What Missourians Need to Know About the MU Healthcare and Anthem Impasse

Missouri Department of Commerce & Insurance (DCI) News Release

The information below is from a Missouri Department of Commerce and Insurance (DCI) news release shared on April 1, 2025. To view the original release, please click here.

Beneath the news release are some tips for how to navigate this situation as a Medicare agent.

JEFFERSON CITY, MO. – University of Missouri (MU) Healthcare and Anthem have failed to reach an agreement by the contract’s end date of March 31, 2025. The Missouri Department of Commerce and Insurance (DCI) wants policyholders to know the facts about where they stand with their coverage.

“We want to emphasize to consumers that there is no reason to panic,” said DCI Director Angela Nelson. “This situation does not mean that you have lost your insurance, nor does it mean that you can no longer see your health care providers at MU Healthcare. However, until Anthem and MU Healthcare establish a new network agreement, individuals may face higher out-of-pocket expenses, such as copays and deductibles, for services received.”

When a provider goes “out of network,” they no longer have an agreement with your insurance company for payment terms. Depending on your insurance plan, this could result in higher out-of-pocket costs if you see a physician not in your network.

“Understanding the complexities of insurance networks can be confusing for many consumers, particularly those receiving treatment for serious illnesses,” Nelson noted. “We are committed to helping policyholders navigate these challenges.”

For consumers undergoing ongoing treatment, it is important to note that you may be eligible for 90 days of in-network coverage, provided you meet the criteria for “continuing care.” This designation includes patients being treated for serious conditions, those who are terminally ill, or individuals currently undergoing inpatient care. There are also no network restrictions for emergency medical care. Policyholders are encouraged to discuss their eligibility with their health care provider.

For more information about out-of-network care, visit insurance.mo.gov or call the DCI Consumer hotline at 800-726-7390.

About the Missouri Department of Commerce & Insurance (DCI):

DCI is charged with protecting Missouri consumers through oversight of the insurance industry, banks, credit unions, utilities, and various professional licenses operating in the state. For more information about the department, please visit our website at dci.mo.gov.

How to Navigate the MU Healthcare and Anthem Impasse as a Medicare Agent

Agents with clients in Mid-Missouri are currently experiencing a big shake up to their networks as Anthem and University of Missouri (MU) Healthcare were not able to reach a network agreement and are officially out of network starting April 1, 2025.

While this doesn’t necessarily mean clients cannot see their doctors at MU Health, they may potentially face higher cost shares with out-of-network costs. If your clients are wanting to make a plan change, give Senior Marketing Specialists a call to try to find an election period so they can see their doctors at in-network pricing. Reassure your clients that they do not immediately lose access to their doctors!