CHANGES FOR SCRIPPS PATIENTS WITH MEDICARE ADVANTAGE PLANS
Scripps Coastal and Scripps Clinic Medical Groups will no longer accept any Medicare Advantage HMO or PPO Plans from any carriers next year. If you see a primary care physician (PCP) in one of those medical groups, here are your options:
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1. Stay on your current Medicare Advantage Plan and choose a new non-Scripps primary care physician (PCP). There are doctors taking new patients in independent medical groups who are Scripps-focused, which means that they will refer you to Scripps Hospitals and Scripps Specialists whenever possible. You will just not have your Scripps primary care physician any more. You can work with your current plan's member services department or an agent to help you with this.
2. Stay on a Medicare Advantage Plan, but change plans so that you can find a new doctor in a different network, like SHARP, UCSD, or Kaiser.
3. Drop the Medicare Advantage Plans all together and go back to Original Medicare Part A and Part B with a stand-alone Part D Prescription Drug Plan. This option allows you to see any provider, anywhere in the country, as long as they accept Medicare (Scripps doctors do). The risk with only having Original Medicare is that there are deductibles for in-patient hospitalization (currently $1,600) and you are responsible for 20% of all of your outpatient costs (doctors, labs, ambulance, outpatient surgery, emergency room and urgent care, etc.) with no out-of-pocket limit. This could be financially devastating if you had a serious medical event, which is why most people also enroll in a Medicare Supplement.
4. Drop Medicare Advantage Plans all together and enroll in a Medicare Supplement with Part D. Medicare Supplements have monthly premiums, as do the Part D drug plans; but you can see any provider, anywhere in the country, as long as they accept Medicare. AARP/United Healthcare and BlueShield are the only carriers who are offering guaranteed-issue enrollments for those who are losing their Scripps doctors. This means that you will not go through underwriting and cannot be denied a policy with those carriers if you apply during this Annual Enrollment Period (AEP) for a January 1, 2024 effective date.
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RECSOURCES FOR MEDICARE INSURANCE
Scripps Medicare Advantage Information Line (858-677-6935) has the following recommendations:
1) Consult your current insurance company carrier
2) Consult an independent Insurance Broker…
> Your personal insurance broker
> Caress Insurance Agency - works with Scripps Affiliated Medical Groups
Kym Caress-Myers, 760-851-7619, KymCaress@gmail.gov
> Tricia Tool - Independent Sales Agent, Much expertise in Medicare.
858-648-5206, insurewithtricia@gmail.com
> Anna Kozikowski - Bridlewood Insurance - Medicare Made Easy
619-379-2940, anna.kozikowski22@gmail.com,
https://bridlewoodinsurance.com/agent/anna-kozikowski/
3) Contact H.I.C.A.P. (Health Insurance Counseling and Advocacy Program)
858-565-8772 - www.hicap.org 5151 Murphy Canyon Rd #110, S.D 92123
4) Contact medicare 800-633-4227, www.medicare.gov.