Settlement Amount:
$750,000 penalty; full reimbursement of eligible out-of-pocket drug costs plus an automatic $8,850 deductible refund
Claim Deadline:
November 10, 2026
Proof Required:
Proof of the prescription, proof of payment showing you personally paid out of pocket, and a signed affidavit confirming the drug was purchased and paid for out of pocket
Official Settlement Website:
📄 Full claim guide: Read the complete Anthem grandfathered Rx settlement breakdown on OpenClassActions.com for eligibility details, payout tiers, and step-by-step filing instructions.
What Is the Case About?
Anthem allegedly failed to cover medically necessary brand-name prescription drugs required by California law and charged an $8,850 deductible for such coverage. Anthem resolved the matter through the California Department of Insurance without admitting liability, disagreeing with the Department’s interpretation of the law.
Who Qualifies?
Anthem Core 5000, Tonik DN14, Tonik DN15, or RightPlan members in California who paid out of pocket for brand-name single-source drugs that were denied solely because of brand status, between January 1, 2017 and May 8, 2026.
How Much Can You Get?
Full reimbursement of actual out-of-pocket expenses for eligible drugs, with no fixed per-person cap, plus a separate automatic refund of the $8,850 deductible (no claim form is needed for the deductible refund).
How to File
Submit a claim with the required proof of prescription, proof of payment, and signed affidavit by November 10, 2026.
Key Deadlines
- Order Adopting Special Notice of Defense effective: March 23, 2026
- Claim deadline: November 10, 2026
Case Details
| Case Name | In the Matter of the License and Licensing Rights of Anthem Blue Cross Life and Health Insurance Company |
| Case Number | File No. PF-2020-02635 |
| Court | California Department of Insurance — Office of the Insurance Commissioner |
| Administrator | Rust Consulting, Inc. |
| Settlement Amount | $750,000 penalty plus reimbursements |
File / Check Official Settlement Site
→ See the full Anthem grandfathered Rx settlement details on OpenClassActions.com
By Felix Levine. OpenClassActions.org is a consumer news and information site and is not a class action administrator, class counsel, or a law firm. This page summarizes a public class action settlement and is general information, not legal advice. Deadlines and payment timing may change — always verify details at the official settlement website before filing. Class action claim forms are submitted under penalty of perjury; submit only truthful information.