Keeping Healthcare Affordable in Maine
June 09, 2025Important Information for Anthem Blue Cross and Blue Shield Members
About Our Negotiations with Northern Light Health
About Our Negotiations with Northern Light Health
We’re working to improve access to affordable healthcare in Maine. Our current contract with Northern Light Health expire later this year, and we are negotiating in good faith to keep them in our network. However, Northern Light Health wants to drastically increase the prices it charges to its patients and their employers.
What's Happening?
Anthem’s network contract with Northern Light Health will expire later this year. These contracts sets the prices Northern Light Health charges to its patients covered by Anthem employer-based, individual, and Medicare Advantage health plans. Our goal is to improve healthcare affordability for the patients, employers, and taxpayers that pay for care.
If we are unable to reach a new agreement:
- All Northern Light doctors, specialists, other professionals, outpatient clinics, and other non-hospital facilities will exit Anthem’s network for employer-sponsored and individual health plans on September 30, 2025. This includes hospital-based physicians.
- Northern Light hospitals will exit Anthem’s network for employer-sponsored and individual health plans on December 30, 2025.
- All Northern Light facilities and professionals will exit Anthem’s network for Medicare Advantage health plans on December 31, 2025.
We know these different contract expiration dates are confusing. We asked Northern Light to align all dates to December 31, 2025, to avoid additional confusion and care disruption for patients, but they refused to do so.
The Core Issue: A 30% Increase in Healthcare Prices
Our negotiations focus on healthcare affordability. Northern Light Health seeks to increase its prices by 30% over the next three years. That would mean $218 million in new healthcare costs — a bill Northern Light Health’s patients and Maine employers, unions, school districts, and city governments would pay. Healthcare price increases of this magnitude could cause people to avoid care they need, including important preventive care. Some examples of how costs would increase include:
- $580 more for an ER visit
- $1,200 more for a colonoscopy
- $4,400 more to deliver a baby at Northern Light Health
- $17,400 more for a knee or hip replacement
- $36,600 more for open heart surgery
Our Commitment to Affordability
Anthem is dedicated to improving access to high-quality, affordable healthcare for all Mainers. Here’s why:
- According to KFF surveys, about half of U.S. adults say it’s difficult to afford healthcare costs and, alarmingly, one in four adults delays needed care because of high costs. Hospital price increases raise patient costs through higher copayments, deductibles, and insurance premiums.
- Employers are also affected; higher hospital prices lead to higher insurance premiums, and many Maine employers pay their employees’ healthcare claims directly – so high healthcare costs disadvantage them compared to other states. These costs can limit wages, hiring, investment, and growth.
We negotiate on behalf of our members and Maine employers to secure affordable care at Northern Light Health and all our provider partners.
Our Proposal: Fair Payment for Northern Light Health, Affordable Care for Our Members
We’ve asked Northern Light Health to lower its price increases to match those of other Maine health systems. Our offers include payment increases that are higher than the inflation rate and improve affordability for our members. We also propose incentives that offer Northern Light Health the opportunity to earn millions more by delivering high quality care.
Together, our offered rates would significantly moderate cost trends for Northern Light Health’s patients and their employers, while still fairly compensating Northern Light Health for the services it delivers and encouraging better health outcomes.
Commitment to Keeping Northern Light Health in Our Networks
Anthem and Northern Light Health continue to work toward a new, long-term agreement. We want Northern Light Health to remain in our network, and we’re confident we will reach a new agreement before our current contract runs out.
Frequently Asked Questions
Earlier, Anthem indicated that the current contract with Northern Light runs through December 30, 2025. Why are you now saying that some plans and provider types expire on September 30?
Northern Light notified us very recently that they intend to remove their doctors, specialists, other professionals, outpatient clinics, and other non-hospital facilities from our network for individual and employer-based health plans on September 30. Northern Light has rejected our requests to align all network exit dates to December 31 to minimize patient confusion.
Throughout this process, Northern Light has repeatedly and unnecessarily chosen to use patient fear and care disruption as a negotiation tactic in their quest to increase prices by 30%.
What should Anthem members do right now?
Keep seeking care at Northern Light Health as you have. Northern Light Health is in Anthem’s network through at least the dates indicated above, and we’re confident we will reach an agreement that keeps them in network for years to come.
Please continue to check this website for updates. We will share more information as negotiations continue.
Will an agreement be reached to keep Northern Light Health in Anthem’s network?
We’re optimistic we will reach a new agreement — that’s our goal. We want to keep Northern Light Health in our network because we know our members in Maine depend on their doctors and hospitals. However, we must work together to make care more affordable for their patients covered by Anthem.
Northern Light Health says that Anthem has paid them an annual increase of only 1.5%. Is that true?
This is a misleading statement because Northern Light fails to say why their annual increases have been smaller than other health systems. Anthem’s payments to Northern Light have followed the terms we both agreed to in our contract. Under that agreement, Northern Light Health had the opportunity to earn millions more through improved health outcomes. Northern Light Health has not met these agreed-upon quality standards and therefore did not earn the additional payments.
What are my options if Northern Light Health leaves Anthem’s network?
If Northern Light Health leaves our network, we have made arrangements with other Maine provider partners to ensure our members can still access high-quality care. Our network includes every health system in Maine.
You can log in to anthem.com or the Syndey Health app to find care providers near you. You can also call our Member Service Center at the number on your Anthem ID card.
What if I’m being treated at Northern Light Health for a serious condition on the date they leave Anthem’s network?
We understand how concerning this is for members receiving care for serious medical conditions. If Northern Light Health exits our network, we’ll help by reaching out to affected members and offering options, including continuing care with their Northern Light Health provider for a limited time.
Any Anthem member receiving care for a serious or complex condition that will continue past the date they leave our network can contact our Member Service Center at the number on their Anthem ID card. You may be able to continue care at Northern Light Health for a limited period depending on the type of care.
What should I do if I need emergency medical care from Northern Light Health?
Members should always call 9-1-1 or go to the nearest emergency room in a life-threatening situation. We will provide coverage for emergency care based on your policy benefits at in-network cost shares.
Who will be impacted?
If Northern Light Health decides to leave Anthem’s networks, our employer-sponsored, individual, and Medicare Advantage members will be impacted. See above for plan-specific dates. Anthem Medicare Supplement plans will not be affected.
Where can I go for information and updates?
We’ll update this website as negotiations continue. You can also log in to anthem.com or the Sydney Health app or contact our Member Service Center at the number on your Anthem ID card for assistance.
