Blue Shield of California Contract Termination

December 1, 2023 - As Adventist Health continues to meet the health and well-being needs in the communities we serve, we are evaluating our payer contracts to ensure fair and equitable rates for our services.

During this time, we want to reach out to our valued patients, community partners, trusted employers, and our communities to let them know our current contract with Blue Shield of California was terminated at 12:01 a.m. on Dec. 1, 2023, at the following hospitals:

  • Adventist Health Bakersfield
  • Adventist Health Clear Lake
  • Adventist Health Delano
  • Adventist Health Glendale
  • Adventist Health Hanford
  • Adventist Health Howard Memorial
  • Adventist Health Lodi Memorial
  • Adventist Health Mendocino Coast
  • Adventist Health Reedley
  • Adventist Health Selma
  • Adventist Health Simi Valley
  • Adventist Health Sonora
  • Adventist Health St. Helena
  • Adventist Health Tulare
  • Adventist Health Tehachapi Valley
  • Adventist Health Ukiah Valley
  • Adventist Health White Memorial

Insurance card

We are deeply disappointed that after 11 months of negotiations, we were unable to reach an agreement with Blue Shield of California.

At Adventist Health, our first concern is always our patients. We believe you have chosen to receive your healthcare services from Adventist Health because you recognize our high standards of quality and the valuable services we provide to our community. We will continue to update you as the current situation evolves. Due to the fluid nature of negotiations, we will provide further updates and resources on this page. Thank you for allowing us to serve your healthcare needs and we look forward to partnering in your care for many years to come. If you have questions, please do not hesitate to contact us at (855) 479-5196.

FAQ for patients

The following is a list of frequently asked questions regarding the termination of the Blue Shield of California contract should patients have questions.

Q: What’s happening?
Adventist Health’s contract with Blue Shield of California has terminated on December 1, 2023, which will affect Blue Shield of California commercially insured PPO/EPO/HMO, Medicare Advantage PPO/HMO, and Medi-Cal Managed Care HMO patients who receive our services and the physicians who care for them.

Q: Why is this happening?
After 11 months of negotiations, Adventist health was unable to reach a fair agreement to continue as an in-network participating provider with Blue Shield of California. Our contract with Blue Shield terminated at 12:01 a.m. on December 1, 2023, at Adventist Health Bakersfield, Adventist Health Clear Lake, Adventist Health Delano, Adventist Health Glendale, Adventist Health Hanford, Adventist Health Howard Memorial, Adventist Health Lodi Memorial, Adventist Health Mendocino, Adventist Health Reedley, Adventist Health Selma, Adventist Health Simi Valley, Adventist Health Sonora, Adventist Health St. Helena, Adventist Health Tulare, Adventist Health Tehachapi Valley, Adventist Health Ukiah Valley and Adventist Health White Memorial hospital communities.

Q: I am very concerned about this, what can I do?
If you receive healthcare coverage from your employer, your employer needs to know your concerns. Speak to your human resources department about your concerns.

Q: What does this mean if I am in the hospital on or after 12:01 a.m. on the termination date?
You will be covered by your applicable healthcare service plan until you are discharged from the Adventist Health hospital where you are receiving care. However, your healthcare service plan may elect to transfer you to another contracted hospital, and it may only transfer a patient if the transfer can be safely performed. You will need to confirm the details of your insurance benefit by calling your healthcare service plan customer service number on your insurance card. You can also use this number to ask your health plan if you are eligible to complete your current episode of care at the Adventist Health hospital where you are receiving care as a continuity of care service.

Q: What if I have to go to the Emergency Department?
You can always come to an Adventist Health hospital for medical emergencies. However, you should ALWAYS go to the nearest hospital in an emergency, regardless of your insurance coverage or ability to pay. Blue Shield should cover all emergency visits to the hospital.

Q: What is an Out-of-Network Request form?
Blue Shield has an out-of-network referral request form that can be completed by Adventist Health hospital staff at the patient’s request to allow them to continue care at our local hospitals and clinics as an in-network provider under at least one of the following criteria:

  • There is no network provider/facility within 30 miles of the member’s home.
  • The member’s network provider is unable to perform the necessary service and is forced to an out-of-network specialist/facility.
  • There are significant scheduling barriers whereby the member is unable to make an appointment in a timely manner with a network provider.

Q: Will clinic visits be covered through Blue Shield?
The contract termination affects Adventist Health clinics differently. For most Adventist Health clinics, our contracts remain in effect, and those clinics remain as in-network Blue Shield providers until March or April 2024. Regardless of the market, we hope established patients will continue to see their physicians at our Adventist Health clinics as we continue contract negotiations. Please contact your provider’s office and your insurance plan.

Q: What if I’m scheduled to deliver a baby or have a surgical or outpatient procedure, or receiving care for a chronic or terminal illness (such as cancer)?
Some members may be able to receive care for a period of time as a continuity of care service. You must receive specific authorization from your healthcare service plan for a continuity of care service. You should call the customer service number on your insurance card and ask about continuity of care service.

Q: How can Adventist Health assist patients in completing their request to Blue Shield for continuity of care?
Patients must call their health plan using the number on the back of their insurance card and request continuity of care. Adventist Health can provide a copy of the Blue Shield of California continuity of care brochure and assist the patient in completing the patient and provider information. In addition, Adventist Health will provide patient documents from their treating physician.

Q: I want to continue using my local Adventist Health hospital, what can I do?
Our Adventist Health hospitals are contracted with many different healthcare service plans. You should contact your healthcare service plan’s customer service number to ask about your benefits and out-of-network options for care.

Q: Can I still see my physician at the clinic?
You should contact your applicable healthcare service plan to find out if there is a change in patient responsibility. We realize how important continuity of care is for you with the care team who knows you best.

Q: Will I still have coverage for Adventist Health Home Care?
Yes. Blue Shield of California continues to honor its contract with Adventist Health home care patients.

Q: Will Adventist Health re-establish a contract with Blue Shield?
Adventist Health remains open to discussions. We will provide updates should the current situation change. All the latest information will be shared on this page.

Q: Who should I contact if I have more questions?
Please contact your health plan’s customer service number on your health plan insurance ID card. This will give you the most accurate and up-to-date information regarding your benefits and network. You may also contact the Department of Managed Health Care, which protects HMO consumers, at its toll-free number, voice

888-466-2219 or TDD 877-688-9891; or the California Department of Insurance Consumer Hotline at voice 800-927-4357 or TDD 800-482-4833.