Losing Their Medicare Advantage

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Are You A San Diegan Who Is At Risk Of Losing Their Medicare Advantage?

Amidst concerns raised by a recent San Diego Union-Tribune article detailing potential changes to Medicare Advantage contracts, Pat Salas, an industry veteran and President of SBHIS Insurance Services, sheds light on the situation and outlines possible outcomes for affected seniors. The article, published on August 11, 2023, revealed that Scripps Clinic and Scripps Coastal may discontinue their contracts with Medicare Advantage clients, leaving thousands of enrollees uncertain about their healthcare access. Pat underscored that while no confirmation yet exists, Scripps Clinic and Scripps Coastal have indicated they might not accept Medicare Advantage Plans starting January 1, 2024. This potential development could drastically impact the care available to Medicare Advantage beneficiaries in the region.

Pat described a few possible scenarios for affected seniors. The first option entails using the annual enrollment period, which runs from October 1 to December 7, to switch to a Medicare Supplement plan. Although this provides continuity of care, it comes with a monthly premium ranging from $250 to $450 – a considerable departure from the zero premium many are accustomed to. The second option involves transitioning to a different provider who continues to accept their current Medicare Advantage plan. This route may involve switching to a Medicare HMO or PPO plan. However, with the latter, there is a risk that the chosen provider might opt to terminate the doctor-patient relationship due to increased patient load. Pat particularly highlighted the significance of the Medicare Supplement option, especially for those who want to retain their trusted Scripps Clinic or Scripps Coastal physicians. Notably, due to the potential disruption, those affected could qualify for a special enrollment period, waiving typical underwriting requirements for Medicare Supplements, even if they have pre-existing medical conditions.

While this solution offers stability and direct access to familiar doctors, the cost difference from a zero premium Medicare Advantage plan could pose a financial challenge. Pat acknowledged the difficulty of this decision, stressing that the team at SBHIS Insurance Services is available to guide individuals through their options based on individual needs and circumstances.
The uncertainty around the situation places seniors in a delicate position. Pat stressed the importance of staying informed and prepared, as Scripps Clinic and Scripps Coastal are expected to provide clarity soon. In the meantime, SBHIS Insurance Services offers expertise and support, helping seniors navigate the potential changes and make informed decisions.

Pat, a respected figure in the Medicare industry with over 30 years of experience, urged readers to consider their unique situations when evaluating the available choices. Her insight and advice provide a beacon of guidance amid the uncertainty, offering affected individuals a roadmap to maintaining their healthcare needs while transitioning through possible changes. As the situation unfolds, seniors are reminded to stay tuned and consider the solutions that align with their needs and preferences. SBHIS Insurance Services stands ready to assist you in finding the best path forward in a rapidly evolving healthcare landscape.

For more information call (888)816-9881 or visit www.sbhis.net.

 

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Esteban Villanueva
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