Cleveland Clinic’s Ohio hospitals and doctors will no longer be in network for certain Anthem Blue Cross and Blue Shield members starting January 1, 2027, if the two sides do not reach a new contract. The warning covers Anthem’s Medicare Advantage plans and its employer-sponsored plans.
Nothing has changed yet. On its accepted-insurance page, Cleveland Clinic says “right now, nothing changes,” that patients can keep their appointments, and that its goal is an agreement that keeps it in network. The same page lists Anthem Medicare Preferred, Medicare Select and Senior Advantage as accepted through 12/31/2026 only.
Who would lose Cleveland Clinic if talks fail?
The notice names two groups. One is people covered through an employer-sponsored Anthem Blue Cross and Blue Shield plan. The other is people in an Anthem Blue Cross and Blue Shield Medicare Advantage plan, the private plans that stand in for Original Medicare.
That second group is the one running up against a calendar. Medicare’s yearly enrollment window runs from October 15 to December 7, and Medicare.gov says changes made in that window take effect on January 1. The Clinic’s possible exit date is the same day.
Anyone in an Anthem Medicare Advantage plan who sees a Cleveland Clinic doctor, or who would be sent to a Cleveland Clinic hospital in an emergency, has a real decision to make. The plan year that starts January 1, 2027 could either include those doctors or not, and the answer may not be known by December 7.
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Where the talks stand
Cleveland Clinic says it is working to reach a new agreement with Anthem Blue Cross and Blue Shield. The two have settled before: Akron’s paper reported in December 2024 that Anthem and Cleveland Clinic had hammered out a new multiyear coverage agreement. That earlier deal did not settle the question for 2027, and no new contract has been announced.
If a deal does arrive before the end of the year, nothing changes for patients. If it does not, the exit starts January 1, 2027. Neither outcome is known today, and that is the whole difficulty for anyone choosing a plan this fall.
For updates, the Clinic’s notice points patients to ChooseClevelandClinic.org/Anthem. Its main line is 800.223.2273, and it lists a Patient Financial Advocate at 844.500.9451 for questions about costs. The notice also mentions open enrollment advisor support from November 1 to December 15, with an Ohio advisor line at 888.233.7132.
What an out-of-network doctor can mean for a Medicare Advantage member
Medicare Advantage plans work from a list of doctors and hospitals under contract. Medicare’s plan booklet says that some plans cover nonemergency care out of network, but typically at a higher cost, and that people in an HMO who go outside the network without authorization may pay the full cost. Emergency care stays covered.
The same booklet says a plan’s yearly notice of change lists changes to provider networks that take effect in January, and that these notices are typically mailed before September 30. People in an Anthem Medicare Advantage plan can find that notice and check whether Cleveland Clinic doctors and hospitals are still listed for 2027.
Medicare’s yearly review guide says the plan finder at Medicare.gov/plan-compare lets people search for their doctors and see whether they are in the network of the plans being considered. It also lists 1-800-MEDICARE (1-800-633-4227), open around the clock, for questions.
A call to a doctor’s office asking which plans it expects to accept next year is another quick check. Since the Clinic’s own list shows the Anthem Medicare plans as accepted through 12/31/2026 only, the office may not have a firm answer yet.
What Medicare Advantage members can do before and after December 7
Between October 15 and December 7, Medicare says people can join, drop or switch Medicare Advantage plans, and can move between Original Medicare and an Advantage plan. People who stay in Original Medicare can also join a separate drug plan. Any of those moves would start January 1.
After December 7 there is a smaller second chance. Medicare’s Advantage open enrollment runs from January 1 to March 31 for people already in a Medicare Advantage plan. It allows one change per year, either to another Advantage plan or back to Original Medicare. A change made then starts the first day of the month after the plan gets the request.
Waiting has a cost. If the Clinic does leave Anthem’s network on January 1, anyone who waited would spend at least the first weeks of 2027 in a plan that may not cover their doctors.
People with Anthem coverage through a job follow their employer’s own enrollment calendar instead of Medicare’s. Employees can ask their benefits office when the next chance to change plans comes up, and whether the employer has said anything about the Cleveland Clinic situation.
The open question is simple. The Clinic has said a January 1, 2027 exit is possible, and Medicare’s window to switch closes December 7. Anyone with an Anthem Medicare Advantage plan and a Cleveland Clinic doctor has to decide whether to wait for a deal or compare other plans first.
Using Cleveland Clinic with an Anthem Medicare Advantage plan?
If talks fail, a Medicare Advantage member could be told in January that a long-time heart doctor or hospital is out of network. The window to pick a different plan for 2027 closes December 7, and a second, smaller window only allows one change.
The 2027 Medicare Open Enrollment Decision Kit gives people a cost calculator spreadsheet that compares plans on cost, drugs and doctors, a prescription-by-plan comparison and a provider call script for asking each doctor’s office which plans it will take. It also includes the Open Enrollment calendar, and its Excel calculator does the cost math for each plan side by side.
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
