Starting in 2025, Medicare clients with an Alignment PPO Advantage plan will no longer be able to receive care at Scripps Coastal and Scripps Clinic. This change may leave many patients concerned about continuing with their trusted providers. Fortunately, there’s a solution: you can switch to a Medicare Supplement plan that Scripps accepts under a guaranteed issue provision.
The End of Alignment PPO Advantage Plan Coverage at Scripps
Scripps Coastal and Scripps Clinic are major healthcare providers for many Medicare clients in Southern California. However, beginning in 2025, these facilities will no longer accept Alignment PPO Advantage plans.
This change is part of a larger trend where some providers are limiting the types of Medicare Advantage plans they accept, often citing financial or administrative challenges. For Medicare clients, this shift underscores the importance of choosing a plan that aligns with their preferred healthcare providers.
Your Guaranteed Option: Medicare Supplement Plans
If you’re impacted by this change, you have the right to switch to a Medicare Supplement (Medigap) plan that Scripps will accept. The key advantage here is the availability of a guaranteed issue switch. Supplement plans typically require a medical evaluation to ensure you are healthy enough to join the plan. With guaranteed issue rights, you can enroll in a Supplement plan without undergoing medical underwriting. Anyone on an Alignment PPO Advantage plan will have guaranteed issue meaning pre-existing conditions cannot be used to deny you coverage.
Why Choose a Medicare Supplement Plan?
Medicare Supplement plans are often an excellent choice for clients who want flexibility and comprehensive coverage. Supplement Plans typically have a larger monthly premium compared to Advantage plans. However, you will receive a broader network of doctors on a Supplement plan. These plans are widely accepted, ensuring you can continue seeing top providers like Scripps. Also, Supplement plans have lower Out-of-Pocket Costs: Unlike Advantage plans, Supplement plans help reduce the financial burden of coinsurance, copayments, and deductibles.
Medicare Open Enrollment Ends December 7, 2024
To ensure a smooth transition to a Medicare Supplement plan:
- Verify Your Current Coverage: Confirm whether your current plan will still be accepted at Scripps in 2025.
- Explore Supplement Plan Options: Research plans that align with your healthcare needs and budget.
- Act Quickly: Take advantage of your guaranteed issue rights before the Medicare Annual Enrollment Period (AEP) closes on December 7, 2024.
Let HealthyMarks Medicare Guide You
Navigating changes like these can feel overwhelming, but you don’t have to do it alone. At HealthyMarks Medicare, we specialize in helping clients adapt to shifting healthcare landscapes. We can provide clarity on your guaranteed issue rights, help you compare Medicare Supplement plans, assist with enrollment to ensure uninterrupted access to your preferred providers, and continue to help you for years to come.
Reach out to us today to secure your healthcare coverage for 2025 and beyond!
Keaton Marks is the owner and CEO at HealthyMarks including the medicare team. Keaton was born and raised in Encinitas. He often rode his bike through town and to the local beaches like Moonlight. Keaton knows it is important to have a local resource, someone who understands the area, the hospitals and networks of doctors. Keaton is proud to be a local Medicare broker who is able to assist the people in his town when selecting medicare plans.
Keaton believes one thing above all else: “Medicare is confusing… but it doesn’t have to be! That is where HealthyMarks Medicare comes in” Please contact me with any questions.