Keeping Healthcare Affordable in New York
What You Need to Know About Our Negotiations with Mount Sinai
Our current contract with Mount Sinai expires on December 31, 2025, and we are working to keep them in our network beyond that date.
Here's What's Happening
When Our Current Contract Expires
Anthem’s contract with Mount Sinai ends on December 31, 2025. This agreement sets the rates Mount Sinai currently charges Anthem members.
If we don’t reach a new agreement, Mount Sinai will become out of network on these dates:
- January 1, 2026 — Mount Sinai physicians
- March 1, 2026 —Mount Sinai hospitals, outpatient centers, and all other facilities
Negotiations between health plans and health systems are a routine part of the healthcare industry. We are optimistic we will reach a new agreement with Mount Sinai before our current contract expires.
For Our Medicare Advantage Members
We were unable to reach an agreement on the Medicare Advantage line of business. Because the 2026 open enrollment period began October 15, 2025, Anthem and Mount Sinai have mutually agreed that Mount Sinai’s doctors and hospitals will exit Anthem’s Medicare Advantage network effective January 1, 2026.
Mount Sinai remains in your network through December 31, 2025. After that date, our Medicare Advantage members will pay considerably more for non-emergency care at Mount Sinai. If you choose to keep your Anthem Medicare Advantage health plan in 2026, our member service center can assist you in finding alternative in-network care providers. You may also choose to select a different health plan during the Medicare open enrollment period. Visit Medicare.gov for more information.
The termination applies to Medicare Advantage plans but does not impact Medicare Supplement (Medigap) plans that do not use a provider network.
Why Affordability Matters
Anthem is dedicated to improving access to high-quality, affordable healthcare for all New Yorkers. Here’s why:
- About half of U.S. adults say it’s difficult to afford healthcare costs and, alarmingly, one in four adults delayed needed care because of high costs (KFF). When hospitals raise prices, patients pay more—through higher copayments, deductibles, and insurance premiums.
- High costs also impact businesses and other employers; 90% of Anthem New York employers pay their employees’ healthcare claims directly – that means that high healthcare costs can limit wages, hiring, investment, and growth.
That’s why we negotiate on behalf of our members as well as New York unions, employers, and taxpayers to secure affordable care with our care provider partners.
Commitment to Keeping Mount Sinai in Our Network
Anthem is working closely with Mount Sinai to reach a long-term agreement for our employer-sponsored, individual ACA, and Medicaid health plans. We’re committed to keeping their doctors and hospitals in our network. At the same time, unaffordable healthcare is inaccessible health care. So, it’s critical that we work with Mount Sinai and our other care providers to achieve reasonable price increases.