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Ensuring Patient Access at Mount Sinai

Update About Our Participation With Certain Insurance Plans

Patient Letters

Anthem Individual Marketplace Patient Letter – English/Spanish/Chinese
Anthem Medicare Advantage Patient Letter – English/Spanish/Chinese
Molina Medicaid Patient Letter – English/Spanish/Chinese
Molina Child Health Plus Patient Letter – English/Spanish/Chinese
Molina Essential Plans Patient Letter – English/Spanish/Chinese
VNS Health Patient Letter – English/Spanish/Chinese

Mount Sinai may be out of network with your health insurance provider in 2026. Please carefully read the message below to understand how this may impact you and what you can do today.

Ensuring you have access to the high-quality providers and services you depend upon is our top priority.

After careful consideration, we’ve made the decision to end our participation with certain insurance plans.This affects the following:

  • Anthem Blue Cross Blue Shield (formerly Empire) Medicare Advantage plans
    • Medicare Advantage
    • Individual Marketplace
  • Affinity by Molina plans
    • Medicaid
    • HARP
    • Child Health Plus
    • Essential Plans 1-5

We want to continue caring for you, so we have provided some information below to help you understand the options available to you.

What You Need to Know

  • Mount Sinai will remain in network with your plan until at least Wednesday, December 31, but we encourage you to start exploring your coverage options for 2026 today.
  • You might have to pay more out of pocket. Mount Sinai will be out of network with the plans listed above starting in 2026. If your plan is listed above, you could end up paying more to continue receiving health care from the Mount Sinai providers you trust.
  • Emergency care is always covered, no matter our contract status with a particular insurance provider. Your insurance company is required by law to cover emergencies at in-network rates.
  • No longer accepting your insurance plan would mean that you may need to use out-of-network benefits (if available through your plan) and/or pay for your care without the aid of insurance.
  • Your insurance carrier may continue to cover your care at in-network rates for a period of time through “continuity of care” benefits if you are being treated for certain health conditions. Please see the section below for more information.

Patient Impact and What You Can Do

Anthem Individual Marketplace

Patient Impact

  • Effective Thursday, January 1, Mount Sinai physicians will no longer be in Anthem’s Individual Marketplace network.
  • Effective Sunday, March 1, Mount Sinai hospitals and clinics will no longer be in Anthem’s Individual Marketplace network.

What You Can Do

You have the opportunity to change to a health plan Mount Sinai participates with during the Marketplace Open Enrollment period, which continues through Thursday, January 15.

To change plans, visit the NY State of Health website during the Open Enrollment period.

If you enrolled in your Marketplace plan through NY State of Health please call 1-855-355-5777 (TTY: 1-800-662-1220). Calls are answered Monday through Friday from 8 am to 8 pm, and on Saturday from 9 am to 1 pm.

To view a list of Individual Marketplace plans Mount Sinai will participate with in 2026, click here.

Continuity of Care

If you are currently receiving care from certain Mount Sinai–affiliated specialty providers or using specific specialty services, your health plan may be required to continue covering your care at in-network rates for a limited period of time under continuity-of-care protections.

Mount Sinai is committed to helping our patients maintain access to medically necessary care and has made repeated efforts to work directly with Anthem to support continuity-of-care requests. To date, we have been unable to confirm that Anthem has approved continuity-of-care coverage for any of our patients.

Anthem’s approach to continuity of care has created confusion, delays, and additional administrative hurdles for patients seeking to continue their care. In response, Mount Sinai has begun reaching out directly to patients we believe may be eligible for continuity-of-care protections and is doing everything possible to support patients and coordinate their care.

Anthem controls the continuity-of-care review and approval process and has not enabled a direct or effective pathway for resolution. Determinations regarding eligibility and approval for continuity-of-care benefits are made solely by Anthem, and Mount Sinai physician practices do not have access to Anthem’s internal systems or decision-making processes.

If you believe you qualify for continuity-of-care coverage and have been unable to get clear information or a response from Anthem, we encourage you to seek additional assistance by contacting The New York State Department of Financial Services at 1-800-342-3736, or 1-212-480-6400 if you live in New York City. You can also file a complaint through the New York State Department of Financial Services at dfs.ny.gov/complaint.

Anthem Medicare Advantage Plans

Patient Impact

  • Effective Thursday, January 1, Mount Sinai physicians will no longer be in network with Anthem’s Medicare Advantage plans.
  • Effective Sunday, March 1, Mount Sinai hospitals and clinics will no longer be in network with Anthem’s Medicare Advantage plans.

What You Can Do

Even though the regular Medicare Annual Enrollment period has passed, you may have another opportunity to make changes to your coverage in 2026. If you are currently enrolled in a Medicare Advantage plan, you can make a one-time change to your Medicare coverage between Thursday, January 1, and Tuesday, March 31. Once you make this change, your new coverage will begin on the first day of the following month. To view a list of Medicare plans Mount Sinai will participate with in 2026, click here.

For help enrolling in a Medicare Advantage plan that best meets your needs:

For help enrolling in a Medicare Part D prescription drug plan with Original Medicare:

  • Call Medicare at 1-800-MEDICARE (1-800-633-4227) for assistance or visit Medicare’s website at Medicare.gov and use the Plan Finder tool to compare available Stand-Alone Part D plans and enroll in the one that best meets your needs.

You can also contact your local State Health Insurance Assistance Program (SHIP) for help with Medicare. In New York, call 1-800-701-0501. If you are outside of New York, visit shiphelp.org to find your local SHIP.

If you prefer to continue seeing your Mount Sinai care team but do not want to switch plans, you have the option to:

  • Use out-of-network benefits if your current plan offers them
  • Self-pay at the out-of-network rate

Please be aware that out-of-network benefits generally will not cover all your care and may result in a significant out-of-pocket cost for you.

Molina Medicaid, HARP, and Child Health Plus Plans

Patient Impact

  • Mount Sinai’s physicians will no longer be in Molina’s network beginning Thursday, January 1.
  • Mount Sinai’s hospitals and clinics will no longer be in Molina’s network beginning Sunday, March 1.

What You Can Do

If you wish to continue having your care covered at Mount Sinai, you may be able to switch to an insurance plan that Mount Sinai participates with. To view a list of Medicaid plans Mount Sinai will participate with in 2026, click here.

If you are currently receiving care from certain Mount Sinai-affiliated specialty providers or using specific specialty services, Molina may continue to cover your care at in-network rates for a period of time through continuity-of-care benefits.

Determinations regarding eligibility and approval for continuity of care are ultimately up to Molina. Unfortunately, Mount Sinai physician practices do not have access to or influence over these determinations and cannot provide additional information about individual cases.

If you believe you may be eligible for continuity of care, please contact Molina directly at the number on the back of your insurance card.

If you have a Molina Medicaid or HARP plan:

  • You can change your plan at any time during your first 90 days in a new plan. You can also change your plan after your first full year (12 months) in a health plan.
  • If you enrolled in your Medicaid plan through the NY State of Health website, please call 1-855-355-5777 (TTY: 1-800-662-1220). Calls are answered Monday through Friday from 8 am to 8 pm, and on Saturday from 9 am to 1 pm.
  • If you have Medicaid through your cash assistance case, you can change your plan by calling New York Medicaid Choice at 1-800-505-5678 (TTY 888-329-1541). Calls are answered Monday through Friday from 8:30 am to 8 pm, and on Saturday from 10 am to 6 pm. Have your Medicaid number handy when you call.

If you have a Molina Child Health Plus Plan:

  • To continue receiving care at Mount Sinai with in-network benefits, you can change your Child Health Plus plan at any time during the year by calling NY State of Health, at 1-855-355-5777 (TTY: 1-800-662-1220). Calls are answered Monday through Friday from 8 am to 8 pm, and on Saturday from 9 am to 1 pm.

Molina Essential Plans

Patient Impact

  • Mount Sinai’s physicians will no longer be in Molina’s network beginning Thursday, January 1.
  • Mount Sinai’s hospitals and clinics will no longer be in Molina’s network beginning Sunday, March 1.

What You Can Do

If you wish to continue having your care covered at Mount Sinai, we encourage you to switch to a plan Mount Sinai participates with. To view a list of plans Mount Sinai will participate with in 2026, click here.

  • Get in touch with the assister who enrolled you.
  • Call NY State of Health at 1-855-355-5777 (TTY: 1-800-662-1220). Calls are answered Monday through Friday from 8 am to 8 pm, and on Saturday from 9 am to 1 pm

If you are currently receiving care from certain Mount Sinai-affiliated specialty providers or using specific specialty services, Molina may continue to cover your care at in-network rates for a period of time through continuity-of-care benefits.

Determinations regarding eligibility and approval for continuity of care are ultimately up to Molina. Unfortunately, Mount Sinai physician practices do not have access to or influence over these determinations and cannot provide additional information about individual cases.

If you believe you may be eligible for continuity of care, please contact Molina directly at the number on the back of your insurance card.

VNS Health Plans

Mount Sinai Health System has reached a new agreement to continue participating in VNS’s Medicare Advantage network. This means VNS will continue to cover your care at Mount Sinai at in-network rates through 2026, and there will be no interruption in your in-network access to Mount Sinai’s providers and facilities.  

You may have switched plans during the Medicare Open Enrollment period to a Medicare Advantage plan Mount Sinai will participate with in 2026. If you wish to be insured by VNS next year, you have another opportunity to switch your coverage. If you are enrolled in a Medicare Advantage plan in 2026, you can make a one-time change to your Medicare coverage between Thursday, January 1, and Tuesday, March 31. Once you make this change, your plan will begin on the first day of the following month.  You can call 1-800-MEDICARE (1-800-633-4227) to change your coverage. 

Continuity of Care

For Anthem Individual Marketplace and Molina Medicaid, MLTC, Child Health Plus, HARP, and Essential Plan members

If you are currently receiving care from certain Mount Sinai-affiliated specialty providers or using specific specialty services, your insurer may continue to cover your care at in-network rates for a period of time through continuity-of-care benefits.

Determinations regarding eligibility and approval for continuity of care are ultimately up to your insurer. Unfortunately, Mount Sinai physician practices do not have access to or influence over these determinations and cannot provide additional information about individual cases.

If you believe you may be eligible for continuity of care, please contact your insurer directly at the number on the back of your insurance card.

For Medicare Advantage members

To continue receiving care from Mount Sinai, Medicare Advantage members should switch plans to one Mount Sinai will participate with in 2026. This list can be found here.