Scripps Clinic and Scripps Coastal Dropping Medicare Advantage HMO Plans for 2024

If you currently have a Medicare Advantage HMO and your primary doctor is at Scripps Coastal or Scripps Clinic then you will no longer be able to see that doctor with your current Medicare Advantage HMO plan starting Jan 1st, 2024.

Unfortunately, this affects over 32,000 San Diego residents. 

What are your options?

There are several options depending on your budget and your flexibility regarding your doctors. If you do NOT want to change your primary doctor than you will need to change your plan. If you are open to changing your primary doctor than you may not need to change your Medicare plan.

Option 1: Change your Medicare Advantage Plan to a PPO and see your doctor out-of-network

If you change your Medicare Advantage plan to a PPO and can see any Medicare contracted doctor without a referral. This means you can still see your doctor at Scripps Clinic and Scripps Coastal BUT you will pay the out-of-network copays and coinsurance costs which are usually much higher than the in-network costs.

Option 2: Change to Original Medicare + a Medicare Supplement Plan (Medigap)

With this option you would be dropping the Medicare Advantage Plan and going to Original Medicare A+B as your primary coverage and then adding a supplement plan. This allows you to see ANY doctor in the country that accepts Medicare without a referral including all doctors at Scripps. 

The supplement plans typically cost between $100-$400 depending on your age per month but you will have ultimate freedom to see your doctor of choice. 

Typically you are required to answer health questions to purchase a Medicare Supplement but there are several insurance companies that are allowing folks to join right now without any health underwriting. 

Option 3: Change your primary doctor

This isn’t ideal but some folks may be open to changing their primary doctor. If you do change your primary doctor to one who is with a different medical group you can still have access to Scripps hospitals.

Some specialists from Scripps Clinic and Scripps Coastal also work with these medical groups:

• Mercy Physicians Medical Group (works with some Scripps specialists)
• Scripps Physicians Medical Group
• Health Excel IPA
• Optum Care Network North County (PCAMG)
• Prospect Medical Group SD

Option 4: Do Nothing

If you choose to do nothing then your Medicare Advantage plan will automatically assign you to a new doctor for Jan 1st 2024.

We can help

We work with many of the Medicare Advantage plans and Medicare Supplement companies in San Diego and can help you compare options. Give us a call at 800-208-4974 for assistance today!