Anthem $3.625M Proton Beam Therapy Settlement

Key facts

• Who may qualify You are covered if Anthem identified you in the case records as someone who received proton beam radiation therapy (PBRT) for prostate cancer whose treatment was not covered by insurance. In practice that means you were on an ERISA health plan underwritten or administered by Anthem, asked for coverage of PBRT for prostate cancer, and were denied because Anthem called the treatment experimental, investigational, or unproven. Both pre-service authorization denials and post-service reimbursement denials count. Judges, Anthem staff, Class Counsel and their families, and anyone who opted out are excluded.
• Estimated payout"Anthem has agreed to pay a total of $3,625,000 to settle the Action. After deducting Court-approved attorneys' fees and costs, ervice awards, and the costs of administering the Settlement, the balance will be used to make payments to Settlement Class Members who submit valid Claim Forms." "The Settlement Administrator shall determine the Settlement Payment based on the Settlement Class Member's total Qualifying Payment(s). Qualifying Payment(s) means the total amount of out-of-pocket payments made by a Settlement Class Member for PBRT for the treatment of prostate cancer (meaning treatments were not covered by insurance)."
• Claim deadlineOctober 10, 2026 (closed)
• Proof requiredYes
• What you needDownload and print the Claim Form from the case documents page, fill it out, and mail it to the address on the form. You also have to attach documentation showing the out-of-pocket money you paid, and that paperwork has to show the provider's name, the provider's address, the date of service, a description of the services provided, and the provider charges you paid yourself. The envelope has to be postmarked by the claim deadline.
• CourtUnited States District Court for the Middle District of Tennessee