BJC and WashU to Exit Aetna and Anthem Networks
The St. Louis health systems will drop Aetna and Anthem Medicare Advantage plans starting on January 1, 2027.
Updated on Oct. 21, 2026 in Healthcare
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BJC HealthCare and Washington University Medicine will depart the Aetna and Anthem Medicare Advantage networks effective January 1, 2027. This change impacts approximately 85,800 seniors in the St. Louis metro area who will lose in-network access to 14 BJC hospitals and WashU physician services.
Why it matters
BJC HealthCare stated that contract negotiations failed because Medicare Advantage plans pay hospitals less than traditional Medicare while requiring more administrative work. The exit highlights ongoing friction between large health systems and private insurers over reimbursement rates and claim processing burdens.
The transition affects 72,000 Aetna and 13,800 Anthem Medicare Advantage enrollees in St. Louis. Out-of-network care at these facilities can reach two to three times the cost of standard in-network services.
The players
BJC HealthCare
This nonprofit health system operates 14 hospitals across Missouri and Illinois.
Washington University Medicine
This academic medical organization provides specialized physician services and clinical research in the St. Louis area.
Aetna
This national health insurer provides Medicare Advantage plans to approximately 72,000 residents in the St. Louis metro area.
Anthem
This major health insurance provider manages coverage for roughly 13,800 Medicare Advantage enrollees in the St. Louis region.
The details
Failed contract negotiations between the health systems and the insurers led to this termination of coverage. Medicare Advantage plans are reportedly 70 percent more likely than traditional Medicare to deny claims for incomplete records and twice as likely to deny them for medical necessity.
Timeline
November 16, 2026 is the deadline for Illinois state retirees on Aetna to select new coverage.
December 7, 2026 is the final day for the standard Medicare annual open enrollment period.
January 1, 2027 marks the official date BJC and WashU exit Aetna and Anthem networks.
Market Landscape
This move highlights the growing tension between hospital systems and private insurers operating within the Medicare Advantage program. It signals a shift where major providers are increasingly willing to sacrifice significant patient volumes to pressure insurers for better reimbursement terms.
Impacted seniors must now use the Medicare.gov Plan Finder tool to identify new plans that keep BJC and WashU Medicine in their networks. Patients who remain on their current plans may face significantly higher out-of-pocket costs for care at these facilities starting next year.
The takeaway
Patients should proactively review their insurance benefits and provider directories before the end of the year to avoid unexpected medical bills. Transitioning to traditional Medicare or a different Medicare Advantage plan may be necessary to maintain access to BJC and WashU providers.
What happens next
Illinois state retirees on Aetna must make coverage decisions by November 16, 2026, while the standard Medicare open enrollment period closes for all participants on December 7, 2026.
Further reading
For additional updates on local hospital access, visit Healthcare.
More information
To review plan options, use the Medicare.gov Plan Finder tool.
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Do you trust Medicare Advantage plans to provide reliable, long-term access to your preferred local hospitals?
