SAN DIEGO — Scripps Health will cut coverage for thousands of seniors in San Diego County at the end of this year as it stops participating in the Medicare Advantage program.
On Monday, Lisa Bock and his wife, Lori, received a so-called shocking letter from SCAN, a Medicare Advantage plan.
It reads in part: “As you may be aware, Scripps Clinic and Scripps Coastal primary care physicians will terminate their contracts with Medicare Advantage HMO plans by January 1, 2024. SCAN Because the plan is an HMO, this means: You must see your current primary care physician after December 31, 2023.”
“When Lori read that, she was just blown away because she loves her primary care physician,” Bock recalled. “She freaked out… She started hyperventilating. I had to calm her down.”
Lori and Lisa are just two of the more than 30,000 senior San Diegans enrolled in one of several health care plans like SCAN, but now they can live without major financial burdens. Scripps medical services are not available.
It’s a move that has significant implications for the Boxes, who have been users of Scripps Health for the past 20 years.
“She has heart problems, she has breathing problems, she has early dementia…these things require a lot of treatment, a lot of tests,” Bock said. He talked about his wife, Lori. “She has access to a pain management clinic, but she’s likely to lose that and it’s very important to her health.”
FOX 5 reached out to Scripps Health regarding this matter and they responded with the following statement:
Scripps has long served seniors and other community members enrolled in Medicare and Medicare Advantage plans. Scripps and health systems across the country are facing unprecedented financial pressures. We are reviewing everything we are doing and making difficult decisions as necessary to ensure we continue to meet the needs of the communities we serve. . Revenues from Medicare Advantage plans are not sufficient to cover the cost of the patient care we provide.
As a result, Scripps Clinic and Scripps Coastal Medical Group physicians will no longer be in-network with their individual Medicare Advantage plans in 2024. However, both Scripps Clinic and Scripps Coastal doctors will continue to accept Original Medicare (Part A and Part B). Medicare Advantage plans may continue to be accepted by physicians from other medical groups affiliated with Scripps, and patients may continue to receive care at Scripps hospitals.
We are committed to working closely with both patients and medical groups to ensure the smoothest transition possible.
scripps health
Now, thousands of people affected, including Lisa and Lori, are left scrambling to figure out what happens next.
“Most seniors don’t like change and have become accustomed to their doctors and their networks over the years,” said President and CEO of SBHIS Insurance Services, the county’s largest and oldest Medicare Advantage agency. ) explains Pat Salas.
Salas says patients who want to stay at Scripps Health have options, but they come at a price. “They could look into Medicare subsidies, but that cost will probably be between $300 and $400 per month, including prescriptions. Right now, their payments are zero.”
Another option for keeping your current primary care physician includes disenrolling from your current Medicare Advantage plan and choosing another health plan in the new year.
“We just don’t have that luxury,” Bock said. “We’re both on fixed incomes. We’re both disabled.”
Following this news, SBHIS Insurance Services will hold a conference with Mr. Salas on Monday, October 2 to address user concerns.Patients can: Connect with them here.
The meeting will be held at 740 Bay Blvd. Chula Vista, CA 91910.
