If you use WellStar doctors and chose an Anthem plan for 2020, your doctor may be out of network

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An insurance exchange snafu could cost Georgians who use WellStar doctors significantly if they don’t act soon to choose a new health insurance plan.

According to the Office of Georgia Insurance and Safety Fire Commissioner John F. King, one of Anthem Blue Cross Blue Shield’s 2020 plan offerings on the Affordable Care Act’s Healthcare Marketplace doesn’t actually include WellStar in its network, despite the health system being listed as an in-network provider.

The 2020 Anthem Pathways Network product on HealthCare.gov incorrectly listed WellStar Medical Group as a participating provider. WellStar providers are in fact out-of-network for any of Anthem’s 2020 Georgia plans listed on the Healthcare Marketplace.

“Consumers who have enrolled in the 2020 Anthem Pathways Network individual plan on HealthCare.gov need to know that WellStar providers will not be covered at in-network rates,” said King. “Fortunately, the enrollment period for the Healthcare Marketplace remains open until December 15, so consumers still have over three weeks to make any necessary changes to their plans for next year.”

“We have been working closely with the Georgia Department of Insurance and the Centers for Medicare and Medicaid Services to correct this error,” said Anthem spokeswoman Tina Gaines. “And we are committed to helping those customers who may wish to switch to another plan in light of this information before the enrollment period ends on December 15.”

For more information on updating your plan selection on the Healthcare Exchange, consumers should visit HealthCare.gov.

For other questions regarding open enrollment, call the Georgia Department of Insurance’s Consumer Services Division at 404-656-2070, or toll-free at 1-800-656-2298.


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