CommercialAdministrativeMedium impact
[Georgia] PY2027 Blue Value Individual Network HMO FAQ
Anthem BCBS·GA·Network
Effective date
Jan 1, 2027
We identified it
May 3, 2026
Summary
Anthem Blue Cross and Blue Shield is launching a new Blue Value Individual Network HMO product in select Georgia counties (rating areas 2 and 5) effective January 1, 2027, targeting cost-sensitive individuals earning 100-400% of Federal Poverty Level. Providers currently in Anthem's Medicaid network in these counties will receive opt-out letters and have 30 days to decline participation; Medicaid contract participation is required to join this new network, but participation in the new product is optional.
Action Required
By December 1, 2026: Providers in Anthem's Georgia Medicaid network located in rating areas 2 and 5 (Barrow, Oconee, Jenkins, Clarke, Oglethorpe, Lincoln, Elbert, Burke, McDuffie, Greene, Columbia, Richmond, Jackson, Emanuel, Taliaferro, Madison, Glascock, Warren, Morgan, Jefferson, Wilkes counties) must review the opt-out letter received from Anthem and decide whether to participate in the Blue Value Individual Network HMO. DEADLINE FOR OPT-OUT: Within 30 days of receiving the letter, submit opt-out request via email to AMGP_EXCG@anthem.com or call 833-823-0794 if declining participation. NOTE: Failure to opt out within 30 days will result in automatic enrollment in the new network, but providers may still terminate participation with 120-day written notice. Billing team should: (1) Confirm which providers in the practice are located in targeted counties; (2) Coordinate with providers to determine participation decision; (3) Track opt-out deadline and submission; (4) Update billing system credentialing records to reflect Blue Value Individual HMO network status by January 1, 2027; (5) Ensure claims processing workflow distinguishes between Medicaid and Blue Value individual plans to prevent billing errors. No existing Medicaid contracts will be affected by non-participation in the new product.