Anthem members receiving cancer treatment at a Sentara hospital are set to keep in-network coverage through their full course of care no matter what happens to the rest of Sentara’s contract with the insurer, which is scheduled to lapse for commercial and Medicare agreements on December 31, 2026. Sentara Health says negotiations with Anthem are continuing and a new agreement could still be reached before that date. Medicaid agreements between the two carry a separate expiration in early 2027.
A contract cutoff that lands after enrollment closes: Sentara’s Dec. 31 cutoff for Medicare agreements with Anthem comes after Medicare’s Annual Enrollment Period ends, and The 2027 Medicare Open Enrollment Decision Kit includes the Open Enrollment calendar for tracking dates like this one against a plan renewal. Compare the enrollment calendar against this contract cutoff →
What lapses and what’s carved out regardless
Sentara’s own negotiations page states that “certain commercial and Medicare agreements will expire on December 31, 2026,” while Medicaid agreements are described separately as expiring “in early 2027.” The health system operates more than 100 sites of care across Virginia and North Carolina, and the dispute applies specifically to its Virginia facilities, not to its North Carolina operations.
Four categories of care stay covered no matter what happens to the broader contract: emergency services, critical care, cancer treatment and obstetrics care. Sentara’s page adds that “Anthem is legally required to cover emergency services regardless of whether a hospital is in-network or not,” a distinction that applies independent of anything Sentara and Anthem negotiate between themselves.
That legal backstop for emergency care means a Sentara-Anthem contract lapse would not expose an Anthem member to the same billing risk in an emergency that it could for a routine or scheduled procedure, where in-network status still determines what a patient owes for a hospital stay, an outpatient test or a specialist visit that is not itself an emergency.
If the agreements lapse as scheduled, an Anthem Medicare member without one of the four exceptions would face Sentara facilities as out-of-network for other care, typically meaning higher cost-sharing or, for an HMO-style plan, no coverage for the visit at all. A member with a PPO-style Medicare plan would likely retain some coverage at Sentara but at a higher out-of-pocket cost than the same visit produced while Sentara was in-network.
Sentara’s page does not specify whether the guarantee covering critical care, cancer treatment and obstetrics regardless of network status stems from Anthem’s own continuity-of-care policy, a state insurance regulation, or a specific term the two organizations negotiated; only the emergency-care guarantee is tied explicitly to a legal requirement on the page itself.
Cancer-treatment continuity built into the wind-down
The most specific protection in Sentara’s FAQ covers people already in cancer treatment. Anthem members in active cancer treatment before January 1, 2027 “will continue to be covered through their full course of treatment, including maintenance care and follow-up appointments/care for up to 90 days after treatment ends,” according to the page, regardless of whether Sentara is in-network for Anthem by that date.
That 90-day extension applies on top of the treatment course itself, meaning someone who finishes active treatment shortly before the contract lapses does not lose in-network follow-up care immediately. The provision does not extend the same continuity to patients who have not yet started treatment or to other chronic conditions outside the four always-covered categories.
A contract fight that is not yet resolved
Sentara has not said a deal is unlikely. Its FAQ states the health system “remains committed to reaching a fair agreement with Anthem” and is “working hard to prevent” a loss of in-network status, language that frames December 31 as an outcome still being negotiated rather than one already settled, though the page gives no indication of how close the two sides are to a resolution.
The dispute is one of several playing out nationally in 2026. Becker’s Hospital Review’s tracker, updated September 23, 2026, lists the Sentara-Anthem Medicare Advantage contract among 34 hospital-insurer network changes it has documented across the country, including Fairview Health Services losing UnitedHealthcare Medicare Advantage in-network status in Minnesota on January 1, 2027, and Endeavor Health’s exclusion from Aetna Medicare Advantage networks in Illinois, both following a similar hard-deadline pattern.
Neither Sentara’s page nor Becker’s tracker states how many Anthem members in Virginia use Sentara facilities as their primary source of hospital care, and no resolution date beyond December 31 has been announced by either organization. Whether the two sides reach a new agreement before that date, or whether the lapse takes effect as scheduled, remains an open question as of this reporting.
Medicare enrollment concentrates by definition among people 65 and older, so a hospital-insurer dispute like this one lands squarely on the population an annual enrollment window is built around. Once the fall enrollment period closes, a member who wants to switch away from an affected plan generally cannot do so again until the next annual enrollment period, absent a qualifying life event Medicare recognizes separately.
Sentara’s public language, describing itself as “working hard to prevent” a lapse rather than announcing one as final, mirrors how OHSU described its own dispute with Regence before that one produced a partial settlement in Oregon in August. Neither pattern guarantees a similar outcome here, since a Sentara-Anthem deal covering Medicare specifically has not been announced as of this reporting.
Sentara’s page frames the cancer-treatment carve-out as a protection for patients already in the middle of active treatment, not as a permanent feature of its relationship with Anthem, so a member who has not yet begun cancer treatment before January 1 would not qualify for the same continuity guarantee if the agreements lapse as scheduled.
A deadline that turns on a deal not yet reached
Sentara’s own account frames the Dec. 31 expiration as avoidable rather than final, since the health system says it is still negotiating with Anthem and points to continuity provisions, including the 90-day extension for cancer patients, as evidence the wind-down was planned in case talks fail rather than announced as a certainty.
The 2027 Medicare Open Enrollment Decision Kit pairs the Open Enrollment calendar with a provider call script for households confirming whether a specific hospital’s network status changes before a plan renewal takes effect.
Read the provider call script for asking Sentara and Anthem about a contract’s status in The 2027 Medicare Open Enrollment Decision Kit.
This article was researched and drafted with the assistance of AI and reviewed by The Money Overview editorial team.
