Health & wellness

Anthem Insurance will no longer cap anesthesia coverage at certain time limits for CT, NY patients: official

NBC Universal, Inc. Anthem Blue Cross Blue Shield said Thursday it was not moving ahead with a policy change that would limit reimbursements for anesthesia during surgeries and medical procedures.

Update: Anthem Blue Cross Blue Shield will no longer implement a policy to limit coverage of anesthesia, according to the state comptroller. See the original story below.

Anyone with an Anthem Blue Cross Blue Shield plan will soon have to pay out of pocket for anesthesia if a surgery or procedure goes longer than expected, according to the American Society of Anesthesiologists.

The health insurance provider said they will no longer pay for anesthesia care if a surgery or procedure goes beyond a specific time limit. This will apply to patients in Connecticut, New York and Missouri.

The American Society of Anesthesiologists said Anthem can pre-determine the time allowed for anesthesia, and if an anesthesiologist submits a bill where the actual time of care is longer than Anthem's limit, the company will deny paying for it.

"This is appalling. Saddling patients with thousands of dollars in surprise additional medical debt. And for what? Just to boost corporate profits? Reverse this decision immediately," Sen. Chris Murphy said on social media.

Anthem announced the new policy last month, telling patients that they're changing how they evaluate billed time starting Feb. 1, 2025.

The policy will not apply to patients under the age of 22 or maternity-related care, according to Anthem.

"With this new policy, Anthem will not pay anesthesiologists for delivering safe and effective anesthesia care to patients who may need extra attention because their surgery is difficult, unusual or because a complication arises," The American Society of Anesthesiologists said in a statement.

NBC Connecticut has reached out to Anthem but has not yet heard back.

Anthem said policy holders can file a claim dispute if they disagree with a claim reimbursement decision.

The American Society of Anesthesiologists said people concerned about the policy should contact their state insurance commissioner or state legislator.

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