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Anthem Grandfathered Rx Settlement

Up to $8,850

What happened

Anthem denied coverage for brand name prescription drugs or applied a deductible for brand name drugs under certain health plans, charging members up to an $8,850 deductible. The company settled with California's Department of Insurance to refund deductibles and reimburse members for out-of-pocket expenses on brand name prescriptions that should have been covered.

Do you qualify?

Anyone who was covered under Anthem's Core 5000, Tonik DN14, Tonik DN15, or RightPlan (with generic prescription drug coverage) between January 1, 2017 and May 8, 2026, and paid out of pocket for a brand name prescription drug that was denied solely because it was a brand name product, or who paid the $8,850 deductible for brand name drug coverage.

How to file

For out-of-pocket reimbursement, submit a completed claim form with all required supporting documentation postmarked by November 10, 2026. For deductible refunds, no claim form is needed—eligible members will automatically receive refunds mailed on May 22, 2026. Review the eligibility requirements and documentation checklist in the Notice and Claim Form package mailed on May 8, 2026.

This summary was generated from public settlement documents and may contain errors. Confirm eligibility, deadlines, and payment terms on the official settlement website before filing. ClaimWatch is not a law firm and this is not legal advice. Filing a claim is free.

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