson Kersha Cartwright told Virginia Business that Sentara ended the talks after Anthem declined demands for more reimbursement than Sentara receives today. She said Anthem remains willing to negotiate across all lines of business, including the three Sentara has stopped discussing, and that the company is “actively preparing continuity of care support.” She also pointed to payment speed: “Anthem pays 97% of claims within 14 days and 99% within 30 days.” Cartwright did not disclose what rate changes Anthem proposed for the three lines.
25,000 Medicare members inside a 96,000-member dispute
Virginia Business, citing Sentara’s figures, reports about 96,000 Anthem members across the three affected lines. Roughly 25,000 of them are in Medicare, about 18,000 are on individual ACA Exchange plans, and about 53,000 are in Medicaid. The dates differ by line. Medicare Advantage and ACA Exchange plans go out of network on Jan. 1, 2027, and Medicaid plans follow on Jan. 28, 2027.
Nothing changes immediately. Sentara says Anthem members stay in network through at least Dec. 31, 2026. Patients in active cancer treatment or obstetrics care who qualify under continuity-of-care protections keep in-network access further into 2027, according to the system.
Enrollment dates for each line
The windows are not the same for everyone caught in the dispute, and Sentara’s notice spells them out. Medicare Advantage open enrollment runs Oct. 15 to Dec. 7, 2026. The Exchange window opens Nov. 1, 2026 and runs to Jan. 15, 2027. Sentara lists two Medicaid windows for regions it names, one from Aug. 19 to Oct. 31, 2026 in the Charlottesville and western Halifax area and another from Dec. 19, 2026 to Feb. 28, 2027 in southwest Virginia.
Because the Medicare window closes Dec. 7 and the network change arrives Jan. 1, only a deal between the two companies would make the decision moot.
Comparing plans by doctor and drug before Dec. 7
Sentara’s own page is the place to start. The system tells members to find a plan that keeps them in network and points to its plan-shopping links and updates. It also names Chapter, a licensed Medicare advisory service, as free for people who qualify for Medicare Advantage, reachable at askchapter.org/sentara or 1-855-531-2355.
Before comparing anything, a member needs a short list: every Sentara hospital and Sentara-affiliated doctor they see, every prescription with its dose, and the pharmacy they use. A plan that keeps the hospital but drops a drug from its formulary can cost more than the network problem it solves.
Members also need to watch the calendar from both directions. A late agreement between Sentara and Anthem would change the math, so a member who switches should confirm the new plan’s network status for 2027 in writing, and one who stays should confirm Sentara’s status again in December. Sentara’s notice gives the continuity-of-care exception only to patients in active cancer treatment or obstetrics care, so everyone else should plan on a clean break on Jan. 1.
Dec. 7 is the deadline to replace Sentara
Miss Dec. 7 and an Anthem Medicare Advantage member is still on a plan whose network no longer includes Sentara hospitals on Jan. 1. The 2027 Medicare Open Enrollment Decision Kit gives members a cost calculator spreadsheet that compares plans on cost, drugs and doctors, plus a prescription-by-plan comparison, so the choice to keep, switch or wait comes with a written reason. Its Open Enrollment calendar keeps the Oct. 15 to Dec. 7 dates in front of the decision.
Compare replacement plans for the Sentara exit with the Open Enrollment Decision Kit →
This article was produced with AI assistance and reviewed by The Financial Wire’s editorial team.
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.
