SAN DIEGO — Scripps Health is dropping out of the Medicare Advantage program at the end of the year.
It’s a move affecting 32,000 people in San Diego County who have Scripps Clinic and Scripps Coastal primary care doctors under several health plans.
Patients recently received shocking notices and now have less than a month to decide what to do with their coverage.
“We have till December 7th to make a decision. After December 7th, it’s locked in for January 1st,” said John Mendoza, an independent health insurance broker in El Cajon. “There’s some PPO plans that will offer that availability to keep their doctors, if they’re willing to pay out-of-network costs.”
Mendoza says those typically range from $150 to $400 a month, depending on age.
It’s a bitter pill to swallow for those who haven’t had to pay anything.
“I have a list of people that have these networks and now they’re pulling their hair out — some of these people are willing to pay for the $400 a month, others saying ‘I can’t afford that,'” Mendoza said.
He says there is good news if patients can be flexible.
“The best thing I could say is that we have a great plethora of great doctors in San Diego County. A lot of the HMOs are zero premium, and if you stay with them and you’re willing to change to some other great doctors, then you’re going to be happy. Because a lot of these have some benefits that original Medicare does not have,” Mendoza said.
In a statement to FOX 5, Scripps Health explained the move, saying: “The revenue from Medicare Advantage plans is not sufficient to cover the cost of the patient care we provide. However, doctors from both Scripps Clinic and Scripps Coastal will continue to accept original Medicare (Part A and Part B).”
Mendoza says for patients who need to make a change, time is of the essence.
“32,000 people are making that change. There’s only so many each panel of doctors in those networks can handle — so first come, first serve, really,” he said.
Mendoza is hosting a series of Medicare seminars, including Nov. 16, 10 a.m. at Denny’s on Jamacha Road in Rancho San Diego and Nov. 21, 10 a.m. at Janet’s Montana Cafe in Alpine.