Blue Shield of California and Hoag Clinic and Facilities Reach New Agreement

New update June 16, 2025

We are pleased to share that Blue Shield of California and Hoag have reached a new agreement. Hoag providers and hospitals will continue to accept Blue Shield Commercial HMO, Commercial PPO and Medicare Advantage members as in-network. Effective January 1, 2026, Hoag Clinic (physician group) will be terminated for Medicare Advantage members; however, Hoag hospitals will continue to remain in-network.

We look forward to continuing our long-standing collaboration for the benefit of our members and patients.

New update as of May 30, 2025

Blue Shield and Hoag Clinic and Facilities continue to negotiate in good faith. This week Blue Shield received a two-week contract extension from Hoag system administrators for our commercial agreements to continue negotiations through July 15.

This means Hoag hospitals and providers are in-network until July 15 for our commercial members. It is our desire to reach an agreement before the extension ends with a new contract that ensures members continue to have access to Hoag Clinics and Facilities at reasonable costs that are sustainably affordable for our customers.

In addition, both Hoag and Blue Shield agreed to extend the current Medicare agreement through December 31, 2025. With this change, all Blue Shield Medicare members have in-network access to Hoag Clinics and Facilities until the end of this year.  

Original update from May 1, 2025

Blue Shield of California is a nonprofit health plan that’s committed to working with our network providers to offer members and customers access to quality, affordable healthcare coverage.  

We are actively negotiating in good faith with Hoag to make health care more affordable for our members and customers. Currently, Hoag hospitals are some of the highest cost facilities for our members in the region. 

Our hope is to come to an arrangement so our members can continue to have access to Hoag hospitals and providers at reasonable cost and reimbursement rates that are sustainably affordable. In the event we are unable to reach an agreement, our existing contract with Hoag will end on June 30, 2025. Should a termination occur, our priority will be to ensure a smooth transition for our members to in-network providers, hospitals or medical facilities in their area that participate in Blue Shield’s provider network. 

Frequently Asked Questions:

What is being negotiated?   

Our goal is to negotiate terms for a new agreement that allows us to continue offering members access to Hoag providers and hospitals without jeopardizing the long-term affordability of healthcare coverage in Orange County.  

Is Hoag currently out of network with Blue Shield? 
Hoag remains in-network with Blue Shield. However, if negotiations are unsuccessful, Hoag hospitals, clinics, and physicians would become out-of-network for Blue Shield members beginning July 1, 2025. 

Will Hoag hospitals' emergency services still be available?   

Blue Shield members who need emergency services should call 911 or seek care at the nearest emergency room. Blue Shield will provide the full emergency care level of benefits for these services, including if emergency services are provided at a Hoag facility. 

What should I do if I’m currently receiving care at Hoag?

Starting July 1, 2025, Hoag hospitals and provider groups might not be in-network for Blue Shield members. However, we are working diligently to retain these providers and facilities.

Members will be informed about the negotiation results and guided to in-network providers if Hoag leaves the plan.

Blue Shield's Continuity of Care program helps eligible members stay with their current provider during this transition. Members can begin the application process 30 days prior to termination of the network. For guidelines and additional information, refer to Continuity of Care | Blue Shield of CA.